— 28

After the rains had brought on the wild vegetables (e.g. weika and maleita) no further cases occurred.

The most marked feature was the common occurrence of haemorrhages into the thigh muscles and the con equent inability to walk. This symptom was accompanied by the characteristic spongy gums, offensive smell, and profound anaemia.

The symptoms cleared up on treatment with fresh vegetables and fresh limes.

Red Sea Province.

This outbreak occurred at Adobana and Akik, situated on the maritime plain towards the extreme south of the Red Sea Province.

The epidemic outbreak occurred in October at a time when owing to the lateness of the rains there was practically no grazing, (and consequently very little milk) and all but the wealthy members of the tribe were living only on dry millet. Four hundred persons were affected. The symptoms cleared up on treatment with fresh limes and fresh vegetables.

SYPHILIS.

In the southern provinces, for purposes of prophylaxis and treatment, syphilis and yaws are dealt with as one disease. A marked diminution in the incidence of these diseases has been noted (vide Yaws page 31).

In the northern and central provinces a steady improvement has been taking place for several years both in the incidence of the disease and the severity of the cases which come under treatment. This is due to the general recognition by the people of the efficacy of Novarsenobenzol injections in removing the symptoms of the disease, and to their ready application to the nearest dispensary for treatment.

An exception to this general improvement is found in the irrigated area of the Blue Nile Province, Up to 192 i the condition as regards syphilis in this province was steadily improving; since then, however, the influx of a heterogeneous and often bachelor population from various parts of the Sudan, the large and fluctuat¬ ing immigrant population from the west, the contract labour from Egypt, and the often demoralising effect of quickly-won money on the indigenous population have all tended to the increased incidence of this disease.

It is to be hoped that as this area adjusts itself to the new conditions thrust upon it and as the newly-arrived elements of the population settle down and form villages or become absorbed into existing villages and towns, the opportunities afforded for immediate treatment will again prevail over the opportunities for infection, and the incidence of the disease will once more decrease. There is a dispensary for every 15,000 acres of this irrigated area so that no sufferer from syphilis has more than a few miles to walk for treatment. In the meanwhile it must be remembe ed that the prosperity that has increased the incidence of this this disease as at tlie same time brought corresponding advantages, notably improved general nutrition and improved housing.

Cerebro-Spinal Syphilis.

One case of locomotor ataxy was reported from Makwar, the Wasser- mann reaction strongly positive. Late cerebro-spinal syphilis is rare among

natives of the Sudan.