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present undetermined over what distance must pipes be laid in order 
to free or produce a marked reduction in anophelines in a given area. 
Serious “ washes out ” of the pipe lines may occur during floods, the 
formation of pools and pot-holes by the scour of flood water entails 
unremitting attention and upkeep. U nless these facts are thoroughly 
understood and appreciated much disappointment will ensue and a 
word of warning is necessary lest the management of estates should 
rush into ill considered and expensive piping operations with the 
conviction that the laying of a certain number of chains of 
underground pipes is a. panacea for malaria and that all other sanitary 
precautions may be neglected. 
Although medication by quinine, oil spraying and piping have 
been referred to as the principal measures of prevention against 
malaria there are many others which cannot be neglected. Extensive 
swampy areas may often be dried up or greatly reduced in size by 
cutting a few drains through them. Natural water courses and 
ditches should he canalized, trained and clean weeded, small 
depressions and hollows which in stiff soils are apt to retain water 
should be tilled or levelled. Agricultural drains will require 
constant attention to avoid silting up and tbe formation of pot-holes 
and back waters. Scrub and undergrowth must be cut down, for 
these afford shelter for mosquitoes and favour the formation of small 
pools and puddles by retarding evaporation. There is no one specific 
remedy for malaria, only by an intelligent combination of methods 
which have been proved to be of practical value will good results to 
be attained. 
Medical Supervision and Hospitals. 
The prevention of sickness is the first and all important duty 
of the medical adviser to an estate. In theory it should not be 
necessary to make arrangements for the treatment of a number 
of sick coolies. Apart from accidents which will occur in spite 
of all laws and codes the Sanitation, of an estate should be so efficient 
and complete that disease has no chance of a successful attack 
upon the labour force. There are, however, few estates in this 
fortunate plight. There are many on which the sick rate is extra- 
ordinarily low, it is possible that the happy state of comparative 
freedom from disease on some of these favoured estates may be 
attributed to the natural salubrity of their surroundings rather 
than to the perfection of the sanitary measures that are in force. 
But we must take tilings as we find them and on the vast majority 
of estates there exist conditions which may become inimical to a 
continued high standard of health in the labourers employed. It is 
the concern of the medical adviser to the estate to combat these 
adverse influences and reduce the potential sources of sickness and 
mortality to a minimum. The main business of an estate doctor 
being the prevention nob the cure of disease, it is evident that this 
object cannot be attained if the whole of his energy is directed to 
