PUBLIC RECORD OFFICE
Reference :-
TTILL C.O. 885
21 PUBLIC RECORD OFFICE, LONDON
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dangerous symptoms, and even to death.
It must be admitted that this depleting treatment would hardly be a good preparation for a voyage through the Bay of Bengal in monsoon."
10. Apart from the desertions which the introduction of this treatment will encourage, exaggerated stories will reach the recruiting grounds up-country of those horrible doings" in Calcutta, and make it extremely difficult for recruiters to carry on their work with any reasonable hope of success, and the number of arrivals in Calcutta will consequently be reduced.
11. If such methods are introduced into the Calcutta depôts, it will take as many months as it formerly took weeks to despatch an 800-coolie steamer to a Colony with a full complement, and during that period the losses by desertion will be very considerable.
12. The earlier arrivals in depôt will rebel at being detained for months without the opportunity of earning wages until a sufficient number of coolies are collected to fill a steamer.
13. To cleanse intending emigrants from ankylostomiasis prior to embarkation can only be effected at very considerable expense, owing to losses by desertion and by very largely reducing the number of available agricultural labourers willing to go abroad, and would, in effect, be equivalent to a partial paralysis of Colonial emigration.
14. This subject was under discussion in the middle of the year 1903, and I enclose a letter from Mr. Mitchell, the British Guiana Emigration Agent at that time, together with one from Colonel Pilgrim, I.M.S., who was, and still is, the Consulting Surgeon to the Agency, and the final reply from the Government Secretary in British Guiana. From these it will be observed that it was decided to abandon any systematic treatment in the Calcutta depôt.
15. The parasite ankylostoma duodenale has been extensively prevalent in British Guiana and the West Indies ever since anything was known of this worm, as may be seen from a reference to Hirsch's book and also Davidson's on geographical pathology, and also, indeed, from the fact that many of the synonyms of ankylosto- miasis originated in the West Indian Islands, both English and French, e.g., (1) Cacherie aqueuse, (2) mal d'estomac des Nègres, (3) Negro consumption, &c., all meaning the same. This being the case, it is not clear what the Medical Inspector in his report to the Surgeon-General, British Guiana, hopes to obtain even if it were possible to send the great majority of coolies to the Colonies free from infection by ankylostomes. The disease is prevalent in the Colony, and unless the most rigid system of disposal of excreta under close supervision exists (no mere erecting of latrines) nothing can prevent the spread of and maintenance of the disease amongst the coolies.
16. I notice that the suggestion about dealing with ankylostome-infected coolies before leaving India comes from the Medical Inspector, Dr. Law, who has for some years advocated this. I do not notice any remarks from the Immigration Agent-General supporting this suggestion, and, indeed, if the Government of British Guiana really considered this examination and treatment necessary or advisable, it would only be necessary for them to send instructions either directly or through the Colonial Office to their Agent here, definitely directing that the coolies should he examined and treated completely prior to embarkation.
17. I observed that in the Surgeon-General's report, page 451, paragraph 100, it is stated :-
"On the sugar estates steady progress was made in the measures which have now for some time been advocated by this Department, viz. :—
(i) The erection of latrines.
"(ii) The systematic examination of all newly-arrived immigrants, and of all persons suffering from anæmia or showing the least sign of being infected with the anchylostome parasite.
(iii) The treatment and constant observation of all known infected
cases,"
This "systematic examination" must, of course, refer to the examination of the motions, and the fact that in the " Medical Inspector's Report" it is stated that 74:44 of the newly-arrived immigrants were infected with ankylostome shows that there must be a systematic examination of the motions of newly-arrived immigrants. This being so, what is his point of the remark in the "Medical Inspector's Report,"
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page 249, paragraph 7, where he states measures should certainly be taken either in India or on board ship to treat these cases, otherwise we shall be compelled in self-defence to isolate every one on arrival-but from the Surgeon-General's remarks the systematic examination and treatment on arrival is already in force.
18. I also notice that in "Dr. Law's Report to the Surgeon-General" (which is the Report referred to by the Colonial Office and also by the Sanitary Commissioner to Government of India) he states, in paragraph 7:
Last season was the worst
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treat-
we have as yet experienced in this direction, 7444 per cent. of the immigrants having been found infected on arrival." Now to be able to say that 74 44 were infected, the motions of all the newly-arrived coolies must have been microscopically examined for ankylostome ova-but if they went to the pains of carrying out this laborious part of the process one wonders why treatment based on the information so obtained could not also have been carried out at the same time, under circum- stances in which the coolies could not change their minds nor give trouble. They almost certainly did, but they are perfectly aware, I fancy, that several ments" and stool examinations by microscope are necessary before a whole batch of coolies could be regarded as free from infection and the power of conveying infection; for, of course, having regard to the enormous number of ova passed in the motions, if, out of a batch of 800 coolies landed by one steamer in British Guiana, some 40 or 50, after various "treatments," still contained some ankylostomes pro- ducing large numbers of ova, this number of infected coolies when distributed to various estates would be fully able to communicate and keep up the disease unless a most rigidly supervised system of disposing of excreta was in force. This being the case, it would be well if the authorities in India, before giving directions for the systematic examination and treatment of coolies in the Indian depôts prior to their despatch to the Colonies, should realise what the process involves and what will be the advantage gained by the Colonies.
19. I am advised by Colonel Pilgrim, Consulting Surgeon to the Depôt, that the examination and treatment will be as follows. Supposing a batch of 80 coolies arrives at the Depôt on the 1st October, the first process will be the examination of the blood, as advised by the Sanitary Commissioner, for eosinophilia. With a skilful and industrious microscopist, the blood can be taken, put on a slide, and microscopically examined in the case of about 40 out of these 80 on 1st October. It is not a case of just looking down a microscope and seeing at once that there is an excess of eosinophiles; the blood cells must, in a large number of the cases, be actually counted; this takes time. Out of the 40 whose blood has been so examined, perhaps about 35 or so will show an eosinophilia. This latter does not necessarily mean that they harbour ankylostome worms, as eosinophilia is produced by other common worms, and also in post febrile and other conditions. Therefore, on the evening of the 1st October, arrangements are made for the careful keeping and separation of the motions of the 35 coolies next morning. During the 2nd October the motions of these 35 coolies are microscoped for the ova of ankylostomes. Ova are not always found at the first examination. I mean that the particular specimen may contain no ova, though another specimen from the same motion may contain several; still, in the great majority, they would be found at the first examina, tion, a few only escaping detection. Out of the 35 motions so examined probably about 32 would be found to contain the ova. On the 2nd October the blood examina-
tion would also be made of the remaining 40 of the batch. On the 3rd October, the 32 coolies whose motions contained ova would be partially starved and purged; and on the 4th October they would receive various doses of thymol and be further purged; all this constituting one treatment.' cient to get rid of the worms in more than about half of the cases; so, on the 10th But one treatment is quite insuffi- October, the motions of these 32 coolies would have to be re-examined micros- copically for ova, and it would then be found that nearly half still contained ova, as the ankylostoma in many cases is resistant to, and survives one treatment by, thymol. On the 10th October, therefore, nearly half, say 13, would be again partially starved and purged; and on the 14th treated with thymol and again purged. On the 20th October the motions of these 13 would be again collected and microscoped, and even now some would have been found to have resisted the second treatment. Probably about three or four of this batch would still contain ova, and require third "treatment," and the same line of treatment would be adopted in the case of these three or four coolies, whose motions would then have to be
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