122 



TROPICAL DISEASES 



death-producing factor. In Calcutta, phthisis is causing some apprehension 

 by its increase. The importance of snake-bite as a cause of death is marked 

 in India. Relapsing fever is also known. 



Ceylon possesses a high infantile mortality, of which the principal factors 

 are infantile diarrhoea and convulsions, and often the bad condition of the 

 mother before the birth of the child, associated with improper and bad food, 

 and lack of proper care of the child. Eugenics requires more study in that 

 island than, so far as we know, it has received. 



The deaths of women in child-birth are high, and the principal cause is 

 puerperal fever. 



Among adults diarrhoea, dysentery, and the various forms of enteric fever 

 are important factors of the death-rate. Plague has recently visited the 

 island, but has been well controlled; cholera is present from time to time; 

 while systematic steps have been taken to deal with the prevalent malaria 

 and ankylostomiasis. Cancer exists in all races, and diabetes is a prevalent 

 disease among better-class natives, such as lawyers, doctors, and merchants. 

 Syphilis is common, though the parasyphilitic diseases are very rare, while 

 insanity is also relatively less than in Europe. Leprosy is endemic, and eye 

 diseases frequent; though, thanks to the Victoria Eye Memorial Hospital, 

 where they are skilfully treated, blindness is less frequently met with. 



With reference to the Straits Settlements, the infantile mortality, after 

 deducting immigrant deaths, is 256'29 per i,ooo births in 1905, and is raci- 



ally classified as follows : — 



Europeans . . . . . . . . . . 57*32 



Other nationalities . . . . . . . . 224-07 



Malays . . . . . . . . . . 229*78 



Indians . . . . . . . . . . 278-72 



Chinese . . . . . . . . . . 302*03 



Eurasians . . . . . . . . . . 307*69 



The general death-rate was 40-51 per 1,000 inhabitants, and its factors were 

 phthisis, beri-beri, unclassed fevers, dysentery, cholera, malaria, cancer, 

 anaemia, sprue, dropsy, and parasites. 



In Indo-China the enteric fevers, the diarrhoeas and dysenteries, liver 

 abscesses, intestinal parasites, cholera, diphtheria, spreading ulcer, which used 

 to be called Cochin Cliina ulcer, scurvy, purpura haemorrhagica, beri-beri, 

 dengue fever, and parasites, are to be mentioned. 



Much has been written on the diseases of China, where Manson and Cantlie 

 did their work, and its diseases are beginning to be known; but of special 

 interest are its trematode infections, its beri-beri, its plague, and its skin 

 diseases. 



Japan is now the centre of much scientific work, and no passing reference 

 would do justice to the valuable work being performed therein; but it may be 

 noted that it is interesting in its parasitic diseases, its tsutsu-gamushi disease, 

 its trematode infections, its fuguismus, its rat-bite and cat-bite diseases, and 

 its beri-beri. 



The Philippine Islands are monuments of American carefulness, forethought, 

 and hard work, and their diseases are well set forth in the valuable Philippine 

 Journal of Tropical Medicine. Especially to be noted are their parasitic affec- 

 tions, their beri-beri, and though much remains to be done, yet much has been 

 done with regard to malaria and smallpox, which has been reduced to insignifi- 

 cant proportions, while tuberculosis, cholera and plague, and the enteric 

 fevers, are present, and the whole problem of eugenics is stiU in its infancy. 



Australasia. 



The diseases of tropical Australia, which includes Queensland, Papua, Torres 

 Straits, Thursday Island, etc., are: — Sprue, amoebic dysenterj^ filariasis, 

 malaria, beri-beri, ulcerative granuloma, framboesia tropica, dengue fever, 

 leprosy. The intestinal parasites are: — Ancylostoma duodenale, Trichuris 

 trichiura, Oxyuris vermicidaris, Strongyloides stercoralis, and Tcenia sagirMa. 



Under the term * sand worm disease,' Breinl describes an inflammation of 



