Medicine: Sleeping Sickness

St. Louis last week appeared to have established its title as the breeding spot for a special kind of sleeping sickness. This type of encephalitis first appeared four years ago at St. Louis, laid 1,000 low, killed 200 directly or by rendering them susceptible to heart failure or pneumonia. That epidemic subsided with the passing of 1933’s hot weather, and there was no notable reappearance of the disease until this summer. By last week it had claimed

160 victims, was responsible for 40 deaths. Although this disease, a virus which attacks the nervous system, in some respects resembles infantile paralysis, practically all its victims are adults, not children.

At the height of an attack of St. Louis’ encephalitis a victim’s brain is inflamed. He has a high fever, a bad headache and becomes irrational. About half of last week’s sufferers were lethargic—drowsy and sleepy. The other half were hyperkinetic. They involuntarily jerked fingers, arms, legs.

Since no one knows how the St. Louis (or other types of encephalitis) is contracted, no one knows how to prevent its spread. As the result of their 1933 experience St. Louis doctors generally feed (give injections of) concentrated glucose solution to sufferers. This is believed to reduce brain inflammation as well as build up a patient’s strength. In four or five days the fever usually abates. The patient then is given blood from a survivor of the disease—by direct transfusion, by a hypodermic injection into the muscle of a buttock, or in the form of blood serum. Professors Howard Anderson McCordock and Walter Joseph Siebert of Washington University, who led in developing this blood treatment, last week admitted that they do not yet know whether it does any good. But they do not know anything else to do, and are hopeful.

Few of the survivors of St. Louis’ encephalitis have yet shown any bad after effects. Residual symptoms of those who have not entirely recovered are sleeplessness at night, drowsiness in the daytime.

The only scientific fact known about this disease is that it is caused by a specific virus. This was ascertained during the 1933 epidemic by one of the most vigorous and concentrated attacks on a disease ever made by Medicine. Immediate discoverers of that virus were Dr. McCordock; Dr. Charles Armstrong, virus expert of the U. S. Public Health Service; Dr. Leslie Tillotson Webster of Rockefeller Institute; Dr. Ralph Stewart Muckenfuss, then of St. Louis, now director of New York .City’s famed Bureau of Laboratories.

St. Louis’ sleeping sickness is one of the two forms of encephalitis for which the causes are known.* The other is a Japanese type. Other, puzzling forms are: epidemic encephalitis, which Dr. Margaret Holden of Columbia University believes is also caused by a virus; Australian X disease; encephalitis following inoculation against diphtheria (rare); encephalitis following an attack of infectious disease, such as chickenpox, measles, whooping cough. Also of undetermined origin is the famed case of Chicago’s Patricia Maguire, 31, who, drowsing for five and a half years, last week could not undergo a badly needed excision of an abdominal tumor because she suffers from inflammation of the veins of her legs.

*”African sleeping sickness,” or trypanosomiasis, is caused by a microorganism introduced into the victim’s blood by bites of the tsetse fly.