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SLEEPING SICKNESS ON THE LUALABA RIVER, CENTRAL AFRICA.
908
1907). 4th Volunteer Battalion the Durham Light Infantry: The undermentioned to be Second Lieutenant: Ernest George Dryden Benson (late Surgeon-Lieutenant) (dated Jan. 15th, 1907). ROYAL ARMY MEDICAL CORPS (VOLUNTEERS). London District :London Companies : Harold Arthur Thomas Fairbank to be Lieutenant (dated March 1st, 1907). Jan. 21st,
INDIAN MEDICAL ARRANGEMENTS. The Standard of March 25th states that Lord Kitchener has decided to reorganise the paid appointments to staff surgeoncies and hospitals among officers of the Royal Army Medical Corps and those of the Indian Medical Service. The establishments will be altered to secure better coördination and working, especially in the north, and the new allotment comes into force on Monday next." THE NEW ARMY SCHEME. Mr. Haldane is indefatigable in his endeavours to render his new schemes for the creation of a really national army a For this purpose he knows a territorial army to be success. absolutely essential and that everything turns upon the willingness of the nation to provide it. The question yet to be answered experimentally is whether the number of men required will be forthcoming. The subject has a hygienic and physical health side to it of a very important kind upon which we have previously commented. Mr. Haldane concluded his recent speech at the Guildhall, when he distributed the prizes to a cadet battalion of the King’s Royal Rifle Corps, by taking up a position for which we have always contended. " Could anyone look upon a first-rate cadet corps without feeling that every young man in it was better and stronger morally and mentally for the discipline to which he had voluntarily subjected himself ? It helped him in life, it helped him in his employment; it helped him to be a better citizen, and fitted him not only for military but civilian duties. From every point of view the cadet corps was a thing to be encouraged in the interests of the nation."
and eight had enlarged glands but not so characAt Pengi 30 out of 50 were found with enlarged glands. At Lambula 25 out of 35 were with enlarged cervical glands. At Karu on Lake Kavele, 15. miles west of the Lualaba, I found 20 per cent. of the people with typical glands. The examination of 129 carriers from Lake Kasali showed 11 per cent. to be infected. The conclusion to be drawn from these observations is that the district is heavily infected. After removing all apparent sources of error it appears on a conservative estimate that at least between 40 and 50 per cent. of the inhabitants have trypanosomiasis. This represents a slightly heavier infection than Dr. Dutton and Dr. Todd found in the districts 200 miles north of this. As before mentioned, the natives themselves recognise sleeping sickness as a new disease. It was also noted above that Dr. Todd had examined at Cabinda two years ago a number of porters from Lake Kasali, but he failed to find in them any indication of trypanosomiasis. It seems, therefore, probable that the disease was not introduced earlier than three years ago at the longest. Dr. Todd mentions that the disease was first noticed at Cabinda in 1900. The mode of introduction seems evident. The Lake Kasali people have for some years carried on an extensive trade in dried fish with Cabinda, 200 miles north. They catch the fish, dry it, and carry it to Cabinda, where they find a ready sale. These carriers have contracted the disease at Cabinda and have been the means of infection on Lake Kasali and the River Lualaba to the south. That it has been introduced in any other way seems improbable, as the Kasali people do not visit any other possible source of
Correspondence. 11 Audi alteram partem."
SLEEPING SICKNESS ON THE LUALABA RIVER, CENTRAL AFRICA. To the Editors of THE LANCET.
SIRS,-Early in the year 1905 Dr. Dutton and Dr. Todd visited the Upper Congo as far as 6° S. Lat. In their valuable report1 they give Buli as the most southern point of infection Buli is on the Lualaba river, 60 miles on the Upper Congo. south of Kasongo and about 5° 30’ S. Lat. Some native porters from Lake Kasali, 200 miles farther south, were
examined but no indications of sleeping sickness were evinced. It was supposed, therefore, that the disease at that time had not extended farther south on the Lualaba than Buli. In August of last year I received a communication from Mr. J. H. Hayes, who was travelling from Lake Kasali southward for 100 miles, stating that the Baluba people in the villages along the Lualaba appeared to be dying in increased numbers and from a disease quite unknown to the people themselves. He believed that it might be sleeping sickness as some of them evinced those symptoms. In October I proceeded to this district on a tour of investigation. At Wundwi, which is a short distance below the Kalenge Rapids on the Lualaba River, and about 100 miles south of Lake Kasali, I found by microscopic examination of cervical gland fluid that 70 per cent. of those examined were infected with trypanosomes. Adults and children alike were inThe women and children were probably more fected. commonly infected than the men. The old people seemed to be more or less free. These proportions as to age applied to all the villages visited. At the Congo Post of Bukama, of 45 soldiers from all parts of the Congo State, ten were shown to harbour the organisms in their cervical glands. Of 20 workers from the surrounding district five were infected. At Tengalonzi, opposite the 1 Memoir xviii., the Liverpool School of Tropical Medicine, March 1906.
