41 — Guinea worm. One case only was met with. The parasite though very prevalent further south, does not seem to have obtained hold in the the Shilluk country.

Gastro-enteritis of children. Fifteen cases of this infective condition were treated. These all occurred sporadically in infants. The disease though rare has a sinister reputation as a cause of infantile mortality. It is remarkable that with the prevailing filth and flies everywhere this disease is not more widely met with.

Leprosy. This disease would appear to have been endemic in the tribe probably for generations.

The following cases were met with: -— Early. Four children aged 4 to 12 years, the progeny of a man at 35 suffering from the disease in its active stage. These had thickened nerve trunks and enlarged glands only.

Active. Four cases all suffering from nodular or mixed leprosy. One child at 5, of one year’s duration, and three men, average age 40, and average duration 3 years.

Burnt out cases. Fourteen men and eight women average duration said to be 5 years, but probably much longer. Their ages averaged 50 to 60 years or more.

It would appear from these figures especially from the relative number and ages of the burnt-out cases that the disease is really on the decrease, and this 1 believe to be the ease owing to the increased health and better feeding throughout the tribe generally.

Circulatory system. Four cardiac cases only were treated. Two cases of mitral stenosis and the other two of cardiac failure due apparently to myocardial degeneration.

Respiratory system. The 686 cases encountered included 679 bronchitis and 7 pneumonia. Bronchitis is very common throughout the tribe especially among children during the cold season, pneumonia occurs only sporadically throughout the tribe.

Alimentary system. The 1388 cases treated were practically all minor complaints speedily cured with a sufficiency of Epsom salts.

Nervous system. Complaints of the nervous system are not common, but are very interesting from an etiological point of view. An analysis of the cases is as follows :— Spastic paraplegia of lower limbs . . . . . . 8 “ Pseudo ” paralysis agitans . . . . . . 2 Epilepsy .. . . .. . . . . . . 5 Flaccid paralysis of lower limbs . . . . 1 Myelitis . . . . . . . . . . . . 1 Hemiplegia . . . . . . . . . . . . 1 18 The cases of spastic paraplegia all occurred in adult males and appeared to be due to a sclerosing condition of the pyramidal tracts, attributable T think to tertiary syphilis or more probably yaws. ;