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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 drinking water; 2. Eating uncooked rice; 3, Malaria; 
4. Ptomaine poisoning, by which we understand the eating of food 
which has commenced to decompose. (Quite recently I met a coolie 
homeward bound with a species of ray which was quite bad, and I 
have no doubt that his intention was to share it with his family, I 
confiscated the fish and got a conviction against the vendor.) 
“ As ptomaine poisoning diarrhoea is difficult of diagnosis, and the 
protraction of the illness very variable, and as it may be confused with 
other diseases (which I shall deal with below) I think that these 
cases ought to be segregated, many of them might be tubercular or 
typhoidal in nature. T\ft necessity of regular inspections of the food 
in the estate shop is a fairly qbvious duty and will help to prevent 
the ptomaine cases if all questionable articles are confiscated and 
destroyed. 
Anchyiostomiasis. 
This disease, of which little is as yet known amongst laymen, has 
bden of late years so threshed out pathologically, that it is now, to the 
tropical physician, an open book, writ large, and eas}' of diagnosis 
microscopically. This scourge of the West Indian planter at one 
time, will be one of the most serious diseases to be dealt with in this 
country, unless prompt precautions are taken with regard to its pre- 
vention and cure in such places as it no\v occurs. 
The disease in its fully developed stage exhibits the following 
symptoms: anaemia, * swelling, diarrhoea, abdominal pains, muscular 
pains or pains in the joints, and a lassitude, which may be remarked 
frequently as the first symptom. 
The disease untreated invariably terminates fatally, but if the 
treatment be applied in time it is not very difficult to deal with, and 
the patient usually recovers. It is due to the action of a minute worm 
which lives in the upper part of the small intestine and sucks blood 
from the pafient, eventually causing a deep anaemia or wateriness of 
the blood, which is followed by the symptoms enumerated above. The 
gravity of the disease is proportional to the number of worms present 
in the intestine. 
The parasite can enter the system either by the mouth in drink- 
ing water, or by the skin, and it works havoc amongst coolies in 
infected areas. 
The worm can live in moist earth for a considerable time, and 
many authorities believe that it can multiply outside the body. 
The ova of the worm are voided in large numbers by sufferers 
from the disease and then undergo development into worms capable 
of infecting persons through the skin. 
