196 
Bilharziosis in South Africa 
place where re-infection cannot occur. But among the natives living in 
the tropical or semi-tropical parts, the complaint does not take such a 
favourable course. 
There is probably no disease which causes the native inhabitants of 
the Province of Mozambique so much worry and anxiety as Bilharziosis. 
They attribute every evil under the sun to it: impotency of men and 
sterility in women, are often considered the result of infection. I must 
admit there seems some justification for the belief. There cannot be 
any doubt that the disease in any case has a debilitating effect on the 
native’s constitution, probably rendering him more subject to tubercu¬ 
losis and other diseases when he leaves his kraal to seek work in a 
colder climate. When the parasite attacks the intestine the result is 
often fatal. 
Geographical Distribution in South Africa. 
In 1851, Bilharz and Griesinger discovered that the haematuria in 
Egypt was due to the presence of a trematode worm and its ova in 
various parts of the body. In 1864, Dr John Harley announced the 
discovery of the parasite in Port Elizabeth and Uitenhage (Cape 
Colony) and renamed the parasite Distoma capense. In 1888, Dr 
Chute, of Kingwilliamstown, wrote an important article on the subject, 
connecting it with the Buffalo River. Dr Darley Hartley, when 
practising in Kingwilliamstown and Cathcart, also had many cases of 
the disease, traced to bathing in this same river. It is well known that 
it occurs in many other places in the Colony. Dr Saunders, of Grahams- 
town, mentions Keiskama, Alice, Konap, Fort Beaufort, as being 
villages from which he has received patients who were suffering from 
the complaint. Several natives suffering from the parasite told me 
they lived near and bathed in the St John’s River in Pondoland. In 
Pietermaritzburg (Natal), European youths have been known to be 
extensively infected for many years. Dr Brock (18.93, Journ. Pathol, 
and Bacteriol. vol. n. p. 52) has demonstrated the prevalence of the 
disease in the Rustenberg district (Trabsvaal), especially along the 
slopes of the Magaliesberg and Pilansberg mountains, and in the valley 
of the Eland, Hex, Magalies, and Crocodile Rivers. More recently, Dr 
Stock, Asst. M.O.H., Johannesburg, reported on an outbreak occurring 
among freshly imported English troops who had bathed in the Aapies 
river at Pretoria. The same author states that cases have been traced 
from the Orange River, Yaal River, Mnkanda (Newcastle, Natal), Mooi 
