PUBLIC RECORD
OFFICE
Reference :-
C.O. 885
9 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
COPYRIGHT PHOTOGRAPH—NOT TO
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15. I regret that His Excellency the High Commissioner does not entertain the continuation of the institution under medical directorship, so assisted, and as suggested by Dr. Daniels, and that he proposes, while devoting the institution to the study of the diseases and interests of plants and animals, to relegate those of the human inhabitants to a very secondary place. Neither from a sentimental point of view nor from an economic point of view does this seem to be right, for surely the interests of the human population should take precedence of those of the lower animals and plants. The life and health of the official, the, farmer, the mechanic, and the labourer are a much more valuable State asset than any number of cattle or acres of plants.
16. His Excellency's proposal to place the direction of the institution in the hands of a Committee will not, if carried out, conduce to harmony or efficiency. There will be too many masters. Nor would it be wise, in my opinion, to hand it over to the Principal Medical Officer, whose time and energies are fully occupied by his own special administrative work and duties.
17. It is true that for such an institution a medical man is the proper director; his education has already put him in touch with chemistry, botany, bacteriology, and other sciences. But this medical director should be actively at work in the institution itself, and completely and constantly in touch with all that is going on in the laboratory, and staff, and with time to give to supervision, and, if necessary, co-ordination.
18. Dr. Daniels, in his letter of 17th May,* states that better opportunities for the study of tropical diseases than exist at Kwala Lumpor are to be found in the West Indies and Egypt, places which have the further advantage of being nearer to England. His Excellency has been influenced somewhat, apparently, by this unfortunate, and not quite accurate, observation in arriving at his proposal to suppress the medical element in the institute. Now, although in some respects certain tropical diseases might be advantageously studied in the countries referred to, there are other and especially two very important diseases, for the study of which Kwala Lumpor is infinitely more suitable, I refer to beriberi and sprue, two most important subjects about which, notwithstanding the desultory efforts of individuals, no real knowledge as to their cause, and, therefore, prevention, has hitherto been acquired.
19. It was recognised, at the inception of the scheme for a comprehensive system of Colonial research laboratories, that whilst all or any of the laboratories might take up the study of such universal tropical diseases as malaria and dysentery, each particular laboratory should give special attention to the diseases or disease peculiar to, or specially prevalent in, the geographical or administrative area with which it was most immediately connected. Thus, the West Indian Laboratory would deal specially with yellow fever, yaws, and filariasis, the West African with blackwater fever, and guinea-worm, the East African with sleeping sickness, and other forms of protozoal disease in man and the lower animals; the Malayan with, as stated, beriberi and sprue. It is almost superfluous to indicate the enormous economic boon that would directly accrue to the Malay States were the cause and mode of acquirement of beriberi to be discovered; equally so as regards sprue, more especially in its bearing on Europeans in Malaya and the Far East.
20. Some progress has been made in elucidating the etiology of beriberi at all events the problems connected with this disease have been, or are in process of being, formulated. It would be an infinite pity were the effort to elucidate them abandoned, and left, perhaps, for some Continental or Japanese pathologist to solve.
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21. His Excellency contemplates the employment from time to time "of a highly trained and qualified scientist' "to undertake special investigations." I would remark that such men are very difficult to find. Young men posing as bacterio- logists and so forth, possessed, doubtless, of some knowledge, but untried as investi- gators can be got easily enough, but when got their education in the special work only commences. It may be that the year or two engaged for is up before they have become sufficiently experienced or intellectually qualified to really proceed with the investigation.
Highly trained scientists will not throw up their investigations and regular work in this country for temporary work abroad unless for very high pay.
22. One of the objects contemplated in projecting the scheme of tropical laboratories was the education of a band of skilled and experienced investigators who would be always available for such special investigation. Such a project would be far more efficient and, in the long run, less expensive than what I might describe as the policy of panic contemplated by His Excellency.
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23. There can be little doubt that many advantages of a less directly beneficial nature than discoveries in pathology would accrue to the Colonies were the scheme efficiently carried out. It would certainly raise the standing of the Colonial Medical Service as a whole, and stimulate the individual members of the Service to observe and think.
Further, the existence of such a laboratory in a group of Colonies would assure the publicity of important life-saving discoveries in medicine soon after they were made.
24. Twenty years elapsed before the discovery of the malarial parasite was properly apprehended in our malarial Colonies, and twice that time before the cause and efficient treatment of that very common, very disabling, and not infrequently fatal disease, Ankylostomiasis.
Scandals of this sort would be obviated by the establishment of institutions whose business it would be to keep abreast of current discovery, and see that it was at once made known and acted upon.
25. His Excellency remarks "that the treatment and solution of the novel pro- blems of public health must take precedence of special research." I cannot exactly understand what he means by this, for the solution of novel problems, in which cate- gory His Excellency, erroneously, I think, includes examinations and investigations in connection with water supply, which are merely part of the routine duties of a Medical Officer of Health, is one of the very objects of research such as is contem- plated.
26. There is another matter which in coming to his decision His Excellency does not appear to have duly considered, and that is the tacit understanding on the part of the Federated Malay States' Government with the London School of Tropical Medicine by which this School was induced to loan Dr. Daniels to the institute, and commit itself to what may prove to be a compromising arrangement with Dr. Low.
27. My conviction of the far-reaching importance of this subject is my excuse for the length of this letter. I feel that if this project of Colonial Laboratories is to be abandoned at the outset by so wealthy a Government as that of the Federated Malay States, the prospect that less prosperous Governments will fall in with the scheme is very poor indeed. If the result in this instance does not appear to be commensurate with the expenditure it should be borne in mind that the investigations the laboratory has concerned itself with are most difficult; that their solution has hitherto baffled medical science, and that it is unreasonable to expect they will be brought to a successful issue in a few months. Of their ultimate solution I do not entertain the slightest doubt, and, moreover, I believe that the scheme of Colonial Laboratories is the most appropriate machinery for attaining this end.
33866
SIR,
No. 162. MALTA.
I am, &c.,
PATRICK MANSON.
COLONEL D. BRUCE to COLONIAL OFFICE. (Received September 30, 1904.) [Answered by No. 173.]
68, Victoria Street, S.W., September 29, 1904. WITH reference to my recent visit to Malta in connection with the investigation of Mediterranean fever, I have the honour to request that you will kindly take into consideration the question of the amount of subsistence allowance to be paid to me for the period of my absence from England.
The amount payable under Army Regulations does not nearly meet the expendi- ture to which I was put, and I beg that I may be granted the same sum, viz., 30s. a day, which has been sanctioned for the member of the Committee sent out by the Local Government Board.
18064
I am, &c.,
From 9th June to 18th July,
DAVID BRUCE,
Colonel, R.A.M.C.
N
33866
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No. 183.
MALTA.