291
IVULTA
ALCURU UFFILE
Reference :-
885/26
PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH-NOT TO
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Research work being undertaken at present:-
1.
Observations on various strains of Trypanosomes.
2. Experimental infections of Rhodnius prolixus with T. cruzi.
3. Observations on T. cruzi in the tissues of inoculated animals.
4. Observations on a rare case of coccidiosis in man Eimeria oxyspora.
5. Observations on a rare flagellate in man, the first case described in this
country. Embadomonas intestinalis.
J. G. THOMSON, M.A., M.B., Ch.B.,
Director of Protozoology.
Enclosure 4 in No. 4.
Á PRELIMINary Report ON WORK CARRIED OUT IN THE PACIFIC BY THE MISSION SENT OUT BY THE LONDON SCHOOL OF Tropical MEDICINE, 1919-1921.
THE object of the expedition just concluded was to visit the Ellice Islands; firstly, to inquire into certain assertions made as to the efficacy of Salvarsan anti other arsenical compounds in the treatment of Filariasis; and, secondly, to study the diseases prevalent in the group. The expedition, which included Dr. A. E. Ridsdale (who volunteered his services), Mr. C. E. Berry, and myself, left London on 18th October, 1919, and arrived in Sydney early in December: owing to the marine labourers strike it was detained in Sydney till 14th January, 1920, when it proceeded to Samoa (en route to the Ellice). During the stay at Samoa, the Administrator of 'British Samoa cabled the school committee and obtained the latter's sanction to my staying in Samoa to investigate the diseases with which the newly arrived medical staff (not trained in Tropical Medicine) were unacquainted. During this period I was able to visit all the islands composing British (late German) Samoa. After two months, the expedition embarked on the s.s." Daure" and sailed 250 to 300 miles north, to the Tokelau or Union group of coral islands. Work was undertaken for about a week on these islands. The vessel next proceeded due west for about 350 miles and arrived at Funafuti, the principal island of the Ellice group, at midnight on 11th April, 1920.
The Ellice group consists of nine coral atolls, of which eight are permanently inhabited. All of these have been visited, almost the whole population has been inspected, and more than one-third has been carefully examined. Owing to a com- plete lack of inter-island transport, I was unable to leave the atoll of Funafuti for six months; but as this island is the centre of Government and possesses the principal hospital of the group, it was the most suitable for my investigations.
In September, 1920, the London Missionary Society's 8.8. "John Williams" arrived, and a passage was provided for Mr. Berry and myself (Dr. Ridedale having left me some months before). On this vessel I visited the other Ellice islands, and I then left the group for the following reasons:-
(1) There was good reason for believing that no other relieving vessel would arrive for many months, or perhaps a year.
(2) No instructions had been sent from Fiji about the expedition to the District Officer at Funafuti, and the latter had in consequence withheld the most important facilities for the successful carrying on of my work.
(3) The main work (the treatment of cases of Filariasis) was impossible, owing to native prejudice; recent experience of the natives with intra-muscular injections, having filled them not only with distrust but with much fear of drug injections as a means of treatment.
(4) My other investigations had been carried so far that a return to Samoa was essential for purposes of comparison of different conditions, and
(5) By the 6.8.
John Williams came an invitation from the Administrator
at Samoa, inviting me back to that group, and promising me the necessary facilities for the conduct of my work.
On this return voyage, the Tokelau Islands were again visited, and the vessel then proceeded to Pago Pago, on Tutuila, the largest island of the American Samoa group. I was now enabled to visit all the inhabited islands of this group, and through the courtesy and kindness of the American Governor and his naval officers I was given every facility for examining a large proportion of the population of each island, and for conducting other investigations. Thus it was possible to make
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a complete survey of some of the diseases of the whole of the Samoan group (British and American) as well as of the whole of Tokelau and Ellice Islands.
I arrived back in Apia in October, 1920, and remained working at the Govern- ment Hospital, Apia, and on different islands, till 13th August, when I embarked for home. I arrived at Tilbury on 19th November, 1921.
A list of the islands (according to their geographical grouping) which were visited, and on which researches were conducted, is appended.
Islands visited (See Map).*
Group I, Samoa-Nine islands, eight of which are volcanic, and which are inhabited, one a coral atoll, uninhabited.
A. American Samoa.-Population 7,550, including whites.
Tutuila (Port, Pago Pago).
T'au.
Olesega. The Manua group, 60 miles east of Tutuila.
Ofu.
B. British (late German) Samoa.-Governed under mandate by New Zealand; population 32,953 natives, half-castes, and whites. Eighty miles from Tutuila.
Upolo (Port, Apia). Monono.
Apolima.
Savaii.
Group II, Tokelau or Union Islands.-Four coral atolls, all inhabited; population 1.000.
Olesega (Swains island).
Fakafu.
Nukonono.
Atafu.
Group III, Ellice Islands.--Nine coral atolls, eight of which are inhabited; one, Sophia, has no permanent population. Population, 3.000.
Nukulaelae. Funafuti. Nukufetan.
Vaitupu.
Work Done.
Nui.
Niutoa. Nanomaga. Nanomea.
General. In brief, the following conditions have been investigated Filariasis, ankylostomiasis, ascariasis, dysenteric infections, yaws, leprosy, tuber- culosis, fish poisoning, skin diseases, intestinal parasitism, and seasonal and rarer infections. A mosquito survey has been made in all the groups, and the life histories The habits and customs of the of all species of mosquitoes found have been studied. natives as regards food and sanitation have been observed in their relation to 'disease. A study of the topographical nature of each of the islands has resulted in the acquirement of important information connected with the greater prevalence of disease in some islands, and a lesser prevalence in others.
Special Investigations. A study of the incidence of filariasis has been made for the first time in all of these islands. More than 5,000 individual cases have been examined, including a large proportion of the total population in both of the atoll groups. The cases which were collected according to family grouping were examined in the following routine way :-A uniform quantity (20 c.m.m.) of blood was taken from the finger and examined, generally when fresh, and always when stained. Counts of microfilaris, when present, were made, and notes were taken on each case as to age, sex, birthplace, present residence, history of journeys and voyages, history of clinical filariasis, condition of epitrochlear glands, and presence or absence of elephantiasis, and parts affected when present. Similar examinations were made of a number of white and half-caste families. I consider the information acquired, as to filariasis in families, to be important.
The question of microfilarial periodicity has been everywhere studied, and for this purpose a large number of cases have been examined at four-hourly intervals for twenty-four hours. The effects of sudden great, and prolonged steady, exertion
* Not reproduced,