PUBLIC RECORD OFFICE
Reference -
TILLC.O.
וווןוויזו וויין
885
20 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH—NOT TO
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As regards contagion, I should like to cite the following instances out of many which seem to me to be conclusive. In the mountains near a cattle post belonging to one of the chiefs, there lived a leper named Maapeha who died of the disease, leaving behind a young widow. After his death the chief's brother went to the cattle post to build a house, and six followers went with him to herd the stock. They all occupied Maapeha's hut for about nine months and shared the widow. The chief, hearing of it, turned the widow and her family out of the country. Since that time-1895-the chief's brother and the six men have all developed leprosy. In no case is there any history of heredity. The woman was not a leper at the time, and having left the country I cannot say what she is now.
In another instance a woman came from an infected village at Berea to Sechele's, in Joel's ward. She developed the disease after marriage, gave it to her husband and two children, and from her and her family six other cases in the village can trace this disease. Letsika's ward. Two of his children have developed the disease, and from them From this village a chief took a wife to several other cases have originated.
At Rampae's village there is a leper woman who got the disease from her mother. Her husband took the disease from her. At the age of 65 the husband's
mother contracted the disease, and now a daughter of the husband by another wife has developed it.
In another, and last, instance a woman took in the child of a brother-in-law to live with her. This child developed leprosy, and the woman's eldest daughter took the disease, and then the woman herself, and lastly a second daughter shows signs of it.
These cases are difficult to explain in any other way than by contagion, and certainly fish played no part in them.
In conclusion, let me summarize
1. Leprosy is spreading and increasing rapidly in Leribe District.
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5.
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7.
It can mostly be traced to Mequatling, Modderpoort, and the Platberg. The Basuto have no name for it except "Lefu la Baroa" (the Hottentot's
disease).
Until seventy years ago they were living isolated from any possible source of infection, and it was only after coming in contact with
the Bastards and Hottentots of the region I have named that the disease was detected amongst them.
As a rule they are not fish eaters, and if they do eat fish, it is fresh or sardines, and then only as a luxury, and not as an article of diet. Salt fish is not sold in the country.
Their habits are such as to render them liable to contract the disease by
contagion.
There has been no segregation.
BECHUANALAND PROTECTORATE.
My experience in the Protectorate, extending over five and a half only two cases of leprosy-both in the southern districts.
years, includes
I have no record of the history of the first case, a girl from the village of Molepolole, who came here to see me four years ago; the second case-that of a girl from Kuma a Kwane, a village some twenty miles away-was brought in a month ago. She is 17 years of age, and, although she has lived most of her life in the Southern Protectorate is in reality a Mangwato, having been born at Palapye. Possibly she may be thus connected with the fish-eating tribes of the north, of whom some occasionally marry into the Bamangwato tribe (Khama's people); but on this point it at present impossible to make any positive statement.
From information collected by me at various times, it would appear that cases of the disease are not infrequent among the Makoba tribe, who inhabit the Okovango marshes of the Lake N'gani district, and whose food for at least six months in the year is largely supplemented with fish-both fresh and dried.
The part played by diet in the causation of the disease will, I presume, be the subject of a good deal of discussion at the forthcoming conference; on account of the startling prominence given it a few years ago by the declaration of one of the greatest of living authorities. in a particular branch of specialisation, namely, Sir
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Jonathan Hutchinson, who stated his belief that leprosy was due to the eating of improperly cured fish.
If I remember rightly, Sir Jonathan visited South Africa in connection with his researches, and specially alluded in his observations to the proneness of the natives of the lake and river regions of Africa to the disease. The general remark that large quantities of improperly cured fish sent from the coast inland for native consumption is responsible for the disease connotes that the influence of locality is merely considered in its particular relationship to this food supply.
The quantity of cured fish imported into the Protectorate is so small-mostly confined to what is required for private consumption- by traders and some other residents-that it cannot affect such a question as this at all. ticular knowledge of it, in respect to curing and preservation, it does not seem From my own par- inferior to many varieties of cured fish at home and elsewhere; it is smoked.
is not only salted,
As
Among the Bechuanas, from Khama's people southwards, fish is only a rare and vacarious article of food. They are not fond of it, and eat it from necessity rather than choice. And then- fresh from the streams and pools of the country. these are dry for the greater part of the year, the quantity of fish consumed annually
so inconsiderable that it may be left out of view as a food factor.
With regard to the Makoba, they are said to be the aboriginal inhabitants of the marshes they now occupy-with what degree of probability or truth it is impossible They eat their fish either fresh or after it has been dried in the sun; I am told that dried in this way it is as free from putrefactive taint as meat pre- served similarly, that is "biltong.'
to say.
If leprosy is due to the eating of improperly cured fish, it is not easy to under- stand how many parts of the British Isles and other countries where the disease is rare or unknown-have not long ago become uninhabited wastes, or segregated communities of lazar houses and such Plutonian horrors as are generally associated with them. The question is a much more complex one.
With regard to the prevalence of the disease in this country, as bearing upon controversial and other points, the occurrence of a few sporadic and even endemic cases does not appear to lend strong support to any exclusive theory as to its aetiology.
D. M. MACRAE, M.B., Medical Officer, Bechuanaland Protectorate Government.
Gaberones, 12th April, 1909.
SOUTHERN RHODESIA.
Medical Director's Office, Salisbury, 29th April, 1909.
The majority of cases occur in the districts abutting on the Zambesi Valley and in Victoria and its sub-districts in the south-east of the territory.
The causes of the increased number of cases in these districts have not yet been sufficiently studied to enable me to supply a statement which would be of any benefit; it could only be conjectured.
Notification cannot be said to be compulsory. With a large native population and a small European, such as we have here, it would be almost impossible to enforce. Natives know the disease and its tendency to spread, and as a rule avoid living with the affected, and inform the Native Commissioners. sioners report all cases known to them direct to the Government, and periodically Native Commis- render a return of the lepers in their several districts. all the cases are notified.
It is probable that almost
The cases are generally fairly advanced and evident before being brought to the notice of the Government. patches, the sufferers undoubtedly endeavour to conceal, or may be unaware of the In the earlier stages, when confined to anæsthetic nature of, their infirmity.
A voluntary asylum is
Compulsory segregation in an asylum is not enforced. kept by the Dutch Reform Mission at Morgenster, Victoria, and financed by the Government. It is under the direct control of the Medical Officer to the Mission. Natives unwilling to go to Morgenster arc segregated in their own districts under the care of the Native Commissioner cases are seen and treated by him.
Where there is a District Surgeon, these
This system is temporary. It is impossible to say at present whether the
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