46 



the Belgian Congo . The report is chiefly concerned with the 

 incidence of sleeping sickness in the district, and they find that 

 the villages of the Yakonia on the right bank of the River 

 Ubangi are the centre of a seriously infected area. 



None of these villages are more than 300 to 400 metres from the 

 river-bank, as beyond that there is an absolutely desert region, 

 parallel with the river, of 15 to 20 kilometres in width. This 

 strip of country constitutes the northern frontier of the infected 

 area. On the east the disease does not reach further than Bosekwi 

 along the banks of the Mbornu, but commences to spread out in 

 the district of Wango and disappears completely from a point 

 marked by the mouth of the Mbari, The position of this infected 

 area and its natural isolation are such that it seems possible to 

 stamp out the disease, or at least to prevent its spreading, which 

 is specially important because it menaces seriously the whole of 

 the neig^ibouring district of Bangassu. 



The author says that it is impossible to assert that tlie limits 

 of the malady are coincident with those of certain insects, and it 

 is equally impossible to say that any area which has been spared 

 up to the present is definitely safe from the disease. Many 

 examples show that it may break out in countries where ])iting 

 flies are rare, and where Glossina is totally absent. In a word, 

 it is not known how the disease is propagated, and there is always 

 the fear, especially in countries which it has never visited, that 

 it may break out with greater violence than in those in whicli it 

 is endemic. 



The author having once passed over the country and observed 

 the conditions, decided to visit all the inhabitants of the Yakoma 

 villages from the mouth of the Kotto as far as Basekwi, and to 

 treat every person found suffering from the disease with an injec- 

 tion of one gramme of atoxyl, not so much with the idea of curing 

 the patients, as of rendering them incapable of contaminating 

 healthy persons, and so to limit the progress of the plague. Out 

 of 6,264 persons examined, he found 1,037 ill with sleeping 

 sickness ; and in certain places the proportion was very much 

 higher. In that part of the river, for example, between Kotto on 

 the one hand and the regularly inundated and inhabited zone 

 which exists above the village of Lazida, on the other, he found 

 66"8 per cent, attacked, and in another village 79 per cent. He 

 then gives figures collected from G. Martin (" La maladie du 

 Sommeil au Congo ") which show that in certain districts where 

 32 cases were found in 1907, there Avere 701 in 1912. 



Dr. Ouzilleau also quotes instances in which a village after 

 suffering very seriously from the disease two years ago is now 

 almost healthy, though in the midst of other villages, the popula- 

 tion of which is being decimated by it. He remarks that in some 

 villages the disease is localised in certain quarters and even in 

 certain houses; for instance, at Ziamba seven out of nine cases 

 Avere in the same family, the members of which either inhabited 

 the same buildings, or buildings within the same fence, and were 

 either the wives or brothers or cliildren of the Chief Ziamba, wlio 

 died of the disease about a montli before the author's visit. Facts 

 of this kind, in the opinion of the author, support the theory 

 that possibly the disease may not be transmitted exclusively by 



