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examined for hookworm disease in the poor-house under your medical charge, and the number of persons