486 



Col. Sir D. Bruce and others. 



[June 7, 



Disti'ibution of " Muliiiiyo " in Uganda. 



The principal focus of the disease is along the eastern shore of Lake Albert 

 Edward, which corresponds nearly to longitude 30° E., in the latitude of 

 the Equator. The most severe cases have been met with at Katwe (Fort 

 George), a settlement on the eastern shore of Lake Albert Edward. It 

 appears to have spread down the eastern shore of this lake, and to have 

 extended in a south-easterly direction into Ankole. Cases have been 

 recorded as far east as the western shore of Lake Victoria, and as far north 

 as the Katonga Eiver, which runs parallel to, and about 10 miles north of, 

 the Equator. The disease is therefore quite limited in its distribution. 



There is no evidence to show how it originated. 



Epidemiology. 



The tribes most effected by the disease are the Bakonjo and the Basougora. 

 The former are morally and socially about the lowest class of people to be 

 met with in Uganda. They are abjectly poor and dirty in their persons and 

 in their habits. They live in rude grass huts, which they share with their 

 domestic animals. The Bakonjo keep goats and, if they can afford them, 

 cattle also. They prefer the milk of the cow, but also drink largely of goats' 

 milk. The Basongora are a higher type of native, and resemble in appear- 

 ance and customs the Bahima, the aristocracy of LTganda. They are not so 

 poor as the Bakonjo, whom they nse as serfs; they keep cattle and goats, 

 and consume tlie milk of both animals. The flesh of the goat is largely 

 eaten by both classes in a partially cooked state. The milk of sheep is 

 occasionally used in default of that of the other animals. 



Clinical Symptoms of " Muliinyo." 



As the result of the examination of the 50 cases sent into Masaka, it 

 appeared that the principal symptoms of " Muhinyo " are fever, profuse 

 sweating, pains in the joints and along the course of nerves, swelling of the 

 various joints, especially the ankles, and extreme weakness and emaciation. 

 The disease is of long duration ; most of tlie patients had been ill for several 

 months. In 13 cases, taken at random, the average duration was three and 

 a-half months. Another had been ill for two years. 



The following temperature chart was the only one which could be 

 ol)taincd. 



1 n most c)f the cases there was no marked enlargement of the spleen or 

 liver, nor symptoms of paresis or paralysis. The microscopical examination 

 of the blood showed various degrees of anaemia, but no parasites or marked 

 changes in the wliite blood corpuscles could be detected. Eurtlier, the 



