This disease is confined to the tropical part of West Africa. Within the last few years three cases have been brought to England for the purpose of study, the results of which have been made public recently by Manson, Mott, and Mackenzie.1 It is a chronic disease, which when introduced into a village may persist for years and cause serious loss of life. The leading clinical characteristic of sleeping sickness is physical and mental lethargy, which begins almost imperceptibly. In the fully-developed disease the patient is almost always asleep; muscular tremor and an itching papular eruption are quite constant. The deepening lethargy and muscular weakness finally render the patient bedridden; death occurs after much wasting, either in an epileptiform seizure or from some intercurrent disease-infection, bedsore, diarrhea, etc. Post-mortem examinations so far recorded have not shown any characteristic naked-eye abnormality. In the blood, Manson has found, in several cases,
THE SLEEPING SICKNESS. JAMA. 1900;XXXV(20):1285–1286. doi:10.1001/jama.1900.02460460035014
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