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A feature in the morbid anatomy of sleeping sickness, to which attention has not previously been directed, is a curious condition found in the stomach. In a number of cases the organ was found to contain a quantity of dark, semi-fluid material. The mucous membrane showed a remarkable alteration ; it was studded with areas of varying size, having a dark centre and a light red periphery. They were most numerous towards the pyloric orifice, vide Plate 7, p. 26G. On microscopical examination they were seen to be petechial liæmor- rhages into the mucous membrane, which had broken down and formed superficial ulcers. No ova of Bilharzia were seen in tho scrapings. A full account is given in the histories of the cases recorded in the Appendix. In all cases in which the stomach was inspected this condition was met with. The condition is comparable with the petechial haemorrhages met with under the endo- and epicardium of the heart in trypanosoma infections.
The members of the Commission take this opportunity of expressing their most sincere thanks to Colonel Hayes-Sadler, C.B., His Majesty’s Commissioner and Consul-General, Uganda, tor his constant kindness and encouragement ; to Mr. George Wilson, C.B., His Majesty’s Acting Commissioner, Uganda, for helping forward the work of the Commission ; to Mr. W. Grant, C.M.G., for his co-operation in the work in Busoga ; to .Major Will, P.M.O., for facilities afforded; to Dr. Moffat, C.M.G., for his valuable help and advice ; to the Bishops of the various churches and their missionaries. We desire to express our best thanks to Professor Ray Lankester, the Director, to Mr. Austen, the entomologist, and Mr. Jeffrey Bell, of the British Museum (Natural History), for their kindness in examining and reporting on specimens sent; lastly, to Mrs. Bruce for several very accurate coloured drawings, and to Colonel Bruce, F.R S., whose co-operation in England has been of the greatest value to us here.
1. The lymphatic glands of every case of sleeping sickness are enlarged and the juice taken by puncture during life contains many active trypanosomes and also disintegrating forms.
Every case of sleeping sickness here has shown enlargement of the lymphatic glands. The enlargement of the femoral, inguinal, axillary and superficial cervical glands can, during life, be readily determined, and after death the abdominal, thoracic and deep cervical.
In the Proceedings of the Royal Society for May, 1904, it was pointed out that the juice of the lymphatic glands, especially the posterior cervical glands, contains many active trypanosomes in all cases and at all stages of sleeping sickness.
Some of the juice can easily be obtained by puncturing a superficial gland in the posterior triangle of the neck with a hypodermic needle and sucking it into the needle by means of a syringe. The drop is then blown out on to a slide, covered with a cover glass and examined under a low power, 150 to