062 REPORT OF THE HARVARD AFRICAN EXPEDITION 
quite unwilling to spare one of the teeth. This patient also had elephantiasis 
of the scrotum and penis. 
Beriberi occasionally occurs in the interior of Liberia and a case was observed 
there which, however, had apparently originated in Monrovia. Beriberi, how- 
ever, 1S an uncommon condition in Liberia. 
Neither relapsing fever nor bubonic plague were observed in Liberia. 
Relapsing Fever. —Ornithodoros was not found in Liberia and has, indeed, 
not been reported on the West Coast of Africa. For its distribution, see map 
No. IX, page 813. Dyce Sharp! also points out that the tick-borne form 
of relapsing fever has never been recorded in British West Africa. However, 
in his article entitled ‘“‘Epidemic Diseases in West Africa, the menace, of the 
future,” he refers to the fact that sporadic cases of relapsing fever have been 
reported from time to time both in Nigeria and the Gold Coast. It seemed 
probable to him that these cases were louse-borne, and he further states that 
in his opinion the relapsing fever which is now scourging the West African 
native from Timbuctoo to the Bight of Benin was introduced from Europe by 
the returning French troops. He also refers to the investigations of Kerrest, 
Gambier and Bouron who traced the spread of the disease down the Niger 
from village to village. As an example of the danger of the extension of the 
infection he recalls the epidemic of relapsing fever which occurred in Accra 
on the Gold Coast in 1922. Caffrey? also points out that all the evidence 
available points to the disease being transmitted in Nigeria by the louse Pedicu- 
lus corporis. The incidence reached its height in March when the relative 
temperature and humidity had risen, ideal conditions to favor the bionomies 
of Pediculus. Only a few cases were found during the season of heavy rainfall. 
Riding * also refers to the fact that relapsing fever has been present in north- 
ern Nigeria and French Equatorial Africa for some years, having arrived there 
in all probability along the caravan routes from Morocco or Tunis. 
Mathis, Durieux and Ewstiefeief * have recorded recently cases of relaps- 
ing fever occurring at Dakar in which the infection, in some, undoubtedly 
occurred in that city. They believe that the strain of spirillum isolated from 
these human cases behaved upon inoculation into animals more like the or- 
ganism of tick fever than that of the louse-borne disease. The absence of Ornitho- 
doros at Dakar suggested some other vector, as well as the possibility of the 
spirochaete being identical with the organism of the shrew Spirochaeta cro- 
cidurae. ‘They believe that at Dakar there is an endemic focus of relapsing 
fever. 
In a later communication Mathis ° confirms the identity of the spirochaete 
of the shrew Crocidura and that of man in Dakar. He states that while the 
manner in which the disease is communicated at Dakar is still unknown, by 
1 Sharp: Trans. Royal Soc. Trop. Med. and Hyg. (1925-1926), XIX, 256. 
2 Caffrey: Trans. Roy. Soc. Trop. Med. and Hyg. (1926-1927), XX, 195. 
’ Riding and Macdowell: Trans. Royal Soc. Trop. Med. and Hyg. (1926- 1927), XX, 626: 
4 Mathis, Durieux and Ewstiefeief: Bull. Soc. Path. Exot. (1927), XX, 441; Ibid., XX, 700. 
6 Mathis: C. R. Acad. Sci. (1928), CLXX XVI, pp. 46, 177; Bull. Soc. Path. Exot. (1928), XXII, 
173. 
