552 
THOMPSON YATES LABORATORIES REPORT 
Typhoid Fever and Dysentery are also very uncommonly met with or diagnosed as 
a local product. Such water supply as there is seems to be fairly well protected from 
contamination at the source. 
2'aws and Lobar Pneumonia are not recognized. 
Tetanus is not uncommon. 
Rabies is said to occur now and again. Lately steps have been taken to under- 
take the preparation of spinal cords for Pasteurian treatment. Hitherto, when 
required, the material has been imported. Curiously enough, the more effective and 
economical step of clearing out the more or less ownerless and scavenging dogs has 
not been taken. Numbers of dogs, usually in a disgusting state of mange, covered 
with ticks, and their feet full of jiggers (Sarcopsylld), are seen about the town, which 
might well be destroyed, and would be calculated to make the disease common, when 
it is introduced. 
(I understand that Manaos was once cleared of stray dogs by the cruel method 
of transporting them over the river to an island). 
For practical purposes the acute diseases at Para, which are the most dire for the 
place and region, are malarial fevers for which a careful survey of the Anopheles 
breeding-grounds is desirable ; so far as they were seen, they ought to be easily 
dealt with in the precincts of the city. Smallpox which is already being attacked by 
vaccination and isolation. Tuberculosis, which requires the introduction of more 
hygienic personal habits amongst the people. Yellow fever, which requires the care- 
ful and early recognition and notification of the cases, their early and compulsory 
isolation, and the destruction of breeding-grounds (casual waters, cesspools, rain 
gutters, etc.), for mosquitoes about the houses. Filarial disease has not been men- 
tioned above ; a few cases are seen of obvious lymphscrotum, and a few cases of 
elephantiasis about the town. The protection of the general hospitals by means of 
permanent ' bars ' in the windows ; doorways to keep out mosquitoes, and so prevent 
these places from being a sort of filaria exchange is all that need be said, except that 
it would be advisable for persons to avoid having infected persons living in the 
houses. It may be noted that one of the mosquitoes caught in one of the hotels was 
found to contain an embryo filaria. 
It seems that the undertaking of any of these points would be more profitable 
than a considerable outlay against more or less hypothetical rabies, and conduce to the 
improvement of the local sanitary condition. 
It remains to say a few words concerning the hygienic steps taken by human 
interference apart from the natural conditions which obtain. 
Water Supply. The supply of water is bad, from the points of view of quantity, 
quality, and the possibility of contamination. For more than two years the water 
has not been sufficient in quantity, partly owing to the inadequate size of the mains 
and the pumps ; thus in one house in the city it was not possible to get a shower 
