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سلاسلسا

PUBLIC

RECORD OFFICE

Reference :-

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

9 PUBLIC RECORD OFFICE, LONDON

by mere palpation enlarged cervical glands are readily detectable even by non- professional persons.

If their claim is to be accepted, some such scheme as that advocated by them might, however costly, and however disturbing of trade and of administration generally, be worthy of trial. It would entail procedure as follows:-

(a) Need to regard as

glands.

;

"

46 infected all persons exhibiting enlarged cervical

(b) Establishment on a plurality of trade routes of posts of observation whereat all natives travelling from an infected towards non-infected areas might be tested as to whether or not their cervical glands were enlarged. (c) Arrest of persons found at such posts of observation to be exhibiting enlarged cervical glands and relegation of such persons to already infected districts, with a view to incarcerating them there until they died eventually of sleeping sickness or of some other disease.

The magnitude of the operations thus indicated may be judged of from the circumstances that of 3,817 persons "palpated" by Drs. Todd and Dutton no less than 1,662 (above 40 per cent.) were found to have their cervical glands enlarged in greater or less degree, viz., 57 per cent. of persons in infected, and 35 per cent. of persons in uninfected, localities.

The fact that 35 per cent. of persons in uninfected localities exhibited enlarged cervical glands is a surprising circumstance, and unquestionably it invalidates the conclusion provisionally arrived at by these observers, viz., that the greater majority of cases of enlarged cervical glands in apparently healthy negroes mean trypanoso- miasis. It is true that the persons in question exhibited enlargement of cervical glands in minor degree only. But so did some 40 per cent. of persons "palpated in heavily infected localities. The outcome, therefore, of the more extended obser- vations of Drs. Todd and Dutton is that in Congo country a minor degree of enlargement of cervical glands is no certain criterion of trypanosomiasis.

This later ascertained fact has an important bearing administratively. For unless it be practicable to distinguish among persons, the subjects of minor enlarge- ment of cervical glands, individuals in a stage of incipient trypanosomiasis from individuals entirely free from such malady, there would be risk, on the one hand, of sending absolutely healthy people to sleeping sickness segregation camps, and, on the other, of permitting persons destined to develop trypanosomiasis to pass to, and roam freely within, uninfected areas. As a corollary, therefore, to the particular measures advocated, additional segregation camps would be necessary on trade routes for the purpose of keeping doubtful cases under sustained observation until it could be determined whether or not they were the subjects of trypanosomiasis. The establishment and the "policing" of these additional segregation camps would probably increase materially the difficulties and the costliness of administration undertaken in suppression of trypanosomiasis.

Upon the whole it may be doubted whether measures to the above end of the sort and on the scale advocated by Drs. Todd and Dutton are, in the present state of knowledge of the subject, sufficiently warranted.

August 1, 1906.

26615

No. 62.

W. H. POWER.

COLONIAL OFFICE to LIVERPOOL SCHOOL OF TROPICAL MEDICINE. SIR,

Downing Street, August 3, 1906. I AM directed by the Earl of Elgin to inform you, with reference to your letter of the 20th of July, that the question of the measures to be taken to combat sleeping sickness in Uganda is receiving his earnest consideration, and that a further communication on the subject will be sent to you as soon as practicable.

I am, &c.,

• No. 60.

R. L. ANTROBUS.

29107

SIR,

No. 63.

TREASURY to COLONIAL OFFICE.

(Received August 8, 1906.)

Treasury Chambers, August 7, 1906. I HAVE laid before the Lords Commissioners of His Majesty's Treasury Mr. Antrobus's letter (24017/1906) of the 23rd ultimo,* as to the printing of future reports on the investigation of sleeping sickness.

In reply I am to request you to inform the Earl of Elgin that, having regard to all the circumstances, My Lords are willing that, so long as the investigation is continued on the present lines, the printing of future reports shall be undertaken by the Stationery Office, at the cost of Imperial funds.

Their Lordships regret, however, to be unable to sanction the employment for this purpose of contractors who are not on the list of contractors for the Stationery Office.

Subject to the foregoing paragraph, the printing of the report now in tion may be undertaken by the Stationery Office. But the cost of any work for this prepara- report (and this report only) which has already been entrusted to an outside firm should be defrayed from Protectorate funds.

I am,

&c.,

29259

SIR,

No. 64.

G. H. MURRAY,

DR. R. N. MOFFAT to COLONIAL OFFICE. Received August 9, 1906.)

Knockholt, Kent, August 7, 1906. In reply to your letter, No. 26196, dated August 2nd, 1906,† with regard to the proposed removal of Entebbe, I beg to state that, in my opinion, the question is certainly one which merits consideration. In the following remarks I shall confine myself entirely to the sanitary aspect of the case, while assuming that a port on the lake is essential.

In the present state of our knowledge the facts are as follows:-

(1.) Sleeping sickness is an incurable disease caused by a micro-organism (the trypanosome), which is transmitted to man through the agency of a species of tsetse-fly (Glossina palpalis).

The disease is now endemic in certain parts of Uganda, its distribution corre- sponding with that of the fly, which latter is so far only found in certain fairly- defined areas, such as the islands, and the vicinity of the lake shore and of the larger streams flowing in or out of the lake.

No certain methods are known for exterminating or diminishing the fly in these areas.

(2.) The only logical conclusion from the foregoing is that regions where Glossina palpalis exists are unsuitable for human beings, and that such regions should be avoided.

(3.) If such a procedure could be rigidly carried out, it is conceivable that in ten years' time the disease might have disappeared. Yet it should be remembered that the wild animals on which the tsetse-fly would feed in the absence of man, may possibly harbour the trypanosome which is so fatal to man, and if this be so the evacuation of the infected area would not achieve the desired result.

It does not seem advisable to attempt such a difficult and radical measure when there is an element of doubt as to its utility, not to speak of the fact that the whole economic development of the country is dependent upon the waterway afforded by the Victoria Lake.

• Not printed.

† 26196: not printed.

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