( 8g ) 



ligature above the seat of the bite if possible ; 2. Burn the bite itself 

 with a hot iron; 3. Apply carbolic acid. The ligation should be 

 retained in position for about three hours. The incubation period from 

 the bite or contact, to the development of hydrophobia is variable, 

 but may be set down at from 4 weeks to 16. 



Suspected dogs and other animals should be firmly tied up and 

 kept under observation, or they may be killed by shooting them in the 

 head, their spinal cord or a portion of it removed, placed in a bottle 

 containing glycerin, and sent to the nearest laboratory to be examin- 

 ed as to the exact diagnosis. 



All uncared for animals should be shot for an area of about 10 

 miles round the focus of the disease. 



In the unfortunate event of one being bitten by an animal doubt- 

 fully mad, the patient should be sent to Saigon or one of the Indian 

 Pasteur Institutes, with a piece of the spinal cord of the animal which 

 bit him, for confirmation of the fact of madness, and, if confirmed, for 

 treatment. The reason for taking the cord is that some animals show 

 very rapidly the effect of the poison, and the disease can be with 

 certainty diagnosed by injecting them, and treatment rapidly started. 



Hospitals. 



Under the Labour Code which deals practically exclusively with 

 Chinese, sec. 79 lays down "that the resident may order an hospital to 

 be built, and a dresser engaged provided not less than 50 labourers 

 be employed." 



Under the Indian Immigration Enactment Rules, "Hospital acco- 

 modation of eight beds for every 100, is required, they should be under 

 the charge of a resident and qualified apothecary." The demensions, 

 floor-space, etc., are all laid down, it will therefore suffice if I express 

 my fixed opinion that the appointment of a qualified resident apothe- 

 cary is most advisable in every hospital in this country if good work 



I have seen every class in charge of the sick I think, and the more 

 I see of the estates which endeavour to economise on their medical 

 department, the more convinced am I that it is folly of the most 

 superior brand. 



I much regret that I have yet to meet the dresser, on $30 to §5° 

 a month, who is dependable for a diagnosis; returns one can obtain 

 galore! but they wither under the light of day. 



p . The differential diagnosis between say malarial cachexia and 

 fright's disease, and ankylostomiasis (with which you are now 1 tru 

 familiar) are of the utmost import to the future of an estate ; and aeam, 

 th <: separation of plague from venereal bubo with fever small- pox from 

 ^cken-pox, typhoid from a simple diarrhoea, and choler from 

 Ptomaine poisoning, and a host of similar cases which may require 

 Prompt recognition^ must surely prove my point, that the dearer article 

 is the cheaper! 



