MORTALITY AMONG AFRICAN NEGROES

1559

emotional than men does not give much illmuina- tion until we are agreed as to the meaning of +, emotion" and "emotional," and when opinionshave been brought into harmony on the point of 1

definition they will probably be found to differ

vehemently on the truth of the general assertion. iDr. Shaw evidently felt the hampering influenceof our defective knowledge and our ill-defined

terminology, and limited himself, more or less, to acritical and inquiring attitude, which is certainly tobe commended in a subject that so generally induces on either side a spirit of fanatical certitude. As he

justly pointed out, we know too little to be able toforetell what will be the ultimate development and effect of the tendencies which we see at work

to-day; all we can do is to point out that violentrevolution is not the way of nature, and that theadjustment of the new to the old, never a very easymatter, is likely to be particularly arduous when itaffects relations so complex and so far-reaching asthose involved in the social and biological institu-tion of the family. And Dr. Shaw also didwell to sound a warning note with regard tothe dangers of an excessive consciousness of sex;the direction of the mind to sexual functionis far too common a tendency in much of theliterature and drama of our time, and it iswell that an alienist of Dr. Shaw’s distinctionshould call attention to the morbid influencethat such a tendency is likely to exercise onthe young. ____

MORTALITY AMONG AFRICAN NEGROES.

AT what age does a negro in tropical Africa die ? As there is no official registration of birth, and the natives are quite careless about the ages they state J

for themselves, this question cannot be directly ianswered. But Dr. R. Mouchet, of Liege (Belgium), ! awho has been working for two years at Leopold- ville in the Middle Congo, where he has performed i

over 100 post-mortem examinations of natives (the offer of a shroud silenced objections), asserts in the Archiv fiir Schiffs- und Tropen-Hygiene tfor October, that the native dies far youngerthan the European. His reasons are interesting.In the first place, a grey-haired native its rare, nor is obesity often seen. Cataract,tumours, atheroma and kidney disease are

hardly ever found, and ossification of the costal cartilages is exceptional. Further, a nativegenerally dies from a single uncomplicated disease,and when his body is examined post mortem there are frequently no associated lesions found

accompanying the effective cause of death; theyhave not had time to develop. The negro has alesser vital resistance than the European, andthis whether for a disease new to him, as

tuberculosis, or for tropical diseases againstwhich his race has struggled for genera-tions. Dr. Mouchet ascribes this feeble resist-ance to poor food, bad housing, and intestinalparasites. In 127 bodies examined ankylostomaoccurred in 114; only seven were quite free fromintestinal parasites. Then, too, the native diesvery often from amoebic dysentery, or from theperforations it causes, rarely living till a liverabscess has time to form; while the Europeansurvives the first onset of the disease, and if hesuccumbs later it is due to the abscess. Tuber-culosis is the chief cause of death, and gaveoccasion for 37 in 100 necropsies. Small-poxhas almost disappeared, thanks to vaccinationwith dried vaccine. Trypanosomiasis has been

overcome at Leopoldville, where there are now

no longer any glossinæ. In another part of this

journal comes a wail from French West Africa aboutblic great increase in insanity due to trypanosomiasis,and the need for specially instructed physicians forits management.

____

BRONZED DIABETES.

BRONZED diabetes, or haemochromatosis, is a rarelisease which was first described in 1882 by Hanottild Chauffard. So far only 60 cases have beenrecorded. It is characterised by three conditions-cirrhosis of the liver, diabetes mellitus, and deposi-ion of pigment in the viscera, and in the greatnajorityof cases in the skin also. In the MedicalChronnicle for September Dr. Donald E. Core has

reported two cases and discussed its pathogeny,which is still obscure. In the first case the patientwas a stevedore aged 56 years. He was admittedto hospital after losing weight and strength forthree months, during which his skin darkened. Hisprevious health had been good. Soon after theonset he became persistently thirsty, and duringbhe last month there was polyuria. He drankbeer in moderation and there was no historyof venereal disease. On examination he was

slightly built and very intelligent. There was

slaty-grey pigmentation, uniform over the face andextremities, but accompanied on the abdomen andnpper part of the thighs by several darker, freckle-like spots. The tongue was clean and therewas no pigmentation of the mouth. The liverwas enlarged, firm, and tender. The spleenwas felt as a firm, rounded mass on inspira-tion. The left retina showed moderate pig-mentation. The urine averaged 115 oz. daily,and contained sugar in quantities varying from2000 to 3700 grains. Under rest and treat-ment he gained weight, but after two monthsdiacetic acid appeared in the urine. He wassent to a convalescent hospital, but returnedafter eight weeks, having lost weight, and com-plaining of severe epigastric pain. From 3000 to4000 grains of sugar were passed daily, and diaceticacid was always present. Six weeks after readmis-sion he died comatose. During life a piece of skinwas removed from the abdomen. It gave a definiteiron reaction and microscopically showed pigmentgranules in the lower layers of the cutis vera. Atthe necropsy hepatic cirrhosis, hypertrophy of thekidneys, perisplenitis, fibrinous peritonitis, andaortic and coronary atheroma were found. Theviscera were pigmented. Microscopic examinationof the pancreas revealed overgrowth of fibroustissue. The majority of the parenchymatous cellswere crammed with light brown pigment granules,including those of the islands of Langerhans. Inthe second case the patient, a bricklayer aged50 years, was admitted to hospital with a sixweeks’ history of progressive weakness withattacks of giddiness. For four weeks therehad been attacks of drowsiness and epigastricpains coming on an hour after meals with

vomiting. For three weeks there had beenintense thirst and polyuria. On examination hewas emaciated and somnolent. There was faintlight-bronze pigmentation of the arms and legs.The liver was enlarged and the epigastrium wasslightly tender. The tongue was dry and fissured,and the breath smelt of acetone. The urineaveraged 104 oz. in the 24 hours, and contained2400 grains of sugar and diacetic acid. He diedcomatose on the thirteenth day after admission.