CO885-9 — Page 312

PUBLIC RECORD OFFICE

Reference :-

885

9 PUBLIC RECORD OFFICE, LONDON

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am directed by the Secretary of State for India in Council to forward, for submission to the Secretary of State for the Colonies, a copy of a letter from the Government of India regarding the proposed recognition of the services of Captain E. D. W. Greig, I.M.S., in the investigation of sleeping sickness in Uganda.

SIR,

Enclosure in No. 51.

No. 37 of 1905. GOVERNMENT of India.

HOME DEPARTMENT. Sanitary.--Medical.

I have, &c.,

A. GODLEY.

Calcutta, December 7, 1905. Wгrи reference to your revenue despatch, No. 152, dated the 15th September, 1905, we have the honour to state that Captain Greig, I.M.S., is not at present eligible for accelerated promotion, while we cannot consider that the services which he ren- dered in connection with the investigation of sleeping sickness were of such a nature as to be suitably rewarded by brevet promotion under the terms of the Royal Warrant of 1903. In our opinion recognition by the Royal Society itself, under whose direction Captain Greig was employed, would be the most appropriate reward for the work which he has done, and we would ask that this be suggested to the Society.

To the Right Honourable

St. John Brodrick.

His Majesty's Secretary of State for India.

15690

No. 52.

We have, &c.,

MINTO. KITCHENER. A. T. ARUNDEL.

DENZIL IBBETSON.

H. E. RICHARDS.

J. P. HEWETT.

E. N. BAKER.

C. H. SCOTT

THE LIVERPOOL SCHOOL OF TROPICAL MEDICINE to COLONIAL

OFFICE.

(Received May 3, 1906.)

[Answered by Nos. 54 and 68.]

B 10, Exchange Buildings, Liverpool, May 2, 1906.

MY LORD,

I AM directed by the Liverpool School of Tropical Medicine to transmit, for the use of your Department, the accompanying draft report on the subject of the danger of the spread of sleeping sickness in Africa, which has been drawn up by the staff of the school.

I am respectfully to ask that the recommendations made therein may receive the earliest consideration of His Majesty's Government.

I regret I am not yet in a position to send you a copy of Memoir XVIII. referred to in the report, as it is still in the printers' hands, but as soon as it is ready copies will be sent to you.

I have, &c.,

A. H. MILNE.

1.

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Enclosure in No. 52.

THE PREVENTION OF THE SPREAD OF SLEEPING SICKNESS.

'Sleeping sickness," or human trypanosomiasis, has become very wide- spread, especially in Equatorial Africa. It is still advancing with alarming rapidity and may be expected to spread to the limit of the distribution of the tsetse-fly which transmits it.

The red areas charted on the accompanying map* represent districts in which the disease is known to exist.

2. The history of the various epidemics of this disease show that it spreads comparatively slowly from an infected area, but may be carried with great ease by infected persons to localities where it did not previously exist.

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In the Congo Free State it is, for example, along the main trade routes that the disease has extended. On the map red dots indicate a few of the posts, in uninfected districts, at which imported cases of "sleeping sickness' have been observed. All of these patients were soldiers, labourers, or their wives brought long distances from their homes, as a direct result of the opening up of the country by Arabs and Europeans.

3. The extension of human trypanosomiasis may, therefore, be checked by preventing infected persons from entering districts where the disease does not

occur.

4. It has been shown that:-

(a) In apparently healthy negroes, in the earliest stages of human trypano- somiasis, the presence of the causative parasite,_Trypanosome gam- biense, may be detected by the palpation and puncture of the lymphatic glands.

(b) In practice, every negro whose neck glands are enlarged, without obvious cause, must be considered to be a case of trypanosomiasis until the contrary is proved.

5. Good results may be expected from the serious application of quarantine measures dependent for their efficiency upon cervical gland palpation.

6. The measures recommended are briefly :-

(a) The establishment of medical posts of inspection along the trade routes

leading from infected to uninfected districts.

(b) The removal of infected persons from posts in uninfected districts to

places already infected.

7. If success is to be obtained the application of these measures must be thorough. The details of the way in which they are to be made effective must be left to those who are to administer them.

It may be suggested that in most instances it will be impossible for the existing medical officers to enforce such measures in addition to performing their ordinary duties. The situation is quite serious enough to require the whole attention of special medical officers aided by competent staffs.

8. As an example of the applicability of the proposed measures consider the case of Nyassa-land.

It is certain (see map) that the natives of the southern as well as of the northern shores of Lake Tanganyika will shortly be very heavily infected with trypano-

somiasis.

Labourers are engaged from the neighbourhood of Tanganyika to work in Nyassa-land. There is constant communication between these two districts, since one of the most important caravan routes to Central Africa runs between Lake Nyassa and Lake Tanganyika. It is, in the opinion of the school, only a question of months before imported cases of the disease will be reported from Nyassa-land.

It is evident that the communication between these two areas should be stringently controlled.

Posts of inspection should be established to prevent infected porters, in cara- vans, or labourers from entering the country. Every employer of labour must be made to understand the danger of enlarged neck glands and instructed to send

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