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PUBLIC RECORD OFFICE
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C.O.8
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18 PUBLIC RECORD OFFICE, LONDON
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Free State, and stated at one of the mines in the Ruwe neighbourhood a case (or cases) of sleeping sickness had occurred, and a large batch of natives coming from the same district as the infected man had been returned to their homes.
On 10th December instant, I asked W. Morris Elmes, Esquire, M.B., R.C.S.I., for an opinion as to what procedure should be taken in this neighbourhood with regard to natives entering, this territory, so as to be in a position to lay before His Honour the views expressed by a local man, well able to judge obtaining diffi- culties and conditions. have now received his reply to my communication, and transmit, for His Honour's information, a copy of his letter together with all known details in the matter. Instructions have been given to the villages along the routes from the Congo Free State and North-Eastern Rhodesia to send every strange native to this station, and in my pending itinerary I shall inform the border villages of the utmost importance of examination.
On 13th December last, a native of this District was sent to me in order that I could observe the symptoms of sleeping sickness the man had developed.
Yesterday, I learn another case has been detected.
I am unaware whether or not the tsetse fly of this district (Glossina morsitans, I believe) transmits this terrible scourge, but from the fact of almost the whole of the Ndola District being infested by tsetse fly, the subject is one calling for most urgent measures.
The Secretary, Kalomo.
I have, &c.,
J. E. STEPHENSON, Assistant District Commissioner.
SIR,
I HAVE the honour to acknowledge the receipt of your letter of the 10th instant, and in reply beg to state that I recommend that no natives must be allowed to proceed south from North-Eastern Rhodesia unless they have been first examined either by your officers or myself for sleeping sickness symptoms. The matter is most serious, and requires very urgent attention, and I shall be most pleased to render you any further assistance in my power; I have already written Mr. Moffat, our General Manager, on this subject, informing him of all details.
Bwana Nkubwa Mine, December 20, 1906.
Re the case I sent for you to look at on the 13th, if on your travels through the District you come across similar cases, kindly let me know, and have them sent to me at once for confirmation, and to be quarantined.
The Assistant District Commissioner,
SIR,
Ndola,
Yours, &c.,
W. MORRIS ELMES
Kalomo Hospital, Kalomo, January 22, 1907. Sleeping Sickness.
In reply to His Honour's request for my views on the cases of sleeping sickness now at or near the station of Ndola, Mwomboshi sub-district, and on the reports of the Assistant District Commissioner, Ndola, and the Assistant District Commissioner, Loangwa, relating to cases of the disease, I have the honour to append the follow- ing:-
1. The Case in the Mwomboshi Sub-District. It is not quite clear to me as to whether or no this native is actually lying sick in a tsetse fly belt. If he is, I should advise his instant removal to Dr. Elmes's segregation camp, or, if this is not practicable, to a camp, to be at once formed for treating such cases in a neigh- bourhood free from fly.
On the other hand, if he is in a fly-free district, he could be treated locally by means of a couple of intelligent messengers instructed by the Assistant. District ('ommissioner, and himself in turn by Dr. Elmes.
I have no doubt Dr. Elmes would be willing to offer the Assistant District Commissioner this assistance. I can supply from here the necessary drugs, &c., required by the Assistant District Commissioner for this purpose.
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2. I advise that all fresh cases of suspects be collected and sent to Dr. Elmes. for confirmation and treatment. Dr. Elmes has already apparently formed a segre- gation camp in a locality free of fly, and this should be made use of by arrangement with the Broken Hill Development Company or whatever Company is concerned
to the fullest extent.
3. The ports of entry should be restricted to one, or two at the most, and local indunas prevailed upon to co-operate to this end. Systematic examination should be made of all natives entering the territory and quarantine imposed upon every native coming from an infected or "suspect" region, until such time as Dr. Elmes or other medical man is satisfied by examination that the quarantined natives are free of infection.
4. Dr. Daniels, of the London School of Tropical Medicine, whose opinion is of great value, and should carry great weight, advises the employment of a compe- tent entomologist to study the conditions of life of the flies belonging to the genus Glossina. It should not be difficult to arrange with the Administration of North- Eastern Rhodesia; the Tanganyika Concessions Company, Limited; the Broken Hill Development Company; and the Belgian Government (Congo Administra tion) to combine in fitting out a properly equipped research expedition to deal with the subject thoroughly, and to extend their researches to blackwater fever about which little is really known, and much remains to be elucidated. The Royal Society and the London School of Tropical Medicine would probably contribute to the funds necessary for such an expedition.
Mr. Robert Williams, in his letter to the Congo Free State Officials mentions that Dr. Neave left England on the 24th November last to investigate this disease, and possibly he is fulfilling the functions of the entomologist Dr. Daniels had in
his mind.
5. Present treatment of cases in this territory will have to take the form of quarantine, segregation, and treatment wherever possible by officials, civil or police, acting under instructions of the local medical man, if there is one, or from here. The Cologne Gazette states that Dr. Koch has discovered that atoxyl (meta-arsenic- anilide), is an effectual remedy against this disease. I expect to be able to get a supply of this drug locally, and to provide the Assistant District Commissioner, Ndola, with a quantity sufficient for his immediate requirements. Further distri- bution to other centres where the drug may be required will be undertaken immedi ately on receipt. This drug (atoxyl) is allied to methylarsenate of soda, which has been used with success in the treatment of Nagana, the tsetse fly discase of cattle, horses, &c.
6. I see no need to take an alarmist view of the situation as it presents itself up to date. The possibility of this disease becoming a fatal and decimating scourge in the manner that the bubonic plague has become in India is, I think, remote if it be true and apparently it is a matter of common knowledge to transport drivers and others less concerned in this country-that tsetse fly occurs in belts only, and those pretty well defined, and not depending upon the movement of game
and vary- ing with their movements, which are extensive. Whether or no the tsetse and one species of that genus only (Glossina Palpalis) is the only fly capable of conveying the disease is, I take it, still a matter requiring settlement. The native population of these belts is nowhere, so far as I know, a teeming one, comparable to the plague infected districts of India, and it is only where you get congregations of natives living under conditions favourable to the acquirement and spread of infection that grave danger exists.
A mine situated in a fly belt, with Glossina palpalis in evidence, and recruiting its labour from known infected areas whose labourers pass through infected areas such as exist in the Congo Free State and on the west coast of Tanganyika, supplies the favourable conditions I refer to. Possibly some of the mines present these condi- tions; of this I have no knowledge, however.
Isolated cases, occurring outside the fly belts, beyond being possible indicators of the source of infection, and, therefore, danger signals, are not of themselves of alarming import.
At the latter end of 1905 a solitary case (fatal) of sleeping sickness occurred in Livingstone in a native employed by Government, but where this native came from, or how long he was employed by the Government, I have not been able to discover.
I do not in any way wish to minimise a danger that has been pointed out by
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