SANITAKY NOTES. KHARTOUM 
91 
in any one month occurring in December. Here, again, there is no evidence that the Nile 
water is markedly at fault, and the conditions which formerly in large manner determined both 
the presence and the monthly incidence of dysentery in Khartoum are now in part lacking. 
I refer, of course, to the fouling of the surface soil, and to the summer rains. There can be little 
doubt that, given dry conditions, even persistent fouling may produce but little evil results in 
the presence of a powerful and sterilising sun, and personally 1 believe that this partly explains 
why we do not have extensive outbreaks of epidemic disease when the Nile begins to rise. The 
filth and refuse which have accumulated on the sand-banks and foreshore, the deposit of which 
it is very difficult to prevent, has been practically sterilised by the intense heat and light or 
ever it is washed away by the rising river. As the fouling goes on daily, some of it, of course, 
if infected, must he in an infectious condition when carried down stream, but this state 
of things cannot he at all common, especially as regards enteric fever, for, as stated, this 
disease is rare in natives, and it is these who chiefly, under cover of night, use the dry 
river bed as a place of convenience. 
With what has been said on 73 we may conclude this consideration, remembering, 
however, that our efforts must be devoted to combating every faulty sanitary condition, and 
that general statements of the type indicated are to he carefully avoided, or, if made, to be 
adjudged at their proper value. 
Disinfection .— The town possesses a Thresh “ Emergency Disinfector,” but the Sanitary 
Service has permission to employ the steam disinfector at the Military Hospital —a privilege 
of which it has several times availed itself. A Mackenzie spray has also been supplied, and it 
is intended to introduce the knapsack spray as modified by Eobertson. 
When fumigation is required, the formalin and permanganate method with preliminary 
moistening of the atmosphere, is employed. A cart for the conveyance of infected bedding, 
clothing, etc., is in use. 
I believe the introduction of the portable Clayton system would be beneficial, especially as 
the river steamers could be fumigated, and mosquitoes thus destroyed. As a matter of fact, 
we have, as a rule, very little disinfection to perform. 
Vital Sto<i6'<ics. —Unfortunately, under present conditions, it is not possible to present 
statistics which can be considered absolutely reliable. Hence, it is better not to attempt the 
task. It is unfortunate, for nothing better indicates the sanitary growth of a town than a 
series of reliable statistics detailing birth rate, death rate, infantile mortality, and incidence 
of infectious disease. It is hoped ere long that we may be in a position to record these 
properly. At present I can only append the cases of infectious disease notified during the 
years 1904-1907 inclusive, and those for the months of the present sanitary year. Each 
sanitary year commences in October, and I can present the records of the past ten months. 
Of late I have been classifying the returns under the three headings—Civil, Egyptian 
Military, British Barracks. 
Considerations of space prohibit the insertion of the tables of monthly incidence which, 
except in a few instances—enteric, dysentery and diphtheria—are not of special interest. 
Dysentery and 
Dust 
Disinfection 
Vital statistics 
1903- 4 
This was the first year during which notification was in force, and the returns were far 
from reliable. One would only note that 1 case of cerebro-spinal fever and 5 cases of 
diphtheria occui-red. 
1904- 5 
Chicken-pox, 19 (the majority occurring in the Civil Prisons at Khartoum and 
Khartoum North) 
Diphtheria, 4 Hydrophobia, 1 
Dysentery, 12 Measles, 50 
Enteric Eever, 4 Smallpox, 2 
Infectious 
disease 
statistics 
