It might be that this was, in reality, a case of some brain affection accompanied by compression, such as slow haemorrhage, abscess, tumour or simple congestion.

These cases were very difficult at times.

But the appearances in this one did not consistently agree with the symptoms accompanying any of these conditions.

As to sleeping sickness, it was, perhaps a more hopeful suggestion, but I could not decide for or against it until I had more knowledge; and against this view was the weighty fact that the symptoms did exactly agree with the theory of morphine poisoning.
But even so, there was no conclusive evidence of any criminal act.

The patient might be a confirmed opium-eater, and the symptoms heightened by deliberate deception.