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present undetermined over what distance must pipes be laid in order 

 to free or produce a marked reduction in anophelines in a given area. 

 Serious " washes out " of the pipe lines may occur during floods, the 

 formation of pools and pot-holes by the scour of flood water entails 

 unremitting attention and u|)keep. Unless these facts are thoroughly 

 understood and appreciated much disappointment will ensue and a 

 word of warning is necessary lest the management of estates should 

 rush into ill considered and expensive piping operations with the 

 conviction that the laying of a certain number of chains of 

 underground pipes is a panacea for malaria and that all other sanitary 

 precautions may be neglected. 



Although medication by quinine, oil spraying and piping have 

 been referred to as the principal measures of prevention against 

 malaria there are many others which cannot be neglected. Extensive 

 swampy areas may often be dried up or greatly reduced in size by 

 cutting a few drains through them. Natural water courses and 

 ditches should be canalized, ti^ained and clean weeded, small 

 depressions and hollows wliich in stiff soils are apt to I'etain water 

 should be filled or levelled. Agricultural drains will require 

 constant attention to avoid silting up and the formation of pot-holes 

 and back waters. Scrub and undergrowth must be cut down, for 

 these afford shelter for mosquitoes and favour the formation of small 

 pools and puddles by retarding evaporation. There is no one specific 

 remedy for malaria, only by an intelligent combination of methods 

 which have been proved to be of practical value will good results to 

 be attained. 



Mkdicatj Supervision and Hospitals. 

 The prevention of sickness is the fii'st and all important duty 

 of the medical adviser to an estate. In theory it should not be 

 necessary to make arrangements for the treatment of a number 

 of sick coolies. Apart from accidents which will occur in spite 

 of all laws and codes the sanitation of an estate should be so efficient 

 and complete that disease has no chance of a successful attack 

 upon the laboxir force. There are, however, few estates in this 

 fortunate plight. Tliere are many on which the sick rate is extra- 

 ordinarily low, it is possible that the happy state of comparative 

 freedom from disease on some of these favoured estates may be 

 attributed to the natural salubrity of their surroundings rather 

 than to the perfection of the sanitary measures that are in force. 

 But we must take things as we find them and on the vast majority 

 of estates there exist conditions which may become inimical to a 

 continued higli standard of health in the laboui'ers employed. It is 

 the concern of the medical adviser to the estate to combat these 

 adverse influences and reduce the potential sources of sickness and 

 mortality to a mininrum. The main business of an estate doctor 

 being the prevention not the cure of disease, it is evident that this 

 object cannot be attained if tlie whole of his energy is directed to 



