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731 NOTES, COMMENTS, AND ABSTRACTS NATIVE HEALTH AND NUTRITION IN NIGERIA IN Nigeria a rapid extension of European influence is taking place, and the old tribal influences are becoming less important in controlling the modes and manner of the life of the native. If the effects of these increasing administrative and public health services are ever to be measured some " base line " is essential, some picture of present-day conditions by which progress can be assessed. The census of Nigeria, taken in 1931, included detailed studies of selected areas, and from the results of these it was hoped to supply this information. In an earlier volume 1 an intensive study was reported of four villages of the Northern Provinces ; in a recently issued volume 2 an account is given of the investiga- tions made in three southern areas-Abeokuta, urban and rural; Cameroons, forest and hill; and Arogbo, swamp. The report is illuminating not only in its picture of the physical and social conditions of these areas, but also in its description of the difficulties encountered and the inevitable imperfec- tions of the results. For instance, a large percentage of the population evaded the medical census, associat- ing it with counting for taxation purposes, while in the case of leprosy, old age, and probably other crippling diseases, many of the people were not seen. For those that were available for interview and for a partial medical examination " considerable doubt remained that many lies were told." In spite of these serious imperfections there can be no doubt that this inquiry has served a useful purpose. Without some such beginning no accurate and syste- matic collection of vital statistics will ever be built gradually up. The administrative and medical officers responsible have, at least, learnt wherein difficulties and inaccuracies lie, into what it is feasible to inquire, and in what way the method is capable of elaboration and improvement. The present inquiry gives an excellent account of the living conditions, of the native medicine, and the customs in the selected areas. In the nearly complete absence of sanitation the main protection of the native so far, it is con- cluded, has been the low density of population and the purifying effects of the strong sunlight. That these native communities are not without vices that affect both the individual and public health is clear. In most areas there is stated to be over-indulgence in tobacco, while during the palm-wine season in the Cameroons the men in the forest country are more or less continuously drunk. " They lead an epicurean existence of wine, women, and song." From the data collected a fair estimate of the infant mortality- rate for Southern Nigeria appears to be about 300 per 1000, the principal causes of this high mortality probably including congenital debility, incorrect feeding, broncho-pneumonia from exposure and living in a smoke-filled hut, infantile diarrhoea from impure water, and tetanus due to faulty methods in cutting the cord. The completed maximum fertility for women over 40 years of age is computed to vary for the several tribes between four and eight children, though some of the data are difficult to explain " except on the grounds that wholesale lies were told." The general impression is that fertility in most areas is declining, and that gonorrhoea is playing an important role. In various places adult males were questioned during the census on this point, and after confidence was gained roughly 50 per cent. admitted having or having had the disease. Information on syphilis was very vague, but the disease is believed to be less prevalent than gonorrhoea. An account of the diet suggests an absence of vitamins A and D, an excess of carbonydrate, and a 1 Census of Nigeria, 1931. Vol. v. Medical Census, Northern Provinces. By R. C. Jones. 1932. Pp. 92 7s. 2 Ibid. Vol. vi. Medical Census, Southern Provinces. By J. G. S. Turner. 1932. Pp. 101. 8s. lack of animal protein ; at ages over 40 about one-- third of the population are classified as poorly nourished. Improvement could be effected by the introduction of new crops, as is now being carried out in the Cameroons. A minimum estimate of the death-rate is about 30 per 1000, and a more probable- figure is in the neighbourhood of 40 per 1000. Figures collected by the administrative officers show that approximately 50 per cent. of children born do not survive to the age of 15 years. The disease incidence -i.e., of the sample of natives seen-is discussed in detail. It is concluded that epidemic disease is probably the major cause of morbidity and chronic ill-health, while yaws and venereal disease are the chief individual causes of sickness and lessened- efficiency. Malaria in childhood causes much ill- health, but its importance as a cause of death is quite unknown ; the adult population appears to obtain a relative immunity. However imperfect these figures may be, they are sufficient to indicate that there is no lack of scope for the activities of the medical officer. To aid in this work recommendations are included in this report. of a fuller collection of vital statistics in suitable localised areas, of investigations into the incidence of venereal disease and into the native dietary, and of further propaganda work in sanitation. TRANSMISSION OF COLDS THE view is now widely accepted that colds are transmitted from one person to another while the first poor wretch is in the acute stage. Little direct. evidence has been available to show whether infection is often conveyed during the period of incubation ; ;. and, moreover, if the victims themselves are to be believed, which seems unlikely, the incubation period varies in different people. A recent observation by- Perrin H. Long, Eleanor Bliss, and Harriet Carpenter 1 is recorded for what it is worth in throwing light on both these debatable points. These observers, in the course of an investigation on upper respiratory- disease, have been taking weekly cultures from the rhinopharynxes of chimpanzees. Attendants and observers put on masks and gowns and wash their hands thoroughly before visiting the animals, and these measures have usually been effective in pre- venting the spread of respiratory infections in the past. One of the three observers made the routine weekly throat cultures upon nine chimpanzees on the morning of March 14th, 1932. Accompanied by an attendant, she entered the cage of ape A, who- allowed the culture to be taken without protest ;. this was the third ape visited that morning, and cultures were subsequently taken from four others. In the afternoon two more apes were visited ; the first of these, ape B, was a large recalcitrant female who had to be held down while the cultures were taken. By an oversight the observer had neglected. to adjust her mask before entering the cage, and during the struggle her face came into close proximity with that of the ape. Before visiting the last ape of the series the observer adjusted her mask. On the afternoon of the next day she developed sneezing, lacrymation, and irritation of the con- junctiva, and by the following day was suffering from a typical severe cold which lasted a fortnight. On. March 16th, two days after her visit to the cages,. apes A and B developed nasal discharge and obstruc- tion, high temperature, and leucocytosis, and both passed through the typical stages of the common cold. Before March 14th both had been in good health and free from any respiratory infection for over two- months, and none of the attendants or observers had shown signs of respiratory infection during March,. until the observer who took the cultures on the 14th developed her cold. The bacterial flora from the rhinopharynxes of the two apes had been similar 1 A Note on the Communicability of Colds. Bull. Johns Hopkins Hospital, November, 1932.
