PROPHYLAXIS 



1279 



2. The formation of an Executive Sleeping Sickness Commission 

 in each political division of Africa in which the disease exists. 



The different Governments should be invited to co-operate to 

 prevent persons travelling from districts where the disease exists 

 into non-infected regions, and medical posts of inspection should 

 be established for the examination of natives. According to 

 some authorities (Dutton, Todd), all natives presenting enlarged 

 glands should be considered, from a practical point of view, as 

 trypanosome carriers, and prevented from emigrating. This is, 

 perhaps, going a little too far, inasmuch as, in our experience, and 

 in that of Low, Bagshawe, Koch, Hodges, etc., numbers of natives 

 have enlarged glands, though not suffering from trypanosomiasis; 

 and, on the other hand, cases of trypanosomiasis occur in which 

 there is no enlargement of the lymphatic glands. We admit, how- 

 ever, that gland palpation may be of some use in formulating an 

 approximate idea of the extent of the dissemination of the disease. 



The sick should be removed from the fly regions and segregated 

 in places where the Glossina palpalis and G. morsitans are not found, 

 or where the temperature and climatic conditions are unfavourable 

 to the development of trypanosomes in the flies. They should be 

 treated with atoxyl before being moved. 



In the regions where the disease is due to C astellanella castellanii , 

 which is mostly carried by Glossina palpalis, villages should be 

 removed, if possible, from the fly zones; and the occupations carried 

 on in fly zones, such as fashing, should be discouraged. This has 

 been done in certain regions round the Victoria Nyanza Lake, but 

 the result has not been completely successful, as infected flies were 

 found to be plentiful three years after the measures had been carried 

 out. The waste land became full of game and wild animals, some of 

 which are probable reservoirs of the infection. Duke, in fact, has 

 found C. castellanii in two marsh antelopes or situtunga {Tragela- 

 phus spekei), and beheves this observation to be confirmed by the 

 infection of two boys working on an uninhabited island in Lake 

 Victoria. 



Clearing of the bush along the water's edge for 100 yards, and 

 round a village for 300 yards, at least, is to be advised. 



European bungalows should be segregated from native quarters. 

 Houses should be rendered gnat-proof, and natives bringing water 

 from streams should not be allowed to enter the house, as they 

 are liable to be surrounded by tsetse-flies which have followed them. 

 Indeed, some authorities look upon the bath-room as a source of 

 European infection. 



Destruction of the Animals on which the Fly feeds. — Koch recom- 

 mended the destruction of the crocodiles by poison, and by collecting 

 and destroying their eggs. Unfortunately, the crocodile is not the 

 only animal on which the fly feeds. The blood of many other verte- 

 brate animals is palatable to the fly, and therefore this method of 

 prophylaxis is without much practical importance. 



Destruction of the Vertebrate Reservoir. — ^Many authorities have 



