•2o4 



SOMK ASl'ECTS OV TIlOPICAr, SANITATION 



Sinall-|>ox 

 cases may be 

 overlf>oke(I in 

 cliicken-|>ox 

 epidemics 



The Inspector was oi-clcrod to ciit^at^e special iiicii on llic spot, take the hiljoratory 

 steamer, and tow the offending craft down the Nile to the lonely and sandy Tuti Island, 

 where tlio cargo was to he discharged and the holds oiled. It was a cheerful task. 

 The ferry-hoat had no helm, and she and the steamer went waltzing down stream, 

 while the unfortunate experimenter tore his hair in despair, and eventually invaded my 

 sanctum to find out how he really stood, and to learn the enormity of his methods. I nmst 

 say lie was most reasonable. We were able to meet him half-way, and the threatened 

 invasion was averted, but these episodes will show you how varied are the duties of our 

 inspectors when on mosquito prevention work. As regards other diseases, I need say little. 

 I have mentioned small-pox. One has always to be on the watch that, during chicken-pox 

 epidemics, small-pox cases may not occur and be missed. Chicken-pox, as in India, 

 tends to occur in .\pril and to be a disease of adults — a point of considerable importance. 

 As you kiuiw, in unvaccinated communities small-pox reverts to its old type and 

 becomes a disease of infants and of children, one sure proof of the preventive action of 

 vaccination. Happily the native is now well protected and small-pox is rare, but it 

 may be introduced, and then measures must be taken similar to those employed elsewhere. 

 I recall a romantic incident in connection with a case which will give you an insight into 

 another aspect of the inspector's life. If you will you may call it the temptation aspect. 

 A case of small-pox had occurred in the town, and on inquiry it was found that the 

 infected house had been visited by someone from another dwelling. It was necessary 

 to inspect the inhabitants of the latter. I did so in person, accompanied by the " Mamur," 

 as the Sub-Uovernor is called. The door was opened to us by an old, wrinkled, and 

 blear-eyed crone, who, on hearing our mission, forbade us entrance. " The master of 

 the house was absent," she said, " and we must not intrude." It was explained to her 

 that all that was required was to feel the pulses and look at the tongues of the inmates, 

 but the duenna w'as obdurate in the extreme ! Arguments, promises, and entreaties all 

 proving useless, the Mamur took matters into his own hands and entered the outer 

 hoosh or yard. A wooden door guarded the inner yard — a holy of holies. Despite the 

 ancient hag, this was at last pushed slightly ajar, and first of all an aged, white-haired 

 man presented himself, held out a skinny wrist and protruded a tremulous but otherwise 

 normal tongue. Then, after further delay, there appeared a dainty little figure clad in 

 black, with eloquent, and I am inclined to think, interested black eyes, looking out 

 over the " yasmak," or married woman's veil. The situation was carefully explained to 

 this pearl of great price, and a dainty wrist was forthcoming and then thf folds of the 

 silken veil were drawn slightly, very slightly, aside, and a tiny pink tongue appeared, 

 undeniably shapely, undeniably healthy. Satisfied, I beat a retreat, still regarded with 

 suspicion by the she-dragon. Now, while a staid and married Medical Officer of Health may 

 face such a situation with impunity, I ask you how it might have affected a young and sus- 

 ceptible Sanitary Inspector? Truly he has sometimes need of the discretion of a grey beard. 

 The other diseases need scarcely detain us. Cerebro-spinal fever when it occurs 

 is dealt witli as at home. We find formamint lozenges useful. It is possible that 

 Other diseases Phlel)otonms fever, due to the so-called sand-fly, exists in Kiuirtoum as in Malta, 

 Austria-Hungary, and elsewhere. The vector is really a moth-fly or so-called owl-midge, 

 a dipteron belonging to the " Psychodidae," hairy as Esau, and exceedingly vicious. We 

 have two known species in Khartoum, and, so far, their breeding places have defied discovery, 

 though our entomologist, Mr. King, has suggested they may lay their eggs in the crevices 

 in the sides of wells. If this be so we may yet behold our inspectors hanging, like 

 Mahomet's coffin, between earth and heaven, and diligently engaged in desti-oying the 



