V 
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Tape worms occur but rarely ih my experience, but of whip- 
worms the same cannot be said. 
Intestinal worms cause a marked amount of debility and 
frequently anaemia also. 
The treatment of the tape worm is frequently a protracted 
procedure, as the head of the worm is not easy of expulsion, the 
treatment is ext. of male fern, or thymol, both of which drugs require 
careful handling. # 
The round worm is expelled by santonin, which drug — although 
it may cause yellow vision — should occupy in this country a position 
more akin to that occupied by quinine than it at present holds. 
Despite the arbitrariness of the statement, I am of opinion that 
every coolie arriving in poor condition should have an ounce of castor 
oil on the day of his arrival, and 6 grains of santonin next morning. 
The question of the psychological moment for the administration of 
the drug, I leave to the intelligence of managers or hospital assistants ; 
the ideal method would be to treat the whole batch at once. 
Whip worms will require injections for their removal and as they 
cause no actual invaliding do not cause any material effect upon 
the work of the estate. Filtration of or boiling of the drinking water 
is the proper preventive of these diseases. 
Elephantiasis, Chyluria and Varicose Glands. 
The cause of all the abo^e diseases which occur, but are not 
common in this country, is a blood worm. 
The worm is transmitted by the bite of« Cdlek mosquitoes so that 
our anti-malarial measures will help to prevent the diseases. 
Elephantiasis is dia^osed by the swelling of a part, usually a leg 
or a foot, the swelling is hard and brawny, the skin usually wrinkled, 
and very coarse, the disease is usually uni-lateral and the affected part 
does not pit on pressure. 
Chyluria , due to the Filaria also, consists in a milkiness of the urine. 
Varicose glands usually occur in the groin, they are hard and 
painless. 
All these diseases can only be diagnosed microscopically in their 
early stages and have little effect upon health until long established. 
The majority of cases require the scalpel for their treatment. 
Leprosy. 
Unusual amongst coolies who have been medically examined, it is, 
nevertheless, most important that the symptoms of this disease should 
receive all possible publicity, in the interests of the public health. 
