PUBLIC RECORD OFFICE
Reference :-
C.O.8
885
18 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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I have not attempted to give the population of these places, because I have found it under-estimated in previous cases, the chief associating me with the tax- collector.
A. G. BAGSHAWE,
August 1, 1906.
SIR,
Camp Bigera.
MEDICAL OFFICER, Mbarara, to SENIOR MEDICAL OFFICER, Entebbe.
INTERIM REPORT re MUHINYA.
·
Mbarara, July 20, 1906.
I HAVE the honour to inform you that I have made a tour through the Sazas of Sema, Egara, Bunzaragmu, and Bweru in search of cases of muhinya, and beg to report as follows:
have been much hampered by the unwillingness of the people to come forward, as they seem to be afraid of any medical interference, or rather, they have an idea of and fear of witchcraft. In one Saza (Egara), the people are inclined to be hostile, and I could get no cases or first hand information at all.
During the 16 days I saw 42 cases of alleged muhinya or bihimbo, and have taken notes and blood smears.
The name muhinya is, as explained to me, a corruption of enya-enya (1 am broken), and is explained by the severe pains.
Bibimbo simply means a man who walks with two sticks. The two names seem to be used indiscriminately, though bihimbo is naturally applied to a milder form in which the patient is able to get about with the aid of sticks.
In all the places I have enquired how long the disease has been known, and could in no case bear of its being known longer than six years. However, at Ibanda, I heard of a disease of long ago, which was called kisingwa-singwa, which was indistinguishable from muhinya, except by the fact that then only a few people were affected, and now there are many ill. Kisingwa-singwa seems not to be known now, and is probably the same disease.
In many places the disease is said to have come from Uganda. Many of the cases give a history of syphilis, but as they rarely distinguish between syphilis and yaws, this is usually not to be relied upon; more especially as there is not much evidence of syphilis among the people generally.
Incidence. All ages and both sexes seem liable to attacks except perhaps the very young, though at Ibanda my informants could not remember a woman who had been attacked. I certainly only saw one female case.
It is said to be non-contagious, and the well and afflicted live together in the same hut; usually there was only one sick person in each hut, though in one case I found three persons all ill. The only suggestion of contagion was that if a healthy person ate the sick man's food, he would become sick also. It is more prevalent in the dry weather and tends to decrease during the rains.
Prognosis. The mortality seems to be inconsiderable, though when first asked how many die, the answer is always "many "; but when asked particulars I have only been able to hear of few deaths; in no place could they give me a list of more than eight. The old are the only persons who die, the young and strong always
recover.
Symptoms. An attack said always to begin with fever, and for about five days they are unable to say whether or not it is only malaria (musuja), but after the fifth day, pains in the back occur, at first only in the bones, afterwards in the muscles. In a day or two the pains, which are very severe, go to the hip-joints; knees, shoulders, elbows, ankles, and wrists, usually in the order named.
After about a month the fever, which occurs only at night, subsides, and the patient is well, except for the pains and tenderness in the back and joints.
This condition lasts for from three months to as many years, after which the patient gradually recovers.
The glands are not enlarged.
Tongue furred in the earlier stage, clean and healthy after.
Bowels unaffected.
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Appetite while feverish, in abeyance, afterwards either normal or enormously increased (one goat a day I was told in one case was eaten, probably an exaggeration).
Circulation normal after fever subsides.
Lungs normal.
Urine only increased in the exceptional cases where the appetite is enormous. Nervous system normal in most cases, knee jerks absent in a few.
The patient is not more emaciated than one would expect from the confinement.
I am told that should a patient be going to die "upere" (= itch) appears on the legs round the ankles, but not otherwise. No other rash is known. Should a patient start to get fat (ascites or ædema) during his illness, and especially if his scrotum swell, he is certain to die in ten days.
Blood.--Nothing constant in all those I have examined.
I am of opinion the disease may possibly be dengue with persistent joint pains afterwards. It is certainly not sleeping sickness, though the Baganda in the country at first called it mongota, which they no longer do, as no glands are enlarged, and 1 have been unable to find trypanosoma.
L. D. LOWSLEY.
COMMENTS BY DR. BAGSHAWE ON DR. LOWSLEY'S INTERIM REPORT ON MUHINYA,
**tu
Enya-enya-I suspect that Dr. Lowsley had this explanation from an ingenious Muganda interpreter. There is no word in Bunyoro signifying "to break" or be broken" at all like enya-enya, unless it be hendeka, which is used of a broken bone
or sprain. On the other hand menya is the common Luganda for “to break.”
Bihimbo.-I have not met with this word. Here again I much doubt the mean- ing given, “Walking with a stick." I have heard "senjura” and “gendesa onuigo” ("Make a stick to go ").
=
I suggest bihimbo is nearly a variant of mulinya. None of my people here
two and himbo or fimbo recognise it. (It includes the Swahili or Bantu root bi walking stick.-A. D. P. H.)
Kisinga-singwa.-Zinga-zingwa is a word I have heard several times. I dis- cussed its meaning with Mr. Johnson, of the Church Missionary Society. It is explained as meaning loss of power in the legs. The man afflicted goes on hands and knees, or, in milder cases, is able to move with. sticks; his arms, I am told, are unaffected; it suggests paraplegia.
I think it is important to get the correct meaning of these native expressions. I have worked at Lunyoro since April, understand a good deal of what my patients question whether Dr. Lowsley has taken say, and can make them understand me.
the same trouble.
I should be quite willing to abide by the dicta of the Mbarara missionaries as to the meanings of these words.
Age Mortality.—I omitted to ascertain the ages of those who had died. Symptoms. I had no such definite account of the disease; indeed, the accounts given were so different and varied so in an individual case when the patient was cross-examined, that I did not put down much of what was told me.
Dr. Lowsley's account might be that of quite a different disease, such as dengue. Edema.-Patients with redema were not seen by Dr. Lowsley; it might, however, have been overlooked if slight.
Swelling of the scrotum was not mentioned to me.
Blood.-I did not examine sincars myself because my only active stain is carbol- fuchsin, which gives no differentiation. (There is no use for Leishman's.) I have