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When the almost total absence of latrine accommodation for 
coolies is considered, together with the habits of the Tamil, and the 
fact that they work barefooted, the chance of a worm gaining 
admission into a human being must be regarded as “ rosy.” 
The treatment, consisting as it does in the administration of a 
somewhat dangerous drug — namely, thymol — I do not intend to deal 
with herein, but it may be useful to hospital dressers to remember that 
the drug is soluable in the following : chloroform, oils, turpentine, 
alcohol, glycerine, and Ether (a useful pneumonic for these drugs 
iscotage), if they be administered to patients when thymol has been 
exhibited poisoning follows. 
The prophylaxis of the disease is simple, but extremely 
difficult — if I may be permitted the bull, simple because it consists 
in either compelling coolies to wear shoes and gaiters or putties when 
at work, or in smearing their legs with some'sticky substance, before 
they go to work — in the West Indies the planters, driven to extreme 
straits, eventually stamped out the disease by insisting upon the coolies 
stepping into green Stockholm tar before going to work. I believe 
any thick oily substance will serve the purpose, the prophylaxis is 
difficult, because it is obviously a tedious process to prove to the native 
mind that such simple measures are necessary and effective for the 
preservation of their health. Latrines and a lines watchman are 
absolutely necessary to see that sanitary instructions are followed. 
Debility. 
One of the principal headings of disease under which a multitude 
of diseases are in reality included, it is a serious cause of invaliding 
and stoppage of work. 
That there exist cases which are no’t easily releghted to their 
proper heading I am, alas ! only to ready to grant, but that in the 
majority of instances (phese cases can be separated I am equally 
convinced. Amongst others, the following diseases are, I consider, 
largely responsible for “debility” : i. Anchylostomiasis ; 2. Dum-Dum 
fever (which undoubtedly exists amongst Indian coolies in this 
country); 3. Worms; 4. Starvation (due to improperly cooked food 
which cannot be digested) : 5. Sprue ; 6. Malaria in a vicarious form. 
Such cases cannot be separated without careful examination and 
scientific investigation, and the hospital is their proper place. The 
number of coolies who die annually of “ debility ” is at present much 
too high in estate hospitals, and to my mind reflects upon the 
class of dressers employed usually in estate hospitals, and also reflects 
detrimentally upon the planter, and upon the revenue of the country. 
Ulcers. 
That these cases which cause such an enormous number of 
hospital-birds, and “ slackers ” amongst labour forces here, can be 
dealt with by similar methods to those quoted by me above for 
