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streams flowing north from Usoga (also into the Mpologoma) on the one hand, and the Sio on the other, were found to be free from fly, but on the western or southern shore of the Mpologoma, some 30 miles to the west, at which part several of its Usoga tributaries enter it, some patches of fly were found and sleeping sickness was present. This small epidemic area seems to be situated in an outlying corner of the line forming the eastern limit of Glossing palpalis, which was very abundant there, the physical conditions everywhere favouring its presence. These are described as consisting of a series of scrub-covered hills intersected by streams overhung by dense forest. Many of the streams were in flood at the time of the investigation and on the borders of several of these floods the fly was observed to be present.

Apparently this epidemic embraced the Warumbi, Wasettima, and part of the Wamia, the first two mentioned small tribes having suffered very heavily, and the district reported on formed, probably, only the eastern end of it. There seems to be very little communication at the present time between the infected people and their neighbours, and, since there is no direct connection with other fly areas, there is little chance of the extension of sleeping sickness from this centre in either direction.

A word may also be said here about the Nile epidemic, since the conditions in that region and in part of Northern Unyoro differ from those existing in other parts of the Protectorate. The main difference lies in the distribution of Glossina palpalis, owing to the open nature of the rivers and streams. Whereas in other parts the fly areas are for the most part confined to the outer boundaries of the province concerned, they are here dotted over the interior. That part of the Victoria Nile, indeed, which forms the boundary between Unyoro and the Nile Province, is certainly very thickly infested with fly, but the White Nile is haunted irregularly in larger or smaller patches (Note L) and on long reaches of it, as, for instance, that between Wadelai and Nimule, these patches are both small and rarely met with, on account of the wide belts of sudd along the bank, while prac- tically all the inland streams, wherever the conditions of shade, &c., are favourable, are dotted with fly-arcas. These areas are usually small, the range from them is very narrow and the flies seldom numerous. Most of the villages are built out- side the fly-range, and the only connection with the local fly-area is, in many, if not most, cases, through the water supply. I may mention here that the same condition holds in some villages on Lake Victoria, where there are others also in which almost the only connection is through the occupation of fishing and, nevertheless, in some of these villages the rate of infection is high, especially among the adult males. If the Nile natives were intelligent and amenable, this state of affairs might be dealt with comparatively easily by seeking fresh water-supplies or by clearing those which exist. They are, however, very backward and suspicious, and I see no hope of their taking any steps either to help themselves or to assist the Administration in protecting them.

The origin of the Nile epidemic does not appear to be quite certain and, although it was naturally supposed, when sleeping sickness was first discovered there, that it had spread from Lake Victoria viâ Lake Albert, there are, never- theless, certain facts which are not in favour of this conclusion. Dr. Densham, who is investigating this epidemic, reports that very little information can be gathered from the natives generally, but that it seems to be agreed by most that the sickness first started, on this bank of the Nile, about four years ago at Ajei's, a chief settled on the Akkehr River between Wadelai and Nimule, while some state also that it was previously known to exist at a place called Logwari on the Congo side and was introduced from there. It is in favour of the alleged or even of the longer duration that the settlement at Ajei's referred to has been entirely wiped out by the disease and for so long abandoned that little or no trace of it remains, while the fact that not only have a large proportion of the cases so far examined by Dr. Densham originated in the Congo, but that a fair number of these have come from Logwarri* itself, seems to point to the probability of the alleged origin also. On the other hand, it is a fact that all the porterage and a good deal of native Equal Lubari, on the Kibali or Welle River, a tributary of the Congo River. See Map I. A centre of sleeping sickness is marked near here on the Liverpool Sleeping Sickness Commissioner's

map.

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trading, as far as our northern boundary and even into the Congo beyond, is done by enterprising natives of Uganda and Unyoro, and it is within my personal know- ledge that infected Baganda and Banyoro have occasionally penetrated as far as Gondokoro within the last two years if not previously.

As I have pointed out above, under the conditions obtaining in this region, sleeping sickness would spread very slowly, and it would be a long time, after infection was first introduced, until it would be likely to have made considerable headway; moreover, it is a fact not to be ignored, in consideration of the origin, both of this and of the Uganda epidemic, that sleeping sickness might have been present among these people, who have come very little in contact with Europeans, for years without necessarily coming under observation, especially as their custom and instinct is to hide their sick; that it might even yet have remained undiscovered had it not been for special investigation, and might, possibly, have existed here even before infection found its way into Uganda.

In one other part of the Protectorate, namely, Ankole, the streams are mostly open but, since there is, as a rule, little or no shade on their banks, there is apparently no fly. The same will probably be found to apply in a great part of Kavirondo and in the country east and north-east of Lake Victoria. In western Toro, especially round Lake Albert Edward, fly are numerous in places and conditions exist favour- able to an epidemic but, as I have already said, it has not yet been possible to make a thorough investigation. Steps are being taken, however, to limit the risks of infection being carried there from other epidemic areas if it should not have already arrived.

Although it is necessary to bear in mind certain hypotheses, it is well to remember that we probably can never know exactly how the infection of sleeping sickness reached East Central Africa. No doubt it came from the west, but the manner and route of its introduction we can scarcely hope to clear up with any A more certainty at this distance of time and with only native report to guide us. important question is whether, having once been introduced, it can ever be entirely eradicated, and it is to be feared that the balance of probability is against this. It is possible, of course, for there is no native evidence nor record of any value, no European knowledge extending over any lengthened period, that sleeping sickness had visited these regions in former times and that the epidemic had been rolling slowly to and fro from the west coast to the great lakes at intervals, perhaps, of centuries, leaving in its track endemic centres scattered here and there across the continent. It is more probable, however, that the present epidemic is the result of the first introduction of infection and that, once introduced, it will remain endemic in certain areas specially favourable to it, such as, for instance, parts of Usoga. Whatever the truth as to this may be it is certain that, wherever Glossina palpalis exists, we must expect epidemic outbreaks to be more frequent than in the past, owing to the increased frequency and facility of inter-communication. Many facts, too, such as the nature of the disease itself and of the infection causing it, of the carrier, its haunts, and its local numerical prevalence, render it difficult to suppose that it can be utterly abolished, in certain localities especially suitable to the fly, any more than can malaria, and it is, therefore, probable that it will remain endemic in a few parts of the Uganda Protectorate.

Perhaps there is just a possibility that Glossina palpalis may have its cycles of great increase or decrease, becoming, during the former, far more numerous and widely spread than at other times, while the latter may be of sufficient duration to allow the infection to die out in the vertebrate hosts in those localities from which it would for the time disappear. At least, I believe that there are certain lepidoptera, such as the clouded yellow butterfly, which, though ordinarily strictly localised, in certain rare and favourable years, spread in large numbers over regions from which they have been long absent and again, eventually, disappear from them as completely as before and become confined to their former limits. The close con- nection of Glossina palpalis with the waterside might seem to offer some prospect that its local prevalence might be largely influenced by abnormal rainfall or drought. Apart from speculation, however, seeing that there is a probability that sleeping sickness will remain endemic with us, it behoves us the more to consider some means whereby its ravages may be so far'checked that it may cease to be a bug- bear to the people and a barrier to the development of the country.