PUBLIC RECORD OFFICE
Reference :-
mumimmimC.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
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Ankylostome ova are easily detected under microscope, especially after the patient has taken a purgative :-
Microscope Examination.
1913 1912
Year.
Total Stools Examined,
Ankylostome Ovs Found.
Per cent. of Infections.
1,978 1,211
855 818
27.77 25.49
Measures taken to cope with it.-When cases come beta-naphthol is fully administered and the effect of this during an amasarca is very appreciable. Some- times swelling completely disappears within 72 hours. 20 to 60 grains doses are given three times with a purgative before and after in the usual way. This treatment is repeated twice or thrice until all the symptoms have cleared and the examination of stools is negative. Meanwhile hæmatimes are given combined with quinine, strychnine, as very often the patient has one of the malarial infections as well or suffers from the effects of long continued malaria.
D. A. RAO,
Assistant.
SIR,
Office of the Medical Officer, Parit Buntar, 25th February, 1914. IN obedience to your instructions, I have the honour to transmit herewith figures from Parit Buntar hospital records for 1913.
(a) Showing admissions for ankylostomiasis and the places from which they are recorded as having come.
(b) Ankylostomiasis and presence of ankylostome ova found in patients ad- mitted for diseases other than ankylostomiasis and the places from which they are recorded as having come.
2. The methods used for the detection of ova were bad and I think, in consequence, that number of cases of ankylostomiasis is very much underestimated. 3. I have improved the method somewhat, but until there is an adequate staff not much reliance can be placed on the figures, and no value from the scientific point of view should be attached to them.
4. I am unable to give you the population from which these patients came. 5. Many of the patients came from places beyond Parit Buntar, the place to Some of the cases came from Kedah, which I am gazetted as Medical Officer.
Province Wellesley, and from Krian, outside Parit Buntar, and from other places. 6. I do not know whether any steps have been taken to cope with ankylos- tomiasis in Parit Buntar. The Health Officer for the North of Perak will be able to reply for the antihookworm measures on the rubber estates in Parit Buntar.
7. Outside the estates I do not think there are any such measures.
8. The night soil from the towns of Parit Buntar and Bagan Serai is collected under the supervision of the District Officer in his capacity as Chairman of the Sanitary Board.
some rubber 9. I understand that after collection it is deposited on
These estates are under the supervision or cocoanut estates and used as manure. of the Health Officer for the North of Perak, to whom reference should be made in this connexion.
10. As Medical Officer stationed at Parit Buntar, I am Health Officer to the Sanitary Board areas of Parit Buntar, Bagan Serai and Kuala Kurau.
11. There are two Sanitary Inspectors and one Sanitary Board Clerk; they work under the sole direction of the District Officer as Chairman of the Sanitary Board.
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12. The Senior Sanitary Inspector spends more than half his time, I believe, collecting revenue. He collected over $23,000 in 1913, mostly in small sums. have never seen the other Sanitary Inspector. The Sanitary Board Clerk I have only seen as a patient.
13. As Health Officer I have no staff, and until Health Officer gets a staff I do not see that much can be done in collection of information on this very impor-
tant matter.
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14. Although I am not able now to submit statistics, I have given, at every possible opportunity, considerable attention to this disease. The disease is, I am sure, much more prevalent and serious than is generally supposed.
15. In 1908 I was Acting Senior District Surgeon, Klang, and visited many of the estates in Klang, Kuala Selangor, and, in fact, the whole of the coast district. The amount of ankylostomiasis in the district was appalling and the influence on the death rate of this disease must have been great. When Health Officer, Selangor, I recollect that on one estate I began to make records of the disease on estates. there were 46 coolies, 17 of whom I sent at one inspection to hospital as they bore the physical aspect of the disease (swollen feet and eyelids, pallor, &c.) This estate was at that time being visited twice a month by a private practitioner.
16. I am quite unable with my present staff to take any part in the investi- gations of the prevalence of this disease.
I bave, &c.,
The Senior Medical Officer,
Perak.
SIR,
A. REID. Medical Officer, Parit Buntar.
Batu Gajah, Kinta, Perak, Federated Malay States,
I HAVE the honour to put up herewith :-
(1) Return of cases of ankylostomiasis,
(2) Report on cause and prevention and treatment.
16th February, 1914.
In considering the first it is well to bear in mind that patients admitted and
suffering from other diseases are frequently found to have ankylostomiasis, but remain under the heading for which they were originally admitted.
The Senior Medical Officer,
Perak.
I have, &c.,
R. DOWDEN.
Medical Officer, Batu Gajah.
REPORT ON ANKYLOSTOMIASIS in the Federated Malay States, 1903 to 1914.
1. This report is the result of experience gained in Kinta, a mining district, Taiping, mining and rubber, chiefly mining in 1904-5, Seremban, mining and rubber, and Kuantan, mining and rubber.
History. Ankylostomiasis in the mining districts was not, in my opinion, The reason serious disease during 1903-1904-1905, nor is it now on mines.
for this was probably that mining coolies are chiefly Chinese and deposit their excreta in abandoned mining holes, while the dry sandy "tailings" do not present
a favourable ground for the development of the larvæ of the worm.
2. In 1904-1905 the Krian irrigation works were in progress and sick coolies were sent to all the hospitals of North Perak.
3. They were a very poor class of coolie physically and their habits were indescribably filthy. Intestinal parasites were very common, and nearly every Either by itself or in conjunction man, woman and child had ankylostomiasis.
with other diseases it was a common cause of illness, although one well-known authority in the Federated Malay States denies that it can cause serious illness by itself.
4. The conditions were so bad that I believe one District Surgeon suggested the necessity of all coolies going to their work in rubber stockings filled with mercury lotion.
In Tapah in 1905 (Batang Padang District) there were no rubber estates, and ankylostomiasis was comparatively rare as a serious disease.
5. In 1906-07-08-09 many estates opened and many coolies were admitted from this cause.
On some estates latrines of the trench type were opened and used with success.
6. At first the coolies obiected, but it was arranged with the managers to fine The the tyndals of the nearest coolie lines for every motion found near the lines. fines were small and in a short time they had the desired effect.
7. In Seremban in 1909 rubber planting was in full swing, and the incidence of ankylostomiasis accordingly high. As the writer was not a Medical Officer of
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