293 
The  glandular  enlargement  may  not  be  general,  for  in  our  cases  it 
was  the  exception  to  find  that  the  axillary  and  epitrochlear  glands 
were  enlarged  concurrently  with  those  in  the  neck.  We  have  not 
considered  the  inguinal  glands,  as  in  practically  every  native  there 
was  a  noticeable  degree  of  enlargement  in  these  groups. 
Some  idea  of  the  length  of  time  required  for  the  enlargement  to 
attain  a  marked  degree  is  afforded  by  the  fact  that  some  of  our  cases, 
found  on  Lake  Tanganyika,  with  decidedly  ‘  +  ’  glands,  had  been 
seen  by  Spillane  some  six  months  before,  and  had  not  been  punctured 
by  him  on  account  of  the  small  size  at  that  time.  We  were  informed 
by  one  of  the  medical  officers  engaged  in  Sleeping  Sickness  work  in 
Rhodesia,  that  he  had  seen  one  case  in  which  the  enlargement  had 
occurred  within  three  months. 
In  an  endeavour  to  account  for  the  slight  degree  of  enlargement 
which  is  so  common,  we  recorded  the  approximate  age*  and  the  sex 
of  many  of  the  natives  (18,512),  and  the  relation  of  these  factors  may 
be  seen  in  the  following  table  :  — 
Age 
Males 
Females 
No.  palpated 
No.  glands 
Per  cent. 
No.  palpated 
No.  glands 
Per  cent. 
0 — 10 
2589 
1 128 
43'5 
2944 
73^ 
25-5 
II — 20 
1509 
434 
287 
I  104 
'75 
15-8 
21—30 
2331 
439 
'4-5 
3444 
229 
6-6 
31—40 
2066 
184 
8.9 
2090 
85 
4-0 
Over  40 
269 
7 
2*8 
186 
15 
8-0 
The  gradual  decrease  in  the  incidence  of  palpable  glands  with 
advancing  age  is  very  marked,  and  corresponds  to  a  large  degree  with 
the  general  diminution  in  the  lymphoid  tissue  of  the  body  which  is 
known  to  occur  at  this  period.  It  is,  however,  not  clear  why  there 
should  be  such  a  noticeable  difference  in  the  occurrence  of  enlarged 
glands  in  the  two  sexes.  The  enlargement  is  encountered  in  all  parts 
of  the  country,  and  is  not  related  in  any  way  to  the  distribution  of 
*  We  ^ave  assumed  that  the  age  of  puberty  is  about  12,  and  while  we 
n  eayoured  to  estimate  the  ages  of  the  natives  as  correctly  as  we  could,  we 
annot  vouch  for  the  absolute  correctness  of  them.  We  believe  that  by  dividing 
em  into  decades  we  have  succeeded  in  approaching  some  degree  of  accuracy. 
