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food at our camps. It is with great difficulty that some of these people are got

rid of.

The various missions have taken a great interest in our camps. Chapels of both denominations have been built at Buwanuka and are going to be built at Kyetume. Our Usoga camp is close to a mission centre. The camps are constantly visited by missionaries and, native teachers. The natives appreciate this and it all helps towards the main object—to make our camps attractive.

Our camps in Kyagwe and Usoga seem to be very popular, as the present rate of admission shows.

On November 26th Dr. J. H. Goodliffe departed for the Sesse Islands to start a camp on the main island (Bugalla) close to that lately vacated by the German Commission under Professor R. Koch. Many patients have already been treated with atoxyl on these islands. Dr. Goodliffe, in his first letter to me, says that the people, though pleased to have a doctor among them, do not seem very anxious for further atoxyl treatment and thinks they are disappointed with what they have already seen of it.

The islands of Buvuma are still a centre of sleeping sickness. A few patients are going to Kyetume, the nearest camp. Dr. van Someren, after a recent visit to the island, says that he saw a great number of sick, but only a very small per- centage of the total number. The chiefs on the island said that they were having the greatest difficulty in getting the people to go across to Kyagwe, as they did not know Uganda and had all sorts of curious ideas about our camps there. He says that such of the Buvuma who have come to camp have very soon got over their terror, that some have gone on a visit to their homes and have returned to camp again bringing others with them. Dr. van Someren goes on to say, "from what I can gather as to the customs of the islanders it will be almost, if not quite, an impossibility to expect to form camps, such as we have in Uganda, on Buvuma Island, owing to the inadequate food resources, and when it is borne in mind what a great source of infection the islands are, it seems a pity that these persons are not removed as far as possible for a time at least, as it seems reasonable to hope that in time the infection will die out from the fly when the reservoirs of the trypanosomes are removed." I would like to draw attention to this, owing to the large number of children, relatively, that from Buvuma, every one of them is infected. I may say that practically every Muvuma who has come under my notice has been infected, in many cases I have been able to find the trypanosomes in those who declare that they are perfectly well, and I am inclined to the belief that if a systematic examination was made of the inhabitants of these islands, the per- centage of infected persons would be found to be 95 per cent. if not more. The estimated population of these islands at the present time is 6,000. I do not think that a general order to have at least all the children brought for treatment would meet with any great objection, since so many of them are orphans, nor would those who might come over without their parents feel strange for more than a little while, seeing what little home life, as we understand it, there is amongst them.

In conclusion, may I be allowed to point out that our doctors who are in charge of these camps are considerably handicapped by the absence of any proper "Hospital Assistants." So far natives have been the only assistants available, with the result that all clerical work, as well as medical, has fallen on the shoulders of medical officers.

Disputes and petty offences are common among the patients, and these are always brought to the medical officer to settle as being the only white man there. In addition the medical officer has to superintend all the planting and clearing that is going on. The presence of so many lunatics and the chance that some one may set fire to the hospital buildings, makes it almost impossible for the medical officers to leave their camps for even an hour at a time.

Entebbe,

December 6, 1907.

A. C. II. GRAY, Captain, R.A.M.C.,

Medical Officer-in-Charge, Sleeping Sickness Extended Investigations.

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No. 2.

MEMORANDUM OF THE INFORMAL DISCUSSIONS WHICH TOOK PLACE AT THE COLONIAL OFFICE ON THE 10TH AND 11TH OF JANUARY, 1908, BETWEEN THE BRITISH AND GERMAN DELEGATES OF THE INTERNATIONAL CONFERENCE ON SLEEPING SICKNESS.

Professor Koch expressed the opinion that, although there were still points of scientific importance to be settled in connection with the nature and cause of sleep- ing sickness, we already—thanks to the work of British observers, especially Colonel Bruce, who had demonstrated that the disease is caused by Trypanosoma gambiense and that it is conveyed by the bite of Glossina palpalis-knew sufficient to enable us to establish an effective prophylaxis.

He stated that, in certain instances, dogs and monkeys have become naturally infected, but that those animals have become infected so rarely and have died so quickly after being infected, that they may be disregarded practically as reser- voirs of the disease.

Similarly, although it may be possible to infect Glossina fusca and Glossina pallidipes with the trypanosome, this must occur so rarely under natural conditions that they may be disregarded as conveyers of the trypanosome. The same may be said of G. morsitans, which, in the opinion of Professor Koch, but contrary to the experience of certain other observers, attacks man very exceptionally.

He considered that the trypanosome passed through a developmental cycle in the fly, as the presence of several forms in the alimentary canal and of Trypano- soma gambiense in the salivary gland could not otherwise be explained. How long a glossina continued effective he could not say, but probably for a considerable time. This is an important point, and his assistants are now working at it. He knows of no natural enemy of the fly, and considering its feeble reproductive ( energy and its abundance, he considers it must be long-lived.

He considers that in the matter of preventive measures each country should work for itself, from time to time exchanging experiences with its neighbours and settling with them frontier administrative points in a friendly way.

The following recommendations were made:-

(1) Sick natives should be prevented from crossing the frontier.

(2) A native found to be infected, no matter in what country or from what

country, to be detained where he was infected.

(3) Each country to have the power to interdict its natives from entering

infected districts.

(4) Segregation camps to be established by the Administrations of Uganda and German East Africa at corresponding points near the frontier. The Uganda camps to be one at Dumu one at Gori River.

(5) Attempts should Le made by both Powers simultaneously to destroy the crocodiles in Victoria Nyanza, which he believes are the principal food- source of the fly as attested by his finding a blood parasite peculiar to the crocodile in the blood in the stomach of many flies. To accomplish this Professor Koch recommends that the eggs of the crocodiles, which are generally laid in easily accessible spots on the shores of the Lake, should be destroyed and the adults poisoned.

Professor Koch remarked that in Lake Kivu there are no crocodiles and no Glossina palpalis, although in Lake Tanganyika and Victoria Nyanza both abounded, and he concluded from this that the crocodile was essential to the fly, and determined its presence. Dr. Hodges remarked that in Lake Albert Edward crocodiles are absent and Glossina palpalis abound, while an opposite condition exists south of Gondokoro. He suggested that hippopotami are an occasional food supply for the fly, but Professor Koch thought that as Glossina palpalis is active during the day and the hippopotamus during the night such a relationship, although probable, was not important.

Professor Koch considers blood examination the best method of diagnosis- some drops of blood being spread on a slide without fixing and stained with azur II. and eosin. The method requires a month's practice to ensure reliability. If

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