﻿ENTOMOLOGICAL 
  ASPECTS 
  OF 
  AN 
  OUTBREAK 
  OF 
  SLEEPING 
  SICKNESS. 
  341 
  

  

  Except 
  for 
  an 
  old 
  man 
  who 
  insisted 
  that 
  cases 
  occurred 
  even 
  earlier 
  in 
  Usmao 
  — 
  

   just 
  across 
  the 
  Simiyu 
  from 
  Igombe 
  — 
  natives 
  everywhere 
  regarded 
  Igombe, 
  near 
  

   the 
  Simiyu, 
  as 
  an 
  early 
  focus 
  of 
  the 
  disease 
  — 
  " 
  The 
  first 
  news 
  came 
  from 
  Igombe 
  " 
  

   — 
  and 
  they 
  traced 
  its 
  passage 
  thence 
  from 
  village, 
  to 
  village, 
  naming 
  each, 
  until 
  it 
  

   came 
  to 
  their 
  own 
  neighbourhood, 
  when 
  their 
  detailed 
  account 
  of 
  its 
  local 
  course 
  

   was 
  simply 
  a 
  replica 
  of 
  the 
  example 
  I 
  shall 
  give 
  below. 
  I 
  am 
  rather 
  impressed 
  by 
  

   the 
  possibility 
  that 
  the 
  infection 
  occurred 
  first 
  in 
  Usmao 
  because 
  the 
  infested 
  wooding 
  

   there 
  is 
  on 
  the 
  border 
  of 
  a 
  well 
  populated 
  piece 
  of 
  country. 
  There 
  were 
  many 
  

   people 
  near 
  its 
  margins 
  to 
  come 
  into 
  contact 
  with 
  the 
  tsetse, 
  and, 
  there 
  being 
  

   many 
  people, 
  the 
  game 
  would 
  have 
  been 
  particularly 
  heavily 
  reduced, 
  so 
  that 
  the 
  

   tsetse 
  might 
  have 
  been 
  brought 
  into 
  exceptional 
  dependence 
  on 
  man. 
  It 
  seems 
  

   possible 
  (and 
  the 
  special 
  intensity 
  of 
  the 
  infection 
  may 
  favour 
  this 
  view) 
  that 
  Capt. 
  

   Currie's 
  case 
  (from 
  Usmao) 
  was 
  amongst 
  the 
  earliest 
  that 
  occurred. 
  The 
  exact 
  

   locality 
  is, 
  however, 
  a 
  mere 
  matter 
  of 
  detail, 
  for 
  game 
  had 
  been 
  greatly 
  reduced 
  

   throughout 
  the 
  area 
  between 
  Usmao 
  and 
  the 
  Duma. 
  

  

  Mode 
  of 
  Spread 
  of 
  the 
  Outbreak. 
  

  

  It 
  was 
  always 
  easy 
  to 
  trace 
  a 
  sequence 
  between 
  any 
  case 
  and 
  preceding 
  cases. 
  

   Thus 
  a 
  woman 
  sick 
  with 
  " 
  malali 
  " 
  came 
  from 
  Ndagalo 
  and 
  stayed 
  at 
  two 
  villages 
  

   near 
  Nyasambi, 
  at 
  the 
  second 
  of 
  which 
  she 
  died. 
  Her 
  presence 
  was 
  closely 
  followed 
  

   by 
  cases 
  at 
  each 
  village, 
  and 
  the 
  people 
  from 
  neighbouring 
  villages 
  who 
  regularly 
  

   visited 
  and 
  sat 
  with 
  the 
  sick, 
  and 
  attended 
  the 
  mourning, 
  fell 
  sick 
  next 
  and 
  introduced 
  

   the 
  disease 
  into 
  their 
  own 
  villages, 
  in 
  which 
  further 
  cases 
  then 
  occurred. 
  One 
  of 
  

   these 
  cases 
  taken 
  to 
  a 
  clean 
  village 
  to 
  be 
  nursed 
  introduced 
  the 
  disease 
  there, 
  and 
  the 
  

   occurrence 
  of 
  a 
  beer-drink 
  at 
  that 
  village, 
  with 
  many 
  tsetses 
  present, 
  passed 
  the 
  disease 
  

   on 
  farther. 
  This 
  was 
  the 
  story 
  everywhere. 
  

