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The total number of patients seen at the No. 5 Tunnel camps from August (when a resident Assistant Medical Officer was appointed and records could be kept) to December 31st was 403.

Of these the following were the principal diseases :--

Malaria, Ulcers, etc.,
Skin Diseases,
Dysentery and Diarrhoea,
Beri-beri,
Injuries,

Cases of Malaria,
Percentage,
Sept.
Oct.
Nov.
Dec.
.147
.48
41
32
18
.....2.2
2.2
1.4
1

The following table shows the cases sent to Hospital during the year :-

1908 1907 Malaria, 37 89 Dysentery, 11 12 Beri-beri, 16 0 Injuries, 21 12 Cellulitis, Ulcers, etc., 7 12 Debility, 3 3 Chest Diseases, 6 Eye Diseases, 2 Venereal Diseases, 2 8 Alcoholism, 1 Hepatitis, 1 Snake bite 1 Quinsy, 1 1 Leprosy, 1 Plague, 1 Adenitis, 1 Lumbago, 1 Pleurisy, 1 Rheumatism, 1 Total, ..113 146

During the year 44 deaths occurred on or near the Railway Works. The following were the causes :-

1908 1907 Malaria, ..14 5 Beri-beri, .13 7 Injuries, 7 (1 murder). 3 Dysentery, 3 1 Heart failure, 1 Small-pox, 1 Plague, 3 Pneumonia, 10 Phthisis, 2

A great many of these cases are unknown wanderers (not Railway employees) who attach themselves to a camp when sick in the hope of finding shelter.

Five Europeans have been invalided to England for the following diseases :- Abscess of Liver, Malaria; Paralytic Stroke; Malaria, peripheral neuritis; Chronic Bronchitis, peripheral neuritis; Perineal abscesses, boils, etc.

The preventative measures adopted against disease, viz., scavenging, frequent cleansing of coolie-lines, drainage, and the free use of quinine have obviously resulted in diminishing considerably the incidence of the three most prominent and dangerous diseases, viz., Malaria, Dysentery and Beri-beri, as well as others of a less serious nature, and the results of these measures have I think quite justified their adoption and consequent expense. The population is however a floating one and fresh cases are constantly being introduced from without, a serious factor to contend with in the attempt to eradicate disease.

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