CO885-(20-21) — Page 23

PUBLIC RECORD OFFICE

Reference:

لنسائي

C.O.

885

20 PUBLIC RECORD OFFICE, LONDON

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

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Enclosure 4 in No. 2.

SAM. K. NORRIS, Acting Principal Medical Officer, Zomba, to the Honourable the DEPUTY GOVERNOR, Zomba.

November 2nd, 1902,

* SIR,

I HAVE the honour to submit the following report received this morning from Dr. Davey, the medical officer engaged on sleeping sickness investigations :-

He reports that on October 12 he found a native of Chibwana's village, between Chintechi and Nkata Bay, to be suffering from human trypanosomiasis. He was unable to find the parasites in the blood, and they were also scanty in the posterior cervical glands, which he punctured. The glands would come under class +, but were not greatly enlarged. The native informed him that he had gone to Tangan- yika and down the Congo with a Captain Daniel and came home by steamer viâ Cape Town; he has been back in his village for one year and makes no complaint of past or present ill-health. Temperature, 98.8; pulse, 100; slightly irregular in rhythm; no oedema. He appears to be in good health. He was sent, with an Askari, to Chintechi pending instructions. The boy stated that a Yao from Fort Johnston named "Wilson" accompanied him on his journey to the Congo.

On receipt of Dr. Davey's telegram, Captain Hardy was instructed to proceed at once to Chintechi, take over the charge of the patient and isolate him near Dowa, where it has been decided to form a central Sleeping Sickness Segregation Hospital. He will there undergo treatment with atoxyl and mercury.

Dr. Davey goes on to say that he is continuing his journey, but owing to the density of the population along the lake shore his progress is somewhat slow, as he is endeavouring to thoroughly examine all natives on the way. He suggests an examination of "Wilson" being made.

On the receipt of Dr. Davey's telegram on October 12th I at once communicated with the medical officer, Fort Johnston, in whose district "

"Wilson 22 to be living.

was supposed

On Friday last the medical officer, Fort Johnston, reported that he had heard that "Wilson" was drowned; this morning he informs me that he has received reliable information that "Wilson" was not drowned but died two months ago, after three days' illness, with swelling of the legs.

The medical officer, Fort Johnston, also reports that on Thursday last he received a visit from Dr. Brener, of the German Sleeping Sickness Commission, who informed him that he had explored the German coast of Nyasa and had failed to find tsetse fly of any species at any point along that coast.

In a letter received this morning from Captain Hardy, Sleeping Sickness Camp, Dowa, he reports the sleeping sickness patient to be in robust health. he has confirmed the diagnosis he is commencing treatment with mercury and As soon as atoxyl, and will send reports from time to time.

I have, &c.,

SAM, K. NOrris,

Acting Principal Medical Officer.

Enclosure 5 in No. 2.

SAM. K. NORRIS, Acting Principal Medical Officer, Zomba, to the Honourable the DEPUTY GOVERNOR, Zomba. SIR,

28th October, 1908.

I HAVE the honour to submit the following: At the time I submitted my last letter, of date October 16th, dealing with measures to be adopted against sleeping sickness, the whole question, as far as I could judge from the different reports and writings on the subject to which I had access, and lacking all personal acquaintance with the disease, seemed to me a very delicate one on which to form definite opinions. G. palpalis was not known to be present in this country, on the other hand Gl. morsitans was widely distributed, and other species of Glossina, including Gl. fusca, had been found. One case of sleeping sickness had been reported on the lake shore. The report of the Sleeping Sickness Commissioners

Native policeman.

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sent to North-Eastern Rhodesia to study the disease laid great stress on three points connected with the transmission of the disease which very sensibly influenced my opinion:-

1. The only known method of transmission is mechanical.

2. G. palpalis and G. fusca can transmit the disease.

3. At present all other species of Glossina must be regarded with equal

suspicion.

Also I had not on that date read the last report on the epidemic in North- Eastern Rhodesia. Tanganyika I knew, from Dr. Kinghorn's report, was prob- ably heavily infected, but what measures had been taken by the North-Eastern Rhodesian authorities in that region I did not know accurately.

Since that date I have gained a more comprehensive view of the whole situation, chiefly from the following sources :---

1. The conference held in your office, when Dr. Spillane explained the posi- tion in North-Eastern Rhodesia and the measures adopted in that country,

2. From interviews and conversations I had with Dr. Spillane on this subject, when he kindly gave me the result of his twelve months' personal experience in dealing with the disease and the conclusions he had arrived at as the result of that experience.

3. A study of Dr. Spillane's last report, with such annotations on the different

points mentioned therein as he had verbally given me.

For several days past I have been engaged in mentally classifying the different facts thus presented; I have considered the matter from all points in relation to this country, and have arrived at the following general conclusions :—

I. That our greatest danger of infection is from the Tanganyika region, through both German and British territories, to the north end of Nyasa.

II. That our first line of defence must be the measures adopted in North- Eastern Rhodesia. If these measures are efficiently carried out and if they meet with the success which the present state of our knowledge sickness warrants, this line of defence from the position of the Protectorate in relation to North-Eastern Rhodesia, must for some time to come also be our chief one. regard to sleeping III. That between the endemic sleeping sickness areas and this country we have an extensive "guard" area, formed naturally by the whole of North-Eastern Rhodesia, outside the sleeping sickness boundary as laid down by the North-Eastern Rhodesia Administration. This "guard" area has been definitely stated to be free from Gl. palpalis.

IV. That our security becomes lessened in those localities where this country approaches nearest to the endemic areas, and especially at those points where native roads lead from these areas into this country. In these localities protection given by this natural "guard" area gradually diminishes until, where it joins German territory, it becomes nil. Therefore the chief point of danger is the boundary between this country and German territory, the conditions of which both as regards the distribution of Gl. palpalis and the extent of the endemic, and also as to the measures adopted, we are quite in the dark.

V. That we must therefore form a second line of defence in those localities; which means that our chief protective measures must be concentrated in the Karonga district, and that these measures should be as effective and as absolute as possible.

VI. That inside our own boundaries our chief work should be:-

1. The segregation of all imported cases; this must be done by the establish- ment of a segregation camp, and the systematic palpation, with puncture where necessary, of the natives of those districts where our knowledge of the local conditions points to their presence.

2. To investigate systematically and accurately the distribution of the Glossina, and especially to determine whether Gl. palpalis (the only species which up to the present has been incriminated as a natural carrier) is present. On this latter point conclusive evidence must be forthcoming without delay, if necessary by searching localities again and again.

3. If Gl. palpalis is found, to remove all villages outside the range of this fly immediately. This is the most important of all preventive measures to be adopted.