CO885-(18-19) — Page 577

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PUBLIC RECORD OFFICE

Reference :-

C.O.885

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19 PUBLIC RECORD OFFICE, LONDON

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Dr. A. Pearson, Principal Medical Officer to the Tanganyika Concessions, with five years' experience of the country:—

and with regard to the employment of labour at Kambove or at Ruwe I would submit that no risk whatever would be incurred, and with the methods of supervision which I propose to adopt I feel sure that such natives would be as safe from infection as though they had not crossed the Luapula River."

and again from the same letter:-

6.

with regard to the contiguity of the proposed route (to Kambove) to highly infected areas, I believe it can be shown that at no place will the In this statement I am native approach within 100 miles of such an area. well on the safe side, and for the most part they will never be within less than 150 or 200 miles."

As to the suggestion "that the Tanganyika Concessions be required to move the loads across the river and to find carriers in the Congo Free State," I need only state that it has been open to the Tanganyika Concessions to adopt this suggestion since the transport was stopped in April last and up to the end of September they succeeded in moving about 30 to 40 loads. The reason for this was apparent to me when I visited the Congo and found the deplorable paucity of labour there. The Agent at Madona too had the authority to recruit men from the Congo for the same purpose and met with so little success that I thought they might be tempted to tap the populous districts in the endemic area far away to the north and thus bring the disease down to the Luapula. There were no Government regulations restricting the employment of labour from this area at the time of my visit to the Congo.

7. The temporary segregation camp at Madona which Dr. Kinghorn feels is unjustified is a temporary necessity. The same may be said about those at Chiengi and Sumbu. These are the spots where the disease must be faced and fought and where we must have our medical officers, but it was never intended that they should remain as permanent institutions. It is surely better to move the cases into tem- porary camps where they will be moderately safe than to leave them untreated where they were found among the fly.

8. The Swahili smuggling has been definitely stopped and in this connection I witnessed 10 arrests at Chiengi and several more at Sumbu.

9. Since the finding of sleeping sickness in North-Eastern Rhodesia no special permission has to my knowledge been given to anyone proceeding to Broken Hill with Luapula natives. The only instance in which special permission of any sort was granted was the case of an official's wife travelling from Kalungwisi to Broken Hill with Kalungwisi natives before any restrictions had been placed upon them, and, being already at Madona, they were allowed to pass through, viâ Kapepwe. after being certified free from symptoms of trypanosomiasis. The next day an application to go through to Broken Hill with Luapula natives was refused and, as far as I am aware, no such application has yet been granted. I have no knowledge whatever of the " several cases" referred to by Dr. Kinghorn in which this was done by special permission.

10. Dr. Kinghorn seems to have overlooked the fact that a medical officer fresh from home with no knowledge of the country, the native, his language, his manners and customs, cannot be given "charge of the work," whatever that might mean, or have any direct dealings with the native on such important matters. This work requires men of considerable experience and tact in dealing with native affairs and men who have acquired a personal influence among the natives. The medical officer has entire control of the situation in so far as any recommendations or directions he may issue will be carried out by the Native Commissioner.

In conclusion, Dr. Kinghorn has criticised things at too early a stage for such criticism to be of any real value. When he entered the country in July last nothing was known and nothing had been done. He arrived on the Luapula three months afterwards to find a station built and the work of the station at least started. He at once commences to criticise things. I cannot help thinking, too, that Dr. Kinghorn has been led astray on one or two points by local opinion, too often so gratuitously offered to the new-comer by those whose interests perhaps are not enhanced by Government regulations.

J. C. SPILLANE,

Principal Medical Officer.

16345

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No. 11. UGANDA.

THE LIVERPOOL SCHOOL OF TROPICAL MEDICINE to COLONIAL OFFICE.

(Received 8 May, 1903.)

[Copy to Colonel Bruce and to Governor, No. 127, 16 May, 1908. L.F.]

B 10, Exchange Buildings, Liverpool, 7 May, 1909.

Mr. Hesketh Bell's Report* on Sleeping Sickness in Uganda.

SIR,

I HAVE to inform you that on receipt of the above-named report, Dr. Breinl. Director of the Runcorn Research Laboratorics of the School, who is at present I have the honour to working on sleeping sickness, was asked unofficially to go through the report and make any observations thereon that might occur to him. enclose copy of his observations, which no doubt will be of interest to the Secretary of State for the Colonies.

DEAR MR. MILNE,

I am, &c.,

A. H. MILNE.

Enclosure in No. 11.

Runcorn Research Laboratories, Crofton Lodge,

Runcorn, 6 May, 1908.

In answer to your letter of April 27th, I am sorry that I have not had time to go through this report carefully before, as work, at present, is very pressing.

Going through the first report from the 23rd of November, 1906, paragraph 30, No. 2. After the temporary removal of all healthy persons, I think it would be necessary to have a supervision of these people through a trained native com- missioner.

The treatment ought to be a combination of atoxyl and mercury, as the results in small animals were certainly far superior to the results obtained with atoxyl by itself.

No. 42. Concerning the depopulation of the infested belt. To my mind, the diagnosis of sleeping sickness, and especially of the early stages, is extremely difficult. Therefore, I do not think it is possible, from a practical point of view, to select the sick from the healthy. Our experiments with atoxyl, during the incu- bation period, have given very good results, and I think it would be worth while to subject, after segregation, even the apparently healthy people to a short treat- ment of atoxyl.

No. 45.-Concerning the native labour on the peninsula of Entebbe. If it is practically possible and I think it is a registration of native labourers after care- ful medical examination and subsequent close supervision ought to be introduced.

Concerning the report of the 9th December, 1907. It ought to be impressed again and again, that combined treatment of atoxyl and mercury ought to be given a thorough trial. I may repeat again that Moor, Nierenstein, and Todd's experi- ments have shown a combination of atoxyl and mercury decidedly superior to atoxyl by itself. Our experience on the whole shows that, if atoxyl treatment is to be successful, it must be carried out thoroughly and for a prolonged period. In practice at least six months to one year. I am sure that if it is not done in this way it is much better not to start the treatment at all, as it only prolongs the life of infected people, and makes, therefore, a much bigger source of infection for the flies.

Concerning the blindness alluded to in paragraph 30, as far as our experiments go, it is mostly due to an overdose of atoxyl, and as Professor Koch has shown in his large series of cases of sleeping sickness, one gram of the drug given in one injection certainly causes blindness. If the dose is administered within reasonable limits as far as our experience goes-it is not followed by blindness.

I should think that very great care ought to be taken in the depopulation after a previously infected district. I do not think that the flies can carry the infection

• No. 100 in Miscellaneous No. 178.

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