96 
SLEEPING SICKNESS 
Gland 
puncture 
Blood 
examinations 
Local 
conditions 
Preventive 
measures 
distances from the nearest palpalis area and snrronnded by a zone of cleared ground. The 
presence of these flies in such places should, perhaps, he regarded as accidental, and the flies 
seen have probably developed from pupse which may have been carried up in the roots of 
grass used for repairing the roofs of houses, or brought up from a palpalis area in some 
other way. 
P). The Existence, on otherwise, of Sleeping Sickness in the 
Bahr-El-Gh.\zal Province 
Captain Ensor’s investigations extended over a period of eleven months and he 
examined over 4000 natives living in the districts adjacent to the Congo Free State and 
French Congo frontiers. Of these only nine were found to be suffering from a suspicious 
enlargement of cervical glands. Puncture was performed in four of these cases with 
negative results. He notes the presence of a slight enlargement of cervical glands in 
natives due to the irritation of pediculi. 
Blood examinations were conducted and careful enquiries made amongst chiefs and 
others. It was found that cases of sleeping sickness had occurred at the Sudan posts, 
occupied until recently by Congolese troops, and Captain Ensor believes that it is only too 
probable that some of our natives have acquired infection. At the same time he concludes 
by saying that the question as to whether sleeping sickness exists at the present time in the 
Bahr-El-Ghazal cannot be answered either in the affirmative or in the negative. 
C. The Probability, or otherwise, of Sleeping Sickness becoming 
PREVALENT IN THE B A H R-E L-G H A Z A L PROVINCE 
Captain Ensor believes the disease will probably be introduced from the Congo Free 
State and not from the French Congo or the Lado Enclave. 
He points out that there is a wide tract of uninhabited country between the latter and 
the Bahr-El-Ghazal, while, as regards the French Congo frontier, the tribes are still 
independent and probably limit all intercourse with their neighbours to occasional raids 
upon them. 
On the other hand, inter-trihal intercourse between the southern Bahr-El-Ghazal and 
the Congo Free State is common, and has also developed in the Bahr-El-Ghazal owing to 
the more settled conditions which now prevail and the forward march of civilisation. He 
notes that there is no natural barrier and confirms the view I advanced in the Second 
Report of these laboratories. 
D. Preventive Measures 
Captain Ensor concludes with a valuable section on this important subject. As the 
measures advocated are for tlie most part those in vogue in Uganda and elsewhere, one need 
only mention his suggestion to instruct the chiefs and sultans in the southern parts of the 
province and to pay them yearly subsidies on condition that they keep the watering places 
near their villages free from trees and scrub, and that they immediately report all susiiicious 
cases to the nearest Government official. 
Regulations for carriers are put forward and the building of rest-houses in appropriate 
situations is advocated. The abandonment of certain posts is recommended, and the 
appointment of a British Medical Officer in the Southern Bahr-El-Ghazal, to superintend 
operations, is strongly urged. Altogether, there can be no doubt that Captain Ensor’s report 
will prove most useful to those responsible for safe-guarding the province from the invasion 
and spread of a justly dreaded disease. 
