I20 



TROPICAL DISEASES 



produce lasting results, because, as we have already hinted, there 

 is a belief that the third generation of children, with European 

 parents, born and living entirely in the tropics, tend to degeneration 

 in every way, and yet it is desirable that, portions of the tropics 

 should be permanently colonized from temperate climates if possible. 



Lastly, the infantile mortality of most tropical countries is appal- 

 lingly high, and this passes unheeded, even in places where a local 

 dearth of labour indicates to those in authority the necessity for a 

 steady and rapid increase in the population. This is not a book on 

 hygiene, but perhaps as practitioners for many years in various 

 tropical countries we may be permitted to recommend anyone 

 anxious to reduce the death-rate of a district to study the factors 

 which contribute to the local infantile mortality, and to combat 

 those of greatest importance, which will often be found to be tetanus 

 and diarrhoea, the latter being associated with the question of a pure 

 milk supply. 



Enough, perhaps too much, has now been written as regards 

 lines of thought associated with the word eugenics as applied to the 

 tropics, and we will now pass on to consider the incidence of disease 

 in tropical rountries. 



INCIDENCE OF DISEASE. 



In previous editions we gave in considerable detail the analysis 

 of the causes of death in Ceylon, and their incidence in the various 

 peoples inhabiting that island. Several years have passed since these 

 figures were compiled, and as they are old we omit them, and take 

 a general view of the distribution of disease in tropical countries. 



DISTRIBUTION OF DISEASE. 

 Asia. 



Asia Minor is not a tropical country, as it possesses cold and prolonged 

 winters, but it also has very hot summers, during which it resembles the 

 tropics, and becomes the home of many diseases, such as malaria, enteric 

 fevers, dysentery, and often cholera, while diphtheria is usually present, and 

 cerebro-spinal meningitis is by no means unknown. Goitre and cretinism 

 exist in the Valley of the Upper Euphrates. 



In Mesopotamia the winters are temperate, but the summers are very hot, 

 and heat-stroke is well known, while malaria, the enteric fevers, dysenter}^, 

 and cholera are present. Plague is said to have been endemic in this region 

 for years. Typhus, smallpox, measles, whooping-cough, and, it is said, 

 scarlet fever, occur there. Bagdad sore is almost too well known to be 

 mentioned, while beri-beri occurred in the siege of Kut, and also among other 

 troops. 



In Arabia, in addition to the fevers mentioned above, ophthalmia is to be 

 noted. 



Very little is accurately known as to the diseases of Persia, though we 

 possess a large manuscript written thereon many years ago. Cutaneous 

 Leishmaniasis, leprosy, and some form of relapsing fever may be noted. 



As regards India, in the Bombay Presidency the infantile mortality in 

 native races is 220-08 in males and 21 9*0 7 in fem.ales per 1,000 births. In 

 Bombay City the ratios were 557*24 and 569*66, but it is stated that these 

 ratios are very fallacious. 



