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Alastair Compston
DOI: http://dx.doi.org/10.1093/brain/awn070 1163-1164 First published online: 1 May 2008

Writing in The Naval Surgeon (1734), John Atkins (1685–1757) noted that natives in western Africa are prone to a ‘sleeping distemper’, usually fatal, and resulting at best in an irresistible tendency to sleep such that survivors ‘lose the little reason they have and turn idiots’. As Roy Porter explains in The greatest benefit to mankind (1997), HM (Henry) Stanley's success as economic development director to King Leopold II flushed this disease into the central areas, and missionaries conveying the sick to mission stations inadvertently triggered infection of previously uninfected zones such that fatalities soared and the horrors of sleeping sickness seized the public imagination. In Missionary travels and researches in South Africa (1857), David Livingstone gave an account of the tsetse fly and of the disease of livestock resulting from its bite; in line with the ubiquitous approach to most diseases presumed to be infective, he treated ‘nagana’ in horses with arsenic.

Colonial officers and others who worked ‘In Darkest Africa’ have not always had a good press. But, in ‘To sleep; to die’ (with apologies to Hamlet), reviewing The fatal sleep: Africa's killer disease that went undiscovered for centuries by Peter Kennedy, professor of neurology in the University of Glasgow, Eldryd Parry makes a plea for clemency on behalf of those who ran the British Empire and ‘were changed, hardened and matured by the cultural front-line from which there was no retreat’ (page 1402). Professor Parry has worked in Africa since 1960, first in Nigeria and then as professor of medicine in Ethiopia and dean of medicine in Nigeria, Ghana and Somaliland. In 1988, he founded the Tropical Health and Education Trust and, in 2007, was awarded the centenary medal by the Royal Society of Tropical Medicine and Hygiene for life-time achievement in tropical medicine. Writing for Brain from …

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