( 79 ) 



When the almost total absence of latrine accommodation for 

 coolies is considered, together with the habits of the Tamil, and the 

 fact that they work barefooted, the chance of a worm gaining 

 admission into a human being must be regarded as " rosy." 



The treatment, consisting as it does in the administration of a 

 somewhat dangerous drug — namely, thymol — I do not intend to deal 

 with herein, but it may be useful to hospital dressers to remember that 

 the drug is soluable in the following : chloroform, oils, turpentine, 

 alcohol, glycerine, and Ether (a useful pneumonic for these drugs 

 is cotage), if they be administered to patients when thymol has been 

 exhibited poisoning follows. 



The prophylaxis of the disease is simple, but extremely 

 difficult— if I may be permitted the bull, simple because it consists 

 in either compelling coolies to wear shoes and gaiters or putties when 

 at work, or in smearing their legs with some sticky substance, before 

 they go to work — in the West Indies the planters, driven to extreme 

 straits, eventually stamped out the disease by insisting upon the coolies 

 stepping into green Stockholm tar before "going to work. I believe 

 any thick oily substance will serve the purpose, the prophylaxis is 

 difficult, because it is obviously a tedious process to prove to the native 

 mind that such simple measures are necessary and effective for the 

 preservation of their health. Latrines and a lines watchman are 

 absolutely necessary to see that sanitary instructions are followed. 



Debility. 



One of the principal headings of disease under which a multitude 

 of diseases are in reality included, it is a serious cause of invaliding 

 and stoppage of work. 



That there exist cases which are not easily relegated to their 

 proper heading I am, alas ! only to ready to grant, but that in the 

 majority of instances these cases can be separated I am equally 

 convinced. Amongst others, the following diseases are, T consider, 

 largely responsible for "debility": i. Ankylostomiasis; 2. Dum-Dum 

 fever (which undoubtedly exists amongst Indian coolies in this 

 country); 3. Worms; 4. Starvation (due to improperly cooked food 

 which cannot be digested) : 5. Sprue ; 6. Malaria in a vicarious form. 



. Such cases cannot be separated without careful examination and 

 scientific investigation, and the hospital is their proper place. The 

 number of coolies who die annually of " debility " is at present much 

 too high in estate hospitals, and to my mind reflects upon the 

 class of dressers employed usually in estate hospitals, and also reflects 

 detrimentally upon the planter, and upon the revenue of the country. 

 Ulcers. 



That these cases which cause such an enormous number of 

 Jjospital-birds, and " slackers " amongst labour forces here, can be 

 dea lt with by similar methods to those quoted by me above for 



