202 REPORT OF THE HARVARD AFRICAN EXPEDITION 
day. The great majority of the villages in the interior have no latrines and the 
natives retire into the bush or forest. Where the inhabitants have come more 
into contact with civilization, latrines or pits are sometimes made use of, and 
may be screened by thatch. 
Prevailing Diseases. The diseases chiefly encountered in Liberia are ma- 
laria, blackwater fever, filariasis, elephantiasis, onchocerciasis, juxta-articular 
nodules, schistosomiasis, leprosy, yaws, syphilis, granulomatous and ulcerative 
conditions of the skin, smallpox, chicken pox, parasitic infections of the skin, 
ainhum, intestinal parasitism, amoebic dysentery, tuberculosis, and diseases of 
the genital organs, particularly gonorrhoea. Among the diseases more rarely 
encountered are pneumonia, bronchitis, pleurisy, bacillary dysentery, typhoid 
fever, rheumatism, trypanosomiasis, yellow fever, beriberi, and nutritional dis- 
turbances. Neither bubonic plague nor relapsing fever are found. 
Dr. Jourdan ! reported upon the diseases he encountered among the militia 
and Liberian Frontier Force which was sent in 1910 to put down the disturbances 
among the Grebos near Cape Palmas on the Coast. In his report he mentions 
the following diseases as most common; gastric disturbances, ulcers of the legs, 
malaria, diseases of the respiratory tract, lymphangitis, and oedema of the legs. 
Gonorrhoea was also frequently observed, but the cases were almost always 
chronic and imported from Monrovia. Some acute cases, however, were noted. 
Disturbances of the heart due to over-exertion, conjunctivitis, periostitis and 
odontalgia were the disturbances most frequently complained of. Although 
little attention was given to the sterilization of drinking water, only ten cases 
of dysentery occurred. There were only eight cases of beriberi observed. 
Maass ? has also reported very briefly upon the diseases he observed at the 
Missions Hospital at Bolahun, in Liberia, which is situated some forty miles 
from the Sierra Leone border and near the head of the Sierra Leone railway. 
He mentions malaria, yaws, ancylostomiasis and schistosomiasis as being the 
commonest ailments in the region. Leprosy, ascaris and trichuris infections 
were also common. He states that hookworm infections were relatively rare 
and that severe anaemia which could be attributed to hookworm was seen only 
in three cases. He also observed juxta-articular nodules, onchocerciasis and 
rhinopharyngitis mutilans, the last of which was associated with two cases of 
goundou. Blood filariae were found to be rare, and no case of trypanosomiasis 
was observed. ‘Tuberculosis was exceptional. 
The more important diseases which we observed in Liberia and which we 
specially investigated, are described in Part II, page 210. 
1 Jourdan: Ann. d’Hyg. et Méd. Coloniales (1912), July and October. 
2 Maass: Abhandlungen aus den Gebiet der Auslandskunde, Bernard Nocht Festschrift (1927), 
p. 268. Jour. Trop. Med. and Hyg. (1928), XX XI, 102. 
