Following the suggestion of Mr. Flimmer, who found that the trypanosomes were more numerous in the blood of animals at night than in the daytime, some observations were made with the object of determining whether this was the case in men. It will be seen from the following table that some periodicity seems to exist in man also. The percentages which are taken as a rough index of the number of trypanosomes present, in a slide, refer to the number of trypanosomes per polynuclear leucocytes counted :—
Date
1904.
Name.
No.
Parasites in blood, daytime.
Parasites in blood, night time.
Filar.
Mai.
Tryp.
Filar.
Mai.
Tryp.
per
per
cent.
cent.
June 21
Kitsame
303
+ 4
+ 8
„ 23
...
+ 3
+ 10
„ 22
Arcadi
69/K.P.
...
+ 1
+ 1
>> M
Asumani
69/Z.D.
—
+
„ 23
Tenwa
302
—
+
„ 22
J uma
69/J.Q.
-
—
Hamesi
69/F.V.
+ 1
+ 2
» »
Juma
69/J.Q.
"
5. The cells of the cerebrospinal fluid of sleeping sickness cases taken during life by lumbar puncture are lymphocytes and are more numerous in the late stages of the disease.
Having seen that the lymphocytes of the blood are increased in number, the next step to take was to determine whether during life these elements were present in number in the cerebro-spinal fluid of sleeping sickness cases. The total number of cells per c.inm. of cerebro-spinal fluid was determined by means of a Thoma-Zeiss apparatus. Stained preparations were also made of the sediment obtained by centrifuging. The cells were found to be all lymphocytes.
From a study of the following table it will be seen that there is a progressive rise in the number of lymphocytes in the cerebro-spinal fluid as the disease advances, the folloAving are the averages :—
23 per c.mm. 257 per c.mm. 355 per c.mm. 730 per c.mm.
Early Stage (Polyadenitis) 1st Stage (S.S.)
2nd Stage (S.S.)
3rd (S.S.)
This result is of considerable interest when considered in connection with the post-mortem appearances found in the nervous system of sleeping sickness cases ; these were shown by