DISTRIBUTION OF DISEASE 



123 



the inner side of the sole of the foot in the Innisfail and Cairns districts, which, 

 beginning as a small erythematous area, spreads in the form of spirals, and 

 after a time disappears. No animal parasite could be found. It appears to us 

 that this is a form of ' creeping eruption.' He also describes ' barcoo rot.' 



Seligmann, during the eighteen months which he spent in British New 

 Guinea and the islands of the Torres Straits in the years 1898 and 1904, 

 gathered much information as to the incidence of disease among the Papuo- 

 Melanesians of Papua, who are really only just emerging from the Stone Age. 



He found talipes equino-varus to be common, while hare-lip, meningocele, 

 dwarfism, albinism, and erythrism [i.e., aborigines with auburn or reddish- 

 brown hair, pinkish-brown skin, and brown eyes) occur. Albinism and 

 erythrism showed a family distribution. 



Malaria was common, and children with greatly enlarged malarial spleens 

 were easily found. Adults with large spleens could also be seen, but this 

 enlargement might not be malarial. Leprosy was endemic in the valley ot 

 the St. Joseph River — i.e., in the Roro-Mekeo district — and could not be 

 attributed to foreign influences. Yaws was common, but syphilis was con- 

 sidered to have been introduced in comparatively recent times; in fact, he is 

 of the opinion that in Oceania the introduction of syphilis is possibly not 

 antecedent to Captain Cook's voyages. Respiratory diseases and dysentery 

 are very common, as are skin diseases — e.g., eczema, tinea imbricata, tinea 

 flava, keratosis pilaris, and leucoderma. With regard to new growths, he 

 records cutaneous papillomata, fibromata, lipomata, osteoma ta (?), and 

 angiomata. Malignant tumours were rare, but sarcomata were found. He 

 describes and illustrates subcutaneous nodules freely movable over the deep 

 fascia, over or near bony prominences, and especially about the elbow, which 

 are probably juxta-articular nodules. He describes and illustrates a nasal 

 ulceration somewhat similar to gangosa, variously referred to as lupus by 

 Sir WilHam MacGregor and cancer by the white residents of British New 

 Guinea. He also describes a peculiar ulcerative process of the legs and other 

 parts of the body. He draws attention to the impulsive character of the people 

 as a crime-producing factor. Paralysis and psychoses are not corpmon. The 

 presence of cretinism was noted. He did not meet with tuberculosis except 

 in natives in intimate contact with Europeans, nor with arterio-sclerosis, 

 valvular heart disease, rickets, or gout, locomotor ataxy, or general paralysis, 

 while anaemia was rare. 



Oceania. 



This is interesting for its diarrhoeas, dysenteries, and elephantiasis, which 

 have been studied in detail by Baker; for its yaws, leprosy, and skin diseases, 

 which latter are common, and of which tokelau and ringworm may be 

 especially noted. 



Syphilis is believed to have been unknown in the Sandwich Islands before 

 the visit of Cook in 1779, while leprosy is believed to have been introduced 

 therein in 18^0 by Chinese emigrants. 



Epidemic gangrenous rectitis and a similar form of stomatitis occurs accord- 

 ing to Corny in Fiji, Cerebro -spinal meningitis was introduced probably about 

 1876. 



Tropical America. 



The tropical medical schools situate in Harvard University and in other 

 parts of the United States, the work of the American Society of Tropical 

 Medicine and of the Canal Zone Medical Association, added to the researches 

 of the Institute Oswaldo Cruz of Brazil, are steadily increasing our knowledge 

 of the diseases of tropical America, among which malaria, yellow fever, the 

 enteric fevers, the dysenteries, elephantiasis, Chagas' disease. Leishmaniasis, 

 verruga peruviana, parasites, yaws, and certain skin diseases, stand out as 

 pathological features, among which must be given prominence to those caused 

 by the jigger. 



Moreover, it is in tropical America that the most brilliant prophylaxis with 

 regard to malaria and yellow fever has been conducted. 



