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Wade's theory that the majority of persons found infected with trypanoso miasis are descendants of slaves imported from the Northern Territories into Ashanti does not seem to me feasible, because (1) this implies hereditary immunity against the disease amongst pure bred Ashantis; (2) on questioning the people in the Northern Province, one person out of every three will reluctantly admit being descended from an ancestor led into captivity.

The greater incidence of the disease in the male sex is puzzling, considering that women, who are the hewers of wood and drawers of water-to say nothing of their doing most of the clothes washing all over West Africa-are exposed to an equal, if not to a greater, extent than men to the attacks of G. palpalis. Todd has pointed out the rarity of the disease in elderly people, suggesting an acquired immunity. Has the female sex a greater immunity than the male?

A. INGRAM, Medical Officer, Sleeping Sickness Duty.

Kintampo, 5th December, 1913.

33713

No. 16.

42069

No. 17.

GOLD COAST.

THE GOVERNOR to THE SECRETARY OF STATE.

(Received 30th October, 1914.)

[Answered by No. 19.]

[Copy to Imperial Bureau of Entomology and to Tropical Diseases Bureau, 18th November, 1914. L.F.] (No. 731.)

SIR,

Government House, Accra, 28th September, 1914. WITH reference to your despatch No 281, of the 5th May,* on the subject of sleeping sickness, I have the honour to enclose, for your information, copies of minutes by the Principal Medical Officer, and by Mr. Fell, Commissioner of the Western Province of Ashanti.

2. Subject to your approval, I do not propose, at the present time, to attempt to bring pressure to bear upon the native population in order to induce them to make clearings round their villages and water supplies. In this connexion I would invite your attention to the opinions on the subject. which are expressed in Mr. Fell's minute mentioned above.

PUBLIC RECORD OFFICE

Reference :-

LHC.O. 885

23 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-

COPYRIGHT PHOTOGRAPH-NOT TO

SIERRA LEONE.

THE SECRETARY OF STATE to THE GOVERNOR.

(No. 427.) SIR,

Downing Street, 10th September, 1914. I HAVE the honour to acknowledge the receipt of your despatch No. 343, of the 17th of June,* and to inform you that, in accordance with your suggestion, the correspondence with the Tropical Diseases Bureau on the subject of sleeping sick- ness in Sierra Leone was communicated to Dr. Rice, with the request that he would discuss the matter with Dr. Bagshawe.

2. As the result of a recent discussion, Dr. Rice and Dr. Bagshawe have drawn up the joint statement of which a copy is enclosed, and which, they agree, represents the opinion at which they arrived.

I have, &c.,

Enclosure in No. 16. STATEMENT.

L. HARCOURT.

"We do not regard the matter as one of great urgency, but are of opinion that when a suitable man can be found one should be sent (out) to investigate the incidence of the disease throughout the Colony and Protectorate, the investigator to be either a member of the West African Medical Staff or some other suitable man appointed for the purpose.

In the meantime our actions should be confined to offering curative treatment to those who are willing to accept it, and, whilst every effort should be made to ascertain the extent to which the disease is prevalent, great care should be taken to ensure that nothing is done to arouse the suspicion or resentment of the natives-- such, for instance, as compulsory segregation-a contingency that might. handicap our future efforts, both in the direction of prophylaxis and treatment.

"With regard to the possible establishment of a voluntary segregation area at the Cape sanitary station, we are agreed that when funds permit an attempt might be made to clear this area of 'fly," but that such work should only be attempted under the direction on the spot of experts who have had experience of such work.'

* Not printed.

I have, &c.,

HUGH CLIFFORD,

Governor.

Enclosure 1 in No. 17.

MINUTE BY THE PRINCIPAL MEDICAL OFFICER (DR. HOPKINS).

HONOURABLE Colonial SecrETARY,

In reply to (a), (b), (c), (d), (e), and (f) of Dr. Bagshawe's letters, I beg to reply as follows:

2. (a) and (d) North Country Natives Chiefly Infected. Further inquiries on this point I hope to have made in 1915, if the staff will permit of it, which does not appear likely at the present crisis.

3. (b) Immunity of Gaman Cattle. The very interesting report of the Veterinary Officer in North-West Ashanti makes no reference to these herds except that they appeared to thrive, although in-breeding was common. See paragraph 14 of the report.

4. (c) and (e) Prophylactic Measures. We have fairly accurate figures relating to sleeping sickness dating back to 1910, and the evidence goes to show the disease is not on the increase. Clearing round towns and villages are the prin- cipal prophylactic measures for adoption, but, as pointed out by His Excellency the Governor, great hardship would be inflicted by their adoption if rigidly

enforced.

5. A Further Examination of North-West Ashanti-This should be made in two or three years, but in the meantime the travelling Medical Officer will, I hope, be able to do good work, and as Dr. Ingram has signified his willingness to undertake the work, we may be assured of valuable results.

F. G. H., Principal Medical Officer.

7th September, 1914.

* No. 12.

D 2