144 KALA-AZAE COilMISSION 



was fiee of charge. Oue is in most cases met immediately with the reph' " Qulliiia 

 shudad, bi Amanillah" (We are all well, God be praised), but a walk through the village and 

 conversation with the people soon overcomes their fear of the Tourk. One finds that all the 

 maimed, the halt, and the blind, are first .sent to see what effect the " Dawa el tourkowi " 

 will have. If one succeeds in a simple case in giving immediate relief, the whole village, 

 who previously were "shudad." will come clamouring for medicines. Quinine is known 

 practically everywhere as a cure for fever and is asked for freely. Purgatives, the stronger 

 the better, are also in great request, no medicine being considered thoroughly efficient 

 unless accompanied by thorough purgation. 



Nearly all ills are attributed to " Wisaka fi butn " (dirt in the bellyj and they 

 consider it can only be removed by this means. 



Many cases of both surgical and medical interest were seen, but the rooted objection 

 to coming to hospital for operation or prolonged treatment is so great, io addition to 

 the difficulties of transporting the patient, that one rarely got cases to come to Singa. 



The first point to be settled was whether the disease was one recognised by the 

 natives ov not. By questioning the oldei- inhabitants of \Tllages it appeared that kala-azar 

 had been well known for some consideraUe tinje by tihe names of " Sjnieib/' "Dobaal" 

 or " ICarad-el-Seyid," and by western Arabs as "Abu Safar." This was confirmed in the 

 various villages eithei- ' ^ '-^-Mig souie oif the iuhabitants to describe the syiuptoms of 

 tJie disease known as ' or else by describing the syinptojiis and asking vrhat 



the disease was calied 



The symptoms as desc: j aje as foUows. The disease appeared generally 



duiiii^' the "(luuiJ.' '■ . . after iiie rains, about October. The fever is 



f?| - 1, the patieiit g»-a4ual|[y v,»stes away, tliough his abdomen 



»e^jai^s pi TP«y liiescrihe the anaemia by saying " El damm asfar " (the blood 



be. ..1. ■ < .1 J ' i of the feet and face appear. They notice 



<J» . . _ is, cancruin oris, sudden swellings, cough 



with 4yspn«* »»4 bloo4-sit*»nje4 spuitnnj, but these latter, more rarely. The disease lasts 

 as a rnle from three to six it is practically always fatal and appears to attack 



all age<^ j! , ...ii , n,; , . dy cijii4ren and young adults. 



T' (i and chronic, the acute form being almost entirely 



confined to the yownger cases an4 the few chronic ones to the older adults. 



Ti ~ i u a one for the disease, whereas " Dobaal" 



is Tl 1. 1 I . . _;._ Southern districts of the Blue Nile and 



K |Cara4-el-Seyid " is a general t«rm applied to the disease ; " Abu Safar" being 



the »»»«e given to this disease by the Western Arabs. 



The disease was br : .! • • - • - :h P ._.a,.i m ilit- time of the ^ilahdi. and, 



since then, it has alw.. , ^^ ., , i i.ily never in an epidemic form, 



as never more than two or three cases were in the same village. 



It is now less common and some of the older natives say that though they have heard 

 of the disease and know its symptoms, yet they have never seen a case. Others have 

 seen one a long time ago, or heard of a case in another village. 



1 questioned many old Taaishi men as to what they knew of the disease in the west. 



■ ^'i it was never common. 



ports, but vaguely known. 

 .ig supposed etiological factors may be of interest, and possibly have some 

 .; may ul; prove to be the real cause of the disease. 



M.j; is appall. ,M, .tn essential factor in producing it, di-inknij; water irom 



