New-York tribune., 1919-04-06
BY q. Morgan Muren, M. D.,
Lately Major Medical Corps, u. s. A.

Lately Major Medical Corps, u. S. A
TUST as we are recovering from the
epidemic Of so-called Spanish in
fiuenza which swept over the
country with far more disastrous re-
suits and with q much higher mortality
rate than theepidcmic of la grippe that
occurred in the early '9Os, we have to
consider an apparently new disease.
This has been called by many in this
country, sleeping sickness" for want
Of better name and because of one
of its leading symptoms. This is a
misnomer, however, as sleeping sick
ness is definite disease, the causativc
agent of which is we'll known
In the winter Of 1916 and 1917 there
appeared IN Austria an apparently new
disease, for which Won Economo sug-
gested the name "lethargic encephali-
It's" Early in 1918 many cases were
observed in France and England. Re
Gently 1t has made its appearance in
New York, Chicago, and Camp Lee,
Va, and other localities.
The diseases from this new infection,
as 1T almost certainly is, are acute
encephalitis, acute infectious ophthal-
moplegia, symptom complex referred
to as "Nona" in the older literature
and influenza. In addition, it may be
confused with other diseases affecting
the nervous system.
What the Diseases Are
Acute encephalitis inflammation of
the brain) may be confused with this
probable new disease, and a definite
diagnosis of the former is most diff
cult at any time Indeed, doubt exists
IN the minds of many as to the occur
renee of an acute diffuse encephalitis
except in cases of injury
Acute infectious ophthal lmoplegia Ca
paralytic condition of the eye musces)
was discussed in discussion before
the Institute of Medicine Of Chicago
by DR.. Bassoe, who spoke Of dozen
cases in Chicago, six of which he had
personally observed, presenting marked
drowsiness, and some with ocular paral-
ysis. He also referred to an epidemic
occurring in 1740, in which we're many
eases of nervous disease characterized
by somroence. Reference swas also
made to the European epidemic of
10000, in which II complication WAS
noted that wns thought to be I'm ence-
phalits affecting tho brain stem, and
called Mt tho timo "Nona."
Trypanosom insis (slccpinR sickncss)
is discussed az follows; In l8d3, Gruby
discovered parasite in the blood Of
tho frog which he called "trypan osoma
sanguinis." Lnter, it was found to be
n blood parasite common in birds and
fishes. In 1878. Lewis found it in the
rodent, in which it Is apparently harms .
less. It's disease producing significance
was first suggested in 1880 by Griffith
Evans, who found the parasite in the
blood of horses and cattle in India,
having the disease called sura. In 1895
Bruce announced that the tsetze fly
disease (nagana) of South Africa, was
Cue to trypanosome.
The disease made large districts i'm
passble to cattle and horses. Present
in the blood of big game animals Of
it was conveyed by the tsetze fly to the
non-immune horses and cattle brought
into what were known as the fly belts.
Other trypanosomes are found in the
Philippines, in South America and the
Transvaal
In 1901 Dutton found a trypansome
in the blood of a West Indian. In
1903 Castellani found tryparosomes in
the cercbro spinal fluid and blood Of
five cases Of African sleeping sickness.
The Royal Society Commission demon
parasite in the blood and cerebro-
spinal fluid in sleeping sickness, and
considered it a sort of human tsetze
fly infection.
For many years it was known that
the natives of Western Africa were
subject to q malady known as sleeping
sickness. 1t was even noticed in slaves
brought to this country. 1t prevails in
Gambia, Sierra Leone, Liberia, the
Congo Basin, Uganda and Rhodesia.
The opening of formerly isolated
districts where the disease prevailed
has led to its appearance in other
known Within three years after it's
appearance in Uganda, 100000 negroes
died of it. Large numbers Of natives
IN the infected regions harbor the
parasite in the blood with no apparent
suffering from the disease, save for oc-
casional attacks o. fever. The disease
is not confined to negroes.
Three Stages Noticed
The parasite is introduced into the
human blood by the bite of a fly
the bushes on the shores of lakes and
rivers and feeds upon the blood of
crocodlles, antelopes, etc. The para
site undergoes certain changes in the
body of the fly and does not become
capable of injecting the human being
until the thirty-second day. This in
fectivity continues for seventy-five
days (Brucc).
The Uganda commission divides the
course of the disease into three stages.
First, of fever with rapid pulse, dull
mind and loss of weight; second,
tremors, shufhing gait, slow speech,
and, third, the patient becomes lethar-
gic, with low temperature, and presents
a typical picture of the disease. The
duration is rarely longer than eighteen
months.
Sir William Osler, in the latest
edition of his "Practicc of Medicine" ="
states that nine cases in Europeans
have been cured.
In the attempt to combat the raw