ccur but rarely in my experience, but of whip- 



ns cause a marked amount of debility and 



of the tape worm is frequently a protracted 

 procedure, as the head of the worm is not easy of expulsion, the 

 treatment is ext. of male fern, or thymol, both of which drugs require 

 careful handling. 



The round worm is expelled by santonin, which drug — although 

 it may cause yellow vision — should occupy in this country a position 

 more akin to that occupied by quinine than it at present holds. 



Despite the arbitrariness of the statement, I am of opinion that 

 every coolie arriving in poor condition should have an ounce of castor 

 oil on the day of his arrival, and 6 grains of santonin next morning. 

 The question of the psychological moment for the administration of 

 the drug, I leave to the intelligence of managers or hospital assistants ; 

 the ideal method would be to treat the whole batch at once. 



Whit 



the work of the estate. Filtration of or boiling of the drinking i 

 is the proper preventive of these diseases. 



Elephantiasis, Chyluria and Varicose Glands. 



The cause of all the above diseases which occur, but are not 

 common in this country, is a blood worm. 



The worm is transmitted by the bite of Culex mosquitoes so that 

 our anti-malarial measures will help to prevent the diseases. 



Elephantiasis is diagnosed by the swelling of a part, usually a leg 

 or a foot, the swelling is hard and brawny, the skin usually wrinkled, 

 and very coarse, the disease is usually uni-lateral and the affected pari 

 does not pit on pressure. 



Chyhmti, due to the Filaria also, consists in a milkiness of the urine. 



. Varicose glands usually occur in the groin, they are hard and 

 Painless. 



All these diseases can only be diagnosed microscopically in their 

 early stages and have little effect upon health until long established. 

 The majority of cases require the scalpel for their treatment. 

 Leprosy. 



Unusual amongst coolies who have been medically examined, it is, 

 nevertheless, most important that the symptoms of this disease should 

 receive all possible publicity, in the interests of the public health. 



