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cervical glands. Five of these belonged to the x class, and twenty to the x (sic.), the remaining 96 4 per cent. had palpable but impuncturable glands.

No. 2.-Between the Mansa and Luongo 2,908 natives were examined, of whom 628 had enlarged cervical glands and of whom 40 had puncturable glands. Three fresh cases of sleeping sickness were found.

No. 3.-2,114 persons were examined, showing a percentage of 1125 with enlarged cervical glands. No fresh cases of sleeping sickness were found. Glandular enlargement as an indication of the future incidence of trypanosomiasis. Various tables* showing the relative proportion of palpable glands in natives of these closed areas are attached to this report.

A very great deal of significance has been attributed by Dr. Storrs to the large percentage of enlarged cervical glands found in his district, a much larger propor- tion than has been found in other districts in the closed areas. It is notable, how-

ever, that out of, roughly, eleven thousand persons examined by him only 04 per cent. had puncturable glands.

As a symptom during the early stages of infection with the human trypanosome, glandular enlargement is undoubtedly of great value in diagnosis, but judging from the frequency of similar enlargements in natives of other parts of Northern Rhodesia from which all possibility of trypanosome infection can be excluded, I do not think that Dr. Storrs' statement as to its significance is wholly justified. That villages in which the disease may be said to be endemic and which now show a big percentage of glandular enlargement will in the future provide cases of sleeping sickness is more than probable, but that the frequency of these cases will be represented by the present percentage of enlarged glands I do not think is at all likely.

The real significance of this symptom even in endemic areas will not be fully appreciated until the other causes which may produce it are thoroughly understood and until its seasonal variations have been thoroughly worked out. It is, however, a most useful sign in making a selection in controlling the movements of natives.

In the southern part of the Fort Rosebery Division, between the Mansa and Luera Rivers, 2,114 natives were examined, showing a gland index of 11:25 per cent., or 238 individuals with palpable glands. It is now about three years since fly was first found on this part of the Luapula, and up to quite recently the greater part of these natives lived in actual contact with fly. No case of sleeping sickness has yet been found amongst these people. It seems, therefore, reasonable to suppose that some factor other than trypanosomiasis is responsible for the production of these enlarged glands.

Mr. S. A. Neave, in June, 1908, examining thirteen villages and 1,771 persons in the Lueno district and Lake Bangweolo, found an index of 45 per cent.; in the Chambezi Valley 698 persons with an index of 7 per cent.; and in the Chinsali district and Chambezi River, amongst 2,119 persons, an index of 7 per cent. in the absence of the Glossina palpalis and of all suspicion of sleeping sickness.

Up to the present, more than a year and a half afterwards, no case of the disease has been known to have occurred amongst these people.

General Prophylaxis.

That the system of closed areas and the removal of all natives from the vicinity of fly to fly-free districts, the selection of suitable roads, ferries, &c., for traffic, originated by Dr. Spillane some three years ago, has been amply justified by its results there is no doubt; with the exception of a limited area on the Luapula, where unfortunately some villages still remain much too close to the river, the present position with regard to the spread of the disease is eminently satisfactory, and there does not seem to be any reason whatever to fear that the disease will assume epidemic proportions.

The total number of cases known to have occurred up to the present amounts to some 65 (the population of the closed areas is probably, roughly, 100,000)-a very small fractional percentage as compared with the neighbouring territories in German East Africa [where ?] decimation is admitted, and the Belgian Congo, from which a very considerable incidence of the disease is reported.

There are not, however, signs wanting to show that these measures, satisfactory as they have been in the past, now need some modifications.

Large numbers of natives are leaving the closed areas and seeking work in

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Belgian territory (where unfortunately considerable inducement seems to be offered them to do so). This may probably be looked on as the natural result of continuing to maintain these closed areas as they at present exist, necessitating, as it does, the con- finement of large numbers of natives willing and anxious to work and who fail to appreciate the reason why they are not allowed to do so.

From time to time complaints have been made as to the inertia of the Belgian authorities and the inefficiency of measures taken by them for the control of this disease west of the Luapula and Lake Mweru. It does not seem that these com-

plaints were made without justification. A few instances are cited. There is reason to believe that there are at the present moment several diagnosed cases of sleeping sickness living in a village on the Belgian shore of Lake Mweru, where Glossing palpalis is abundant. There are many Congo villages on the banks of the Luapula where fly are known to be plentiful. Canoes are still allowed, and fishing is still carried on by these natives. There is also, I regret to say, justification for the con- tention put forward by the Belgians, "that the severe measures enacted on paper by the British authorities have not been carried out in practice." (This probably refers to the villages on the north of the Sakaluwa River, on which I have previously reported and which matter will soon be adjusted.) accused of interference with the efficacy of our regulations, it can only be a passive If the Congo authorities can be interference, and does not include the breaking of restrictions imposed by the Administration of North-Eastern Rhodesia. They have taken no active measures to interfere with the regulations in force. successful attempt has been made, not by the Belgian authorities, to upset these Recently, however, a very active and regulations, namely, the efforts made to attract labour from Rhodesia into the Congo territory. It is estimated that 1,000 of the able-bodied men in the Fort Rosebery district and a considerably larger number from further north in the closed area are at present variously employed in the Congo on the mines and as carriers. Notwith- standing regulations to the contrary, food, presumably for the Katanga Mines, is constantly being bought in very large quantities by agents who take up a position on the Congo bank of the river and buy from the other side. This food is probably carried to the mines, through a country and by routes about which there seems to be no means of gaining information but which in all probability are not free from danger. The natives employed at this work have had to cross the Luapula surrepti- tiously, and will have to return in a similar manner, a fact which does not diminish the danger of this crossing. At the completion of the work they will probably be turned loose in the Congo to return how and by what routes they choose.

It is generally believed in Rhodesia that the Star of the Congo Mine, and prob- ably the Ruwe Group, are worked mainly by natives from the Luapula Valley. These appear to be recruited by two well-known native agents working on behalf of a European, who no doubt find it easy to cross the river and evade regulations.

Notwithstanding many offers of help from the Katanga authorities in the past, and promises that every effort would be made by them to aid in the efficient carrying out of our regulations, I regret to have to report that these do not seem to have been enacted in practice. The attitude adopted seems to be utterly devoid of any sympathy with the efforts of North-Eastern Rhodesia in enforcing the Sleeping Sickness Regulations in so far as they deal with the movements of natives from and to the closed areas. The presence of these natives at the Katanga mines seems to be taken as a matter of course, and the regulations adopted for preventing their going there resented. They have even gone so far as to specify what treatment should not be adopted towards natives by the authorities responsible for the main- tenance of these regulations.

A communication has been received from Dr. Pearson, the Principal Medical Officer of the Union Minière du Haut Katanga, on the distribution of Glossina palpalis in the south-eastern part of the Congo Free State, which was accompanied by a copy of a letter from him to M. le Représentant de l'Union Minière, from which the following passage is quoted: "I believe that nothing but good could come of an understanding between the two countries that in matters of sleeping sickness all possible information possible confidence established."

This sentiment I can fully endorse. It should have the effect, in the first place, of ensuring the notification of the return of all cases of trypanosomiasis which may he discovered an the Katanga mines, independent of whether the Katanga authori ties happen to agree with the subsequent treatment of these people or not. It will also, no doubt, aid in the spread of information amongst the Katanga authorities as to what our sleeping sickness boundaries, rules, and regulations are. And thirdly,

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