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PUBLIC RECORD OFFICE
Reference :-
C.O.885
18 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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worked little with fresh blood films and therefore considered such examination would take too long.
August 13, 1906.
с
A. G. BAGSHAWE,
Medical Officer, Sleeping Sickness Extended Investigations.
P.S.-Renewed questions as to bibimbo have led to the discovery that there is a rare disease of that name in which the patient has severe pain in one hip with swelling, has to be carried from place to place, and is ill for one or several months. It never affects both sides of the body.-A. G. B.
NOTE. I have examined blood smears from cases both of Dr. Bagshawe and Dr. Lowsley. In no case was there seen anything abnormal beyond a slight anæmia. —A. D. P. H.
NOTES ON APPENDIX Á.
to be little room for doubt that the epidemic, or, more
There would apse described by Dr. Bagshawe is beri-beri, but the native
probably, endemic
names by which it is known seem to embrace all diseases in which the symptoms happen to include pronounced pain in the back or limbs or in both, and also, very likely, cases in which paralysis or paresis of limbs, especially the lower limbs, or lameness occur. The cases which Dr. Lowsley describes might some of them be severe dengue, while others might very well be, and probably some of them are, beri
am inclined to beri, but none of them, as described, are typical or conclusive. think that beri-beri is endemic in patches from Lake Albert Edward through Toro, Northern Ankole, Koki and Buddu to Lake Victoria, the centres being more numerous in the westerly parts of this region, and that severe cases of the epidemic of dengue which passed over the greater part of the Protectorate in 1905-06 have been confused with it. This confusion probably caused the natives to believe that the epidemic beri-beri was becoming more prevalent, and so drew more attention to it. Dr. van Someren reported one case in Buddu, near Lake Victoria, which seemed to be fairly typical beri-beri. It is very probable that some of the deaths from this disease have (Sce been wrongly attributed to sleeping sickness in the native death returns. Appendix E.)
Neither Dr. Bagshawe nor Dr. Lowsley found any trace of sleeping sickness, and enlarged glands were conspicuous by their absence, while the latter reports that though the Baganda living in Ankole called the local "muhinya" "mongota' (sleeping sickness), the more intelligent and better-informed of them recognise that it is quite different, since most of the people attacked do not die. Some of the older inhabitants called the disease kusingwa-singwa, saying that they knew it long ago, but then it attacked only a few. The natives say that it is not contagious, but that one may get it by eating food with a person who is sick. It seems to be confined to the agricultural natives, the pastoral Bahima, whose food and manner of living are quite different, remaining free. The mortality appears to be low and the distri- bution scattered.
Dr. Lowsley says that in 82 cases the history of the attack (onset) showed remarkable similarity, suggesting a regular type. He says that the disease always (according to the natives) begins with fever lasting for five or six days, during which If it is muhinya period they cannot tell whether it is muhinya or ordinary fever. the fever now subsides, returning only at night, and the pains come on, chiefly in the back and neck. The pains also attack the joints, both large and small, and are often so severe as to prevent all inmovement of the joint or joints affected. The pain is described as ing in the bones and it is worse at night. The evening fever lasts about a month, but the pains may persist from three months to three years, and after they disappear recovery is slow. Appetite is lost at first in the febrile stage but afterwards becomes enormous.
Dr. Lowsley says that he found no sign of heart trouble, cedema, anæsthesia or loss of knee jer ut he goes on to quote the natives as saying if a patient "suddenly gets fat or if his scrotum swells he will die in ten days," which is suggestive of beri-beri.
See above, Dr. Bagshawe's comments on Dr. Lowsley's report.
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Further investigation of this disease is needed and will be undertaken as soon as arrangements. can be made.
With regard to prevention, for the present the natives concerned are being recommended to change the sites of their villages, to build better ventilated huts and to limit the number of occupants. There is nothing characteristic, so far as has been ascertained, about their food or drink or the preparation of these as compared with the other natives of the Protectorate.
A. D. P. HODGES, Medical Officer in Charge, Sleeping Sickness Extended Investigations.
APPENDIX B.
FIRST HALF-YEARLY REPOrt of the SLEEPING SICKNESS EXTENDED InvestigaTIONS. ABSTRACTS FROM DR. BAGSHAWE'S AUGUST REPORT.
EXPERIMENTS ON FLIGHT OF GLOSSINA PALPALIS.
(Also Report of Discovery of Breeding-grounds and Pupæ.)
In my June report I commented on the nature of the shelter afforded the fly at Harubale (Mbari) Ford. I was led to think that flies might be present in abundance at a spot far from their breeding-place if a constant supply of animal food were there obtainable, and to devise an experiment which would show how far flies may wander in the course of a river.
Trial experiment.-On August 7th 46 flies were caught at Harubale Ford and brought to the camp. They were taken one by one from their cages. I snipped from each with scissors a portion of the right fore-leg and put them into another cage.
On the 8th 108 flies (47 males, 61 females) were taken at the ford, two of which had a portion of the right fore-leg missing, and were evidently two of those marked the day before.
Clearly here I had a ready means of identifying a retaken fly.
Afterwards the 46 flies so treated were released at the ford.
Experiment No. I.-On the 9th I sat at the ford while the boys caught flies. Each as it was caught was brought to me, held while I snipped off a part of the left fore-leg as nearly as possible through the tibio-femoral joint, its sex noted, and itself put into a fly-box. Seventy-nine were so treated (21 males, 58 females): three others were caught already maimed (on the 7th). These were killed.
In the afternoon I took the 79 maimed flies to hippo. landing-place 500 yards further up the river, at a spot where fly abounded, and released them.
On the 10th I similarly treated 113 flies (49 males and 64 females).
On this occasion I kept a special record of the flies which had followed the fly- boys (my station being 50 yards from the water) and which were caught on the spot : of these 12 were males and 19 females.
It is interesting to note that one of these was a fly I had marked on the 9th, and that it was caught by imprisoning the proboscis in a porter's skin with a scissor blade.
Three others were flies marked on the 9th; they were discarded.
The 113 flies were released on the same spot as the 79, making a total of 192 flies marked in the same way (left fore-leg).
On the 11th 211 flies (92 males and 119 females) were caught at the ford; of these 10 males and 8 females were identified as flies released on the 9th and 10th, i.e., of the 211 flies caught 18 had come from the spot 500 yards higher up, and of the 192 mutilated flies 22 had been recaught, or more than 11 per cent. This result was decidedly encouraging: I resolved to vary the experiment.
Experiment No. II-On the 12th I operated on the flies at the hippo, landing- place mentioned (to be referred to as “H."), snipping the left mid-leg through the tibio-femoral joint. 104 flies (43 and 61) were so treated: they were then liberated at the same spot.
The 13th was dull: no flies were caught.
On the 14th there were caught at a fishing-hut (A) 400 yards below the ford (900 yards from H.) 101 flies, of which 1 male had the left mid-leg deficient.
At the ford were taken 113 flies (48 males and 65 females): of these 2 males
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