Miscellaneous. 



402 



[June 1907. 



In dealing with the question of fever the'rnosquito naturally comes under 

 notice, and before starting upon the means to be adopted to combat the existence 

 of this pest, I must first make my peace with some planters who still believe that 

 this insect is not the only means of propagation of malaria, by stating that the 

 malarial parasite has been constantly found in the stomachs of certain mosquitos, 

 but it has not been found in decomposing granite, nor in any of the other earths 

 and clays, etc , which have been blamed as distributors or propagators of the disease. 

 All experiments with infected Anopheles have been positive, and I am quite willing 

 to guarantee or gamble on the result of the experiment of infecting any new-comer 

 to this country by the means of infected Anopheles, provided the doubting planter 

 will make the necessary arrangements with his newly-arrived assistant. 



Mosquito houses were the only means adopted by the Commission sent 

 out by the London School of Tropical Medicine to that hotbed of malaria the 

 Roman Oampagna, and no cases occured amongst the members of the expedition ; 

 and again, the European who submitted himself to the bites of Anopheles which 

 were infected 48 hours previously in Rome, still occasionally gets fever (Mr./Warren, 

 assistant in the London Tropical School who had an attack while I was studying 

 there). Of oils and paints to keep off the mosquito there are many, amongst others 

 I can state from personal experiment that citronella oil kills two species of Anopheles 

 at least, within 30 minutes, and if renewed about every three hours upon exposed 

 surfaces, it effectually keeps them away. 



Anti-mosquito measures generally speaking consist in : I. Closing all ponds ; 

 2. Draining all swamps ; 3. Covering all necessary water ; 4. Kerosining all large 

 stagnant areas of water ; 5. Clearing the banks of all slow-flowing streams and 

 drains, and to the above I would add from my own experience the felling of secondry 

 jungle, and the cutting of Lallang in the vicinty of houses. 



In connection with malaria it must not be supposed that a rigor (shivering 

 fit) a hot stage, and a heavy sweat, comprise the whole of the disease, as it has been 

 definitely proved that malarial dysentry, and diarrhoea occur frequently in the 

 tropics, and that the whole question as to what symptoms malaria shows is depen- 

 dent upon the particular organ or part of the body in which sporulation of the 

 parasite occurs, should sporulation take place in the brain, convulsions and coma 

 will be present, in the lungs a form of pneumonia, in the intestines a form of dy- 

 sentry, etc. Malaria is not the simple kindly disposed disease which planters 

 frequently imagine. 



Dysentry. — I do not intend to deal exhaustively with this question, but I 

 wish to impress the fact that I believe the vast majority of dysentry cases, as seen 

 amongst coolies, have their origin either in malaria, or are of a bacillary nature and 

 highly infectious, the impossibility of separating the two forms, from a layman's 

 point of view, render a general rule necessary, that rule is : Segregate all dysentry 

 cases. Bilharziosis, when it affects the rectum produces symptoms similar to 

 dysentry ; it is known, but uncommon here. If the health of an estate is a matter 

 of any importance, each dysentry case should be looked upon as if it were cholera, 

 and isolated immediately on its appearance. As a routine treatment a dose of 

 castor-oil, with say 20 drops of chlorodyne, is the safest medicine to start on, and on 

 arrival in hospital 1 am a believer in enemata of various drugs according to the 

 predominating symptoms. 



Diarrhoea.— Diarrhoea causes a large mortality and invaliding rate amongst 

 coolies. I consider it to be chiefly due to one of four causes : I Mica in their drink- 

 in gwater ; 2. Eating uncooked rice ; 3. Malaria ; 4, Ptomaine poisoning, by whic n 

 we understand the eating of food which has commenced to decompose. (Quite 



