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PUBLIC RECORD OFFICE

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C.O.885

18 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO

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No. 44.

NORTHERN NIGERIA.

THE HIGH COMMISSIONER to THE SECRETARY OF STATE.

(Received August 16, 1907.)

[Copy to Sir P. Manson and Royal Society, August 29, 1907. L.F.] (No. 372.)

MY LORD,

Government House, Zungeru, July 18, 1907. WITH reference to my despatch, No. 283, of the 13th ultimo,* I have the honour to transmit copy of a report on the investigation of the native treatment of sleeping sickness by Dr. McGahey, together with a memorandum by the Principal Medical Officer on this report.

I have, &c.,

E. P. C. GIROUARD,

High Commissioner.

Enclosure 1 in No. 44.

REPORT on a Native Treatment of Sleeping Sickness at Loko, River Benue, by Dr. McGAHEY.

March 5, 1907. I arrived at Loko February 28th, and was interviewed shortly after by the Chief and his following, from whom I received a very flattering account of the skill and prowess of the native medicine man, statements which I have since proved to be very much exaggerated. Later on I saw the native doctor. He said he was a native of Bida; he states that the remedy he is now using for sleeping sickness was handed down from father to son, his grandfather having used this remedy before him. He has been practising in Loko for two years, during which time he has treated 83 cases, two of whom died; at present at his isolation camp (three miles from Loko), which consists of five huts, there are five patients, two girls and three boys, ages ranging from nine to 12 years. They have all been under treatment for from two to three months, and one boy is in for the second time, an interval of two months having elapsed from his discharge till his re-admission. They have all had enlargement of the cervical glands, one also the occipital and one supra clavicular; all these glands have now been opened by the native doctor, and are covered with some native medicine. Cases which have been under treatment can be easily recognised by the presence of large keloid-like growths, which grew over the site of the incised gland. I have seen several of such cases in the town; one man I saw who underwent the treatment 20 years ago. I have been unable to discover trypanosomes in the blood of any of those under treatment.

At present the patients have no marked signs or symptoms of sleeping sickness other than the glandular enlargement. One girl has chorea-like movements in the left hand. I have discovered one trypanosome-infected case in Loko. He is a native of Loko, who went to Ibi one year ago. Passing through Keffi and Bautchi two months ago he was seized with extreme lassitude and enlarged cervical glands and inclination to sleep a good deal. His case was diagnosed by a native doctor at Ibi, and he conse- quently returned to Loko for treatment.

The 'disease is evidently endemic in Nassarawa Province, but without any epidemic outbursts. It is known at Damo, Lafia, Keffi, Amar, and Nassarawa, so I have been informed. I hope to be able to get 12 cases to subject to treatment. In the dry season the native doctor informs me cases are very scarce!

Tsetse fly I have not seen since leaving Lokoja. Horses and cattle only live here in the dry season.

April 5, 1907. The following is a summary of the cases which have been under treatment since my arrival.

1. Esan, native of Loko, male, 17 years of age. For the past year resided at Ibi, farming. Admitted to camp March 5, 1907. He was very well nourished. He complained of lassitude and drowsiness, although I never once found him asleep

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whilst in camp. His cervical and occipital glands on both sides were enlarged, but he had no other sign or symptom of sleeping sickness. He was mentally alert, and joined freely in conversation. Puncture of glands was practised and trypanosomes were found after the fourth puncture. He remained in hospital one week; left during the night, and I have not since heard of him. He was not subjected to treat- ment, the native doctor being away at the time.

Í have been unable to trace him since his escape from the isolation camp.

2. Ashia, female, nine years of age, native of Armageddi. Four months in hospital under treatment. On my arrival her cervical, parotid, and inguinal glands, on both sides, had been incised. Her mother states that, on admission, she was unable to stand up alone, and that she slept a good deal. On my arrival she was slightly anæmic, could stand up and walk alone, but the latter with a very unsteady gait, and, holding out her hands, a marked tremor was noticed. There was a slight drooping of the upper eyelids; she did not sleep more than normally; she was mentally dull; she had to be spoken to three or four times before her attention could be attracted, and at times for no apparent reason she would burst out into a hysterical laugh.

On the 17th March, 1907, the native doctor again incised her cervical glands, as it is his custom to repeat the operation if any sign of enlargement persists. The spleen and liver were normal. The puncture of glands was practised several times, and only once did I find anything, on that occasion I got one trypanosome and two specimens of the Filaria persitans. Other than the aforementioned, she had no sign or symptom of sleeping sickness. At the end of March her condition had very much improved, she was less anæmic, and could walk quite well, but with a slightly hesitating gait. She had become much brighter, entered into the general conversa- tion, and the muscular tremor had disappeared. She was still nervous, but I think she was of a hysterical disposition. On April 1st she was discharged to her home as cured by the native doctor without my knowledge.

For the past month I have been unable to find trypanosomes in her blood. Although when I saw her she had no typical symptoms of sleeping sickness, yet I think the foregoing account is in favour of the native medicine having done her good.

May 29, 1907. As stated in my last report, this patient was discharged as cured by the native doctor on April 1st. On April 19th J discovered that she had not returned to her country as I was led to believe, but that she was again under treatment by the native doctor in Loko. On visiting her I found that the native doctor had again incised the area over glands which were still enlarged. Her condition then was somewhat worse than when she left the isolation camp. She was fairly well nourished, but was extremely dull, with very marked muscular tremors and marked ædæma round the eyes. Her mother stated she slept very much more now during the day. I could notice very little change in her condition from day to day, except increasing dullness, and a slight irritability when one attempted to rouse her up.

On May 4th she was seized with extreme lethargy, food then having to be put into her mouth, and being swallowed with difficulty. From this date until May 9th, she slept almost continuously, and died on the latter date. The rapid onset of lethargic symptoms was most marked. She did not have an apoplectic seizure.

Trypanosomes were found in her glands up till death, but could only be found after a lengthy search. They were never found in her peripheral circulation. She had been under native treatment continuously for twenty weeks.

3. Amala, female, eight years of age, native of Loko. Three and a half months in camp, under treatment. This is the second time she has Leen under treatment, two months having clapsed from her discharge until her re-admission.

On my arrival here she presented a miserable picture: she was very emaciated, and extremely anæmic. She is unable to rise from the ground unaided, and can stand alone with great difficulty; there is marked droop of the upper eyelids, and she has a peculiar choreic-like movement of the left hand, and occasional tonic spasms of the hands and feet. There is a marked muscular tremor over the whole body, and this is especially noticeable when she is asleep. The cervical and inguinal glands have been incised. The spleen and liver are normal. her food having to be put into her mouth, as otherwise she would not take any. She She sleeps incessantly, never speaks except when spoken to, and then only in monosyllables, when she again lapses into a soporific state. Her reflexes are normal.

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