CO885-(18-19) — Page 7

PUBLIC RECORD OFFICE

Reference :-

C.O.885

18 PUBLIC RECORD OFFICE, LONDON

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

TO PORT PORTAL

38

To KAKUMIRO.

Main Road

* KIKUMU

SKYEGAYUKI

СНАКА

KASINGA

River

KARWENYU

IZINA

Katonga

To MBARARA ANKOLE

BEUKULA

TO ENTEBBE

The above rough sketch indicates the position of the villages chiefly affected.

Cases.

I give in detail nine cases which were seen on two separate occasions, once at my camp, and again at their own houses. All lived at Karwenyo or Izina.

Case No. 9.-July 20th. Nyakato. A woman, aged 20-30; ill for four months. At first lost strength in limbs and found difficulty in even standing. Was carried to my tent. Able to rise slowly from a sitting to a standing position. Progresses on hands and knees.

Legs-Firm cedema over tibiæ, marked tenderness to pressure of calf muscles. Unsuccessful attempt to test anesthesia. Knee jerk not elicited.

Arms-Grasp good: winces when forearm muscles are slightly squeezed. Heart-Action regular, no bruit, pulsation in neck.

July 23rd. Seen at home was being wet-cupped by means of a horn and incision made above the knees.

Above observations confirmed, pulse 90. Marked pulsation under insertion of R. sternomastoid and in epigastrium.

+

Temperature.-Nòrmal.

Urine. Free from albumen.

Case No. 10-July 20th. Kalyebara. Man, 30-40; ill five months. Thin; walks by himself.

Legs. No cedema; no wincing on pressure of calves; knee jerk absent. Arms. Unable to hurt by his grasp.

Heart.-Action regular. No bruit. Pulsation in neck.

July 23rd. Observations confirmed at house. Inner side of feet seem to be numb. Pulse 110. Neck pulsation slight. Marked acceleration of pulse after walking a few paces. Temperature 99°.

Case No. 11-July 20th. Lwakaikara. Man of (?) 20; ill six months; at first weakness of legs, afterwards swelling. Able to walk with a stick, resting at intervals.

Legs-Deep edema over tibiæ and feet. Winces on pressure of calf muscles. Knee jerk absent.

39

Heart.-No bruit, action regular; pulse 130. Marked pulsation of carotids. Much itch on hands. Glands in neck not palpable.

July 23rd. Seen at home. Drags feet in walking; walks very painfully. Calves slightly tender. Cannot put one leg over the other when sitting without manoeuvring. Pulse 90. Temperature 100.4°. Muscles of limbs decidedly wasted.

Case No. 12-July 20th. Kainyama. Man, 30 (?).; ill 12 months. with the help of a stick. Complains of palpitation on exertion.

Walks

Legs. No adema. Says calves and thighs are painful. Knee jerk absent. Grasp good.

Heart-Faint systolic bruit heard at left nipple; action regular; 110. July 23rd. Seen at home. Wants help to rise from ground, and walks pain- fully with a stick. Does not mind pressure on calves. No heart signs. Chief com- plaint is of pain in sacral region.

Case 13-July 20th. Kyomya. Man, 35-40; ill 12-18 months. Legs.-Deep edema. Knee jerk faint but present. Grasp good. Heart.-Normal; no symptoms; no muscular tenderness; neck glands not

palpable.

Case No. 15.-Nyomgora. Boy of 10; ill two months. Uses sticks.

Legs. Hard edema over tibiæ; much tenderness of muscles. Knee jerk ? (see below).

Muscles No bruit. Heart-Regular. 150.

Marked pulsation in neck. everywhere seem to be tender. Temperature 102°. Neck glands not palpable.

July 24th. Seen at home. Knee jerk impossible to test satisfactorily, owing to apprehension and tenderness. No edema. Heart's action turbulent; impulse 130. No murmur. Tempera- visible in second, third and fourth spaces left. rature 99.6°.

Case No. 23. July 22nd. Bitamazire. Boy, 15; ill six months. Complains of pain in neck, chest, hips, knees and elbows. Thin.

Legs. No oedema; calves a little tender; knee jerk absent. Grasp fair. Heart.-Visible impulse third, fourth and fifth space left, and fourth and fifth right. Marked pulsation behind insertion of right sterno-mastoid and in neck above. At lower end of sternum a bruit which comes and goes. Pulse 90.

Temperature.-99.9°.

July 24th. Seen at home. Bruit behind sternum all the way down (systolic). Pulse 110. Temperature 99.5°.

Case 24. July 22nd. Lukantanga. Woman, æt. 20; ill seven months. Com- plains of pain in back, chest, hips, and feet. Uses a stick. Walks painfully. Legs. No cedema; calves markedly tender; knee jerk absent. Grasp fair. Heart.-No murmur, action fairly quiet. 100. Pulsation visible in episternal notch. Glands in neck palpable.

Temperature-100.5°. July 24th. Seen at home.

ture 99.9°.

No calf tenderness.

Pulse 120. Tempera-

Case No. 25-July 22nd. Mulinyabigo. Man, æt, 20; ill 12 months, now improving. Pain all over; cannot turn head comfortably; walks with stick.

Knee jerk Legs.-No oedema. Volunteers statement his legs are numb. present. Grasp very strong. Pulse quiet. Glands in neck palpable.

July 24th. Seen at home. Insists on the numbness. Knee jerk very active.

Notes on certain symptoms. Anesthesia. This is difficult to test in the native, especially in the slighter forms: it becomes still more difficult when, as in "Lunyoro, there is

A