( 8o ) 
Anchylostomiasis, I have no dbubt. The cause lies beyond question 
hidden in one word, wounds, whether caused by biting flies, the 
Anchylostoma, sugar-cane leaves, *stoney ground, or what not, the 
original cause of ulcer amongst coolies is, I believe, a wound, and the 
method of their prevention is quite obvious. 
The admissions ’for this disease in Krian district during 1905 
amounted to 5,322 in a total labour force of approximately 7,200, and 
if the average number of days for which each case was in hospital be 
put at say 10, the total monetary 4 oss to the estates must have been 
about $14,000. During 1906, 3,617 cases were returned on a labour 
force of 7,135. « 
Dum-Dum Fever. 
This disease undoubtedly does occur in imported Indians, but that 
it can arise or ever has arisen dc novo in this country, is not certain. 
As I have already stated ft may be confused with Anchylosto- 
miasis, and some other debilitating diseases, the diagnosis can only be 
made microscopically, and considerable skill is necessary in the 
preparation of the specimen. 
v. There is as yet no known cure for the disease. 
The disease has also been called Kala-Azar. 
The principal symptoms will be anaemia, swelling, weakness, 
enlargement of the spleen and liver, and great general debility. 
The cases must, of course, be sent to hospital, if only to have the 
diagnosis made. 
' BiJharzia Disease. 
Endemic in Africa, this disease has happily not invaded this 
country to any extent. 
The symptoms affect either the bladder or the rectum, causing 
in either position a discharge of blood and mucus. 
It may be confounded with dysentery when affecting the latter. 
The accurate diagnosis can only be made microscopically and no 
first aid treatment is likely to be necessary. 
In the event of severe bladder pain occurring, the general treat- 
ment of inflammation of that organ (irrespective of the .cause), namely, 
a hot hip bath, and barley water to drink, should be kept in mind. 
The disease is caused through bad drinking water. 
Worms. 
Many natives harbour intestinal parasites, the commonest being 
the round worm. 