Post, of 50 examined 40 showed unmistakable glands by
palpation teristic.
infection. This is the first year that the natives have noticed an increased mortality in their villages. Moreover, they have observed that this increase is only in the villages along the river. Hence, quite on their own initiative they are beginning to move their villages to locations inland. The southern limit of the disease at present seems to be the Kalenge Rapids, about 90 15’ S. Lat. That the disease has not already spread farther south is no doubt due to the fact that the people below the Rapids have practically no intercourse with those above. The glossina palpalis.-The fly was noticed all along the river where the disease was prevalent. It has also been found at the following places which are as yet free from infection. At the junction of Lufupa and Lualaba rivers; on the Mukulezhi river at about 10° 40’ S. Lat.; on the west side of Lake Mwern; at the junction of the Dikulwe with the Lufira river ; on the SouthKaluli river ; on the Luapula river, 10° 29’ S, Lat. (Mr. Arthur Pearson) ; and on the Fwalendesi river. Active measures are being taken to prevent the spread of the disease southward. Posts of inspection are established on the main trade routes and it is believed that much can be At least its advance can be done to stay its progress. much delayed, possibly until such time as a cure may be I am, Sirs, yours faithfully, discovered. A. YALE MASSEY, B.A., M.D. Tor., Medical Officer, Tanganyika Concessions, Limited, Central Africa.
Ruwe, Congo
Free
State, Jan. 22nd, 1907.
ALBINISM IN MAN. To the Editors of THE LANCET. SIRS,-On looking into the various hereditary conditions
which affect man for one which would lend itself to the application of Mendelian methods of investigation that of albinism appealed to me as the most suitable for my purposes. The condition is a striking one, such as may reasonably be expected to impress even the most casual observer, and its occurrence at any time in a family would be a circumstance not likely to be soon forgotten. No estimate that I know of has yet been made as to the frequency with which it occurs in the general population, but it is at least sufficiently common to provide satisfactory data for work such as this. The condition in itself does not call for description for purposes of identification, but when dealing with a subject about which so little is known it may be as well to venture on a description of what I take to be the type. In the first place, then, in the typical human albino the skin is of a, uniform milky colour, except in those parts where the epidermis is thin, allowing the vessels underneath to show through in a highly characteristic manner. The hair system
1907). 4th Volunteer Battalion the Durham Light Infantry: The undermentioned to be Second Lieutenant: Ernest George Dryden Benson (late Surgeon-Lieutenant) (dated Jan. 15th, 1907). ROYAL ARMY MEDICAL CORPS (VOLUNTEERS). London District :London Companies : Harold Arthur Thomas Fairbank to be Lieutenant (dated March 1st, 1907). Jan. 21st,
INDIAN MEDICAL ARRANGEMENTS. The Standard of March 25th states that Lord Kitchener has decided to reorganise the paid appointments to staff surgeoncies and hospitals among officers of the Royal Army Medical Corps and those of the Indian Medical Service. The establishments will be altered to secure better coördination and working, especially in the north, and the new allotment comes into force on Monday next." THE NEW ARMY SCHEME. Mr. Haldane is indefatigable in his endeavours to render his new schemes for the creation of a really national army a For this purpose he knows a territorial army to be success. absolutely essential and that everything turns upon the willingness of the nation to provide it. The question yet to be answered experimentally is whether the number of men required will be forthcoming. The subject has a hygienic and physical health side to it of a very important kind upon which we have previously commented. Mr. Haldane concluded his recent speech at the Guildhall, when he distributed the prizes to a cadet battalion of the King’s Royal Rifle Corps, by taking up a position for which we have always contended. " Could anyone look upon a first-rate cadet corps without feeling that every young man in it was better and stronger morally and mentally for the discipline to which he had voluntarily subjected himself ? It helped him in life, it helped him in his employment; it helped him to be a better citizen, and fitted him not only for military but civilian duties. From every point of view the cadet corps was a thing to be encouraged in the interests of the nation."