  

  Going 
  to 
  see 
  the 
  sick, 
  and 
  taking 
  the 
  sick 
  in, 
  seem 
  to 
  have 
  been 
  the 
  commonest 
  

   sources 
  of 
  infection 
  recognised 
  by 
  the 
  natives. 
  One 
  woman 
  sick 
  with 
  " 
  malali 
  " 
  

   in 
  the 
  Igombe 
  area 
  was 
  said 
  to 
  have 
  wandered 
  for 
  long 
  from 
  village 
  to 
  village, 
  more 
  

   or 
  less 
  demented, 
  and 
  at 
  last 
  to 
  have 
  died 
  in 
  the 
  bush, 
  having 
  probably 
  first 
  infected 
  

   numbers 
  of 
  tsetses 
  and 
  several 
  villages. 
  Business 
  claimed 
  its 
  victims 
  ; 
  a 
  woman 
  

   who 
  went 
  to 
  a 
  sick 
  village 
  in 
  a 
  neighbouring 
  Sultanate 
  to 
  inspect 
  some 
  ground-nuts 
  

   contracted 
  the 
  disease. 
  After 
  her 
  return 
  six 
  other 
  persons 
  got 
  it, 
  and, 
  of 
  the 
  seven, 
  

   six 
  were 
  dead 
  at 
  the 
  time 
  of 
  my 
  visit 
  to 
  her 
  village. 
  Going 
  to 
  work 
  — 
  or 
  stay 
  — 
  in 
  

   Sengerema 
  or 
  Igombe 
  was 
  said 
  to 
  have 
  brought 
  the 
  infection 
  to 
  several 
  places 
  to 
  the 
  

   south 
  and 
  west 
  of 
  them, 
  and 
  at 
  least 
  some 
  of 
  the 
  Sengerema 
  infections 
  were 
  said 
  

   to 
  have 
  been 
  due 
  to 
  the 
  fact 
  that 
  many 
  Igombe 
  people, 
  getting 
  frightened, 
  shifted 
  

   over 
  to 
  that 
  Sultanate. 
  

  

  Two 
  native 
  doctors 
  at 
  Turasi, 
  practising 
  among 
  the 
  victims, 
  were 
  stated 
  to 
  have 
  

   contracted 
  the 
  infection 
  themselves 
  and 
  died. 
  Their 
  methods 
  were 
  long 
  series 
  of 
  

   incisions 
  down 
  the 
  inside 
  of 
  the 
  legs 
  (of 
  which 
  we 
  saw 
  examples), 
  massage 
  and 
  medicine 
  

   by 
  mouth. 
  

  

  Contact 
  with 
  the 
  sick 
  in 
  villages 
  was 
  thus 
  fully 
  recognised 
  by 
  the 
  natives 
  as 
  a 
  

   mode 
  of 
  infection, 
  though 
  they 
  had 
  not 
  realised 
  the 
  part 
  played 
  by 
  the 
  fly. 
  In 
  addition 
  

   to 
  these 
  infections 
  in 
  villages 
  there 
  must 
  have 
  been 
  many 
  infected 
  tsetses 
  travelling 
  

   with 
  the 
  natives 
  on 
  the 
  paths 
  and, 
  if 
  cyclical 
  infection 
  plays 
  its 
  part, 
  present 
  in 
  the 
  

   bush 
  also. 
  

  

  Whenever 
  a 
  narrative 
  came 
  to 
  a 
  patient 
  who 
  migrated 
  to 
  a 
  village 
  well 
  inside 
  

   open 
  country 
  it 
  stopped 
  — 
  " 
  No 
  one 
  else 
  got 
  sick 
  there." 
  

  

  Nevertheless, 
  an 
  exceptional 
  number 
  of 
  cases 
  had 
  occurred 
  apparently 
  along 
  the 
  

   margins 
  of 
  the 
  populated 
  areas, 
  such 
  as 
  that 
  of 
  the 
  cleared 
  strip 
  of 
  Luguru 
  ; 
  no 
  

   doubt, 
  chiefly 
  because 
  it 
  was 
  here 
  that 
  the 
  largest 
  number 
  of 
  people 
  were 
  in 
  contact 
  

   with 
  the 
  fly. 
  It 
  may 
  very 
  well 
  have 
  been 
  due 
  also 
  to 
  the 
  fact 
  that 
  game 
  was 
  scarcest 
  

   there 
  and 
  the 
  fly 
  most 
  dependent 
  on 
  man. 
  

  

  