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- other natives of influence. Opportunity should be taken to acquaint them with the appearance and habits of G. palpalis and specimens should be shown in order to test or aid their knowledge of them. The connection between the fly and sleeping sickness should be explained, how the one is probably powerless to spread the disease without the other, and how important it is to remove huts and villages from within the actual fly-areas and to prevent the sick from remaining in or even visiting such areas, wherever such measures appear possible. Special stress should be laid on the fact that the fly is harmless unless it can bite the sick. It is important also to explain to them the intentions of the Government, which wishes to prevent disease and to see the natives numerous and well-off, and a point might be made of the large sums of money being spent for these objects. As the native immediately seeks a motive to explain any action which he cannot understand, and as he has great difficulty in understanding that Europeans (or others) would do him a good turn for nothing, that is, without some immediate selfish end in view, investigators may, unless care be taken to explain, just as likely be credited with the intention to spread, as with the desire to prevent, sleeping sickness. Any misunderstanding of this nature even in one district would be likely seriously to affect the whole field of

nquiry and cannot be too carefully guarded against.

23. Every effort should be made from the outset to conciliate and gain the confidence of the natives, who should be dealt with as far as possible through their local chiefs. Methods of observation such as gland-puncture should be used at first with caution and discretion and in no case arbitrarily or without permission. But an attempt should be made to accustom the people gradually to such proceedings, so that later on their use may become more generally applicable and so of greater

scientific value.

A patient attending for treatment of an ordinary ailment, for example, might readily submit to gland-puncture, whereas a person casually encountered in a village might strongly object. Again, though the glands in the neck are the most generally adapted for puncture, yet sometimes a patient who objects to puncture in the neck, an operation which he cannot see, will offer no objection to puncture of his supracondyloid glands, a process he can watch, and, since these glands are quite frequently enlarged in sleeping sickness, and yield trypanosomes when punctured, advantage might be taken of this fact.

21. The use of rewards or gratuities should be avoided as a rule, and it will be found less expensive in the long run, as well as more advantageous, to use them in the case of voluntary interpreters or guides who may have gone out of their way to give information and assistance rather than to actual patients. It may, however, sometimes be required to reward patients as being the first to come in or to submit to operation or examination, or the price of food may have to be supplied to such as come from a distance and are kept for a short time under observation. A supply of pice should be carried for these purposes.

25. All provisions and commodities obtained locally from natives should be paid for at the local rates.

26. All expenses, including transport, are chargeable to a special fund under the Head "Special Expenditure, Sleeping Sickness," and money can be drawn from Collectors locally by vouchers under this head. Exact accounts of all items are to be kept and cash-books will be provided.

It will be understood that strict economy is to be used.

27. Medical officers should seek the co-operation of officials of the administra- tion and avail themselves to the utmost of their local knowledge and experience of the natives. Their advice or assistance with reference to such matters as roads, maps, guides, interpreters, local prices of native food, local native prejudices, occupations and methods of communication should be of great help in conducting the investigations.

28. It has been arranged that interpreters for the local dialects or languages will be supplied wherever possible by the local administrative officials. This is of the first importance both for facilitating the work and for gaining the confidence of the natives. Different interpreters may be required or be available for different parts of the same province.

29. Medical officers should pitch their camps outside of actual fly-areas. In so doing they will find, as a rule, no difficulty in keeping in close touch with the investigation they have in hand.

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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