and eight had enlarged glands but not so characAt Pengi 30 out of 50 were found with enlarged glands. At Lambula 25 out of 35 were with enlarged cervical glands. At Karu on Lake Kavele, 15. miles west of the Lualaba, I found 20 per cent. of the people with typical glands. The examination of 129 carriers from Lake Kasali showed 11 per cent. to be infected. The conclusion to be drawn from these observations is that the district is heavily infected. After removing all apparent sources of error it appears on a conservative estimate that at least between 40 and 50 per cent. of the inhabitants have trypanosomiasis. This represents a slightly heavier infection than Dr. Dutton and Dr. Todd found in the districts 200 miles north of this. As before mentioned, the natives themselves recognise sleeping sickness as a new disease. It was also noted above that Dr. Todd had examined at Cabinda two years ago a number of porters from Lake Kasali, but he failed to find in them any indication of trypanosomiasis. It seems, therefore, probable that the disease was not introduced earlier than three years ago at the longest. Dr. Todd mentions that the disease was first noticed at Cabinda in 1900. The mode of introduction seems evident. The Lake Kasali people have for some years carried on an extensive trade in dried fish with Cabinda, 200 miles north. They catch the fish, dry it, and carry it to Cabinda, where they find a ready sale. These carriers have contracted the disease at Cabinda and have been the means of infection on Lake Kasali and the River Lualaba to the south. That it has been introduced in any other way seems improbable, as the Kasali people do not visit any other possible source of
Correspondence. 11 Audi alteram partem."
SLEEPING SICKNESS ON THE LUALABA RIVER, CENTRAL AFRICA. To the Editors of THE LANCET.
SIRS,-Early in the year 1905 Dr. Dutton and Dr. Todd visited the Upper Congo as far as 6° S. Lat. In their valuable report1 they give Buli as the most southern point of infection Buli is on the Lualaba river, 60 miles on the Upper Congo. south of Kasongo and about 5° 30’ S. Lat. Some native porters from Lake Kasali, 200 miles farther south, were
examined but no indications of sleeping sickness were evinced. It was supposed, therefore, that the disease at that time had not extended farther south on the Lualaba than Buli. In August of last year I received a communication from Mr. J. H. Hayes, who was travelling from Lake Kasali southward for 100 miles, stating that the Baluba people in the villages along the Lualaba appeared to be dying in increased numbers and from a disease quite unknown to the people themselves. He believed that it might be sleeping sickness as some of them evinced those symptoms. In October I proceeded to this district on a tour of investigation. At Wundwi, which is a short distance below the Kalenge Rapids on the Lualaba River, and about 100 miles south of Lake Kasali, I found by microscopic examination of cervical gland fluid that 70 per cent. of those examined were infected with trypanosomes. Adults and children alike were inThe women and children were probably more fected. commonly infected than the men. The old people seemed to be more or less free. These proportions as to age applied to all the villages visited. At the Congo Post of Bukama, of 45 soldiers from all parts of the Congo State, ten were shown to harbour the organisms in their cervical glands. Of 20 workers from the surrounding district five were infected. At Tengalonzi, opposite the 1 Memoir xviii., the Liverpool School of Tropical Medicine, March 1906.
Post, of 50 examined 40 showed unmistakable glands by
palpation teristic.
infection. This is the first year that the natives have noticed an increased mortality in their villages. Moreover, they have observed that this increase is only in the villages along the river. Hence, quite on their own initiative they are beginning to move their villages to locations inland. The southern limit of the disease at present seems to be the Kalenge Rapids, about 90 15’ S. Lat. That the disease has not already spread farther south is no doubt due to the fact that the people below the Rapids have practically no intercourse with those above. The glossina palpalis.-The fly was noticed all along the river where the disease was prevalent. It has also been found at the following places which are as yet free from infection. At the junction of Lufupa and Lualaba rivers; on the Mukulezhi river at about 10° 40’ S. Lat.; on the west side of Lake Mwern; at the junction of the Dikulwe with the Lufira river ; on the SouthKaluli river ; on the Luapula river, 10° 29’ S, Lat. (Mr. Arthur Pearson) ; and on the Fwalendesi river. Active measures are being taken to prevent the spread of the disease southward. Posts of inspection are established on the main trade routes and it is believed that much can be At least its advance can be done to stay its progress. much delayed, possibly until such time as a cure may be I am, Sirs, yours faithfully, discovered. A. YALE MASSEY, B.A., M.D. Tor., Medical Officer, Tanganyika Concessions, Limited, Central Africa.
Ruwe, Congo
Free
State, Jan. 22nd, 1907.
ALBINISM IN MAN. To the Editors of THE LANCET. SIRS,-On looking into the various hereditary conditions
which affect man for one which would lend itself to the application of Mendelian methods of investigation that of albinism appealed to me as the most suitable for my purposes. The condition is a striking one, such as may reasonably be expected to impress even the most casual observer, and its occurrence at any time in a family would be a circumstance not likely to be soon forgotten. No estimate that I know of has yet been made as to the frequency with which it occurs in the general population, but it is at least sufficiently common to provide satisfactory data for work such as this. The condition in itself does not call for description for purposes of identification, but when dealing with a subject about which so little is known it may be as well to venture on a description of what I take to be the type. In the first place, then, in the typical human albino the skin is of a, uniform milky colour, except in those parts where the epidermis is thin, allowing the vessels underneath to show through in a highly characteristic manner. The hair system