I990 DISEASES OF THE NERVOUS SYSTEM 



which is 5,000 to 6,000 feet high, and is situated between 13° to 

 14° south latitude, and is inhabited by the Bihe, Bailundo, and 

 Andulu peoples, all of whom are Bantus. 



etiology. — Wellman was unable to find any causative organism 

 in the blood or faeces. Some of the natives also suffered from 

 filariasis, ankylostomiasis, and bilharziosis, but these were adven- 

 titious. His theories are that it may be caused by cold, fermented 

 maize, or nerve-starvation; but he is not satisfied with any of 

 these hypotheses. 



Morbid Anatomy. — In bad cases there is some swelling, erythema, 

 and slight oedema of the affected part; still, biopsies of the skin 

 revealed nothing, and post mortem the nerves were found normal. 



Symptomatology. — The disease usually begins with shooting, 

 pricking, or crawling pains in the legs and forearms, accompanied 

 by numbness, together with an erythematous rash and swelling of 

 the affected area. All these symptoms are increased by cold and 

 damp, and diminished by heat and dryness. They may also appear 

 on the thighs and arms, and occasionally on any part of, or all over, 

 the body. The gait is peculiar, the patient appearing to walk on 

 the toes and heels. The disease may last for years, but spon- 

 taneous recovery is known. 



Diagnosis. — -The diagnosis is easy, for it is distinguished from 

 beri-beri by the absence of pain in the calves, by the absence of, 

 the heart symptoms, and of the paralysis; from elephantiasis by the 

 swelling being transitory; from malaria by an examination of 

 the blood; and from pellagra by the symptoms improving during 

 the warm season. 



Prognosis. — This is good as to life and general health, though the 

 course of the malady may be very protracted. 



Treatment. — No method of treatment is known to do any good. 



ERYTHROMELALGIA TROPICA. 



Under this term Gerrard describes a nerve condition in which 

 natives who work barefoot on roads and plantations in Malaya 

 complain of a feeling of pins and needles in the soles of the feet, 

 followed by an acute burning sensation, which prevents walking and 

 sleeping. Malaria is assigned to be the cause. The treatment 

 recommended is to place the feet in hot salt-water, which is said to 

 give great relief. 



DESERT HALLUCINATIONS. 

 Synonym. — Le Ragle. 



D'Escayrac de Lauture describes hallucinations of the senses of 

 sight, hearing, smell, or taste, or even of common sensations, which 

 attack persons suffering from exhaustion in deserts. The causation 

 is probably inanition. Generally the attack comes on at night, but 

 it may occur in the day-time, when it is considered to be more 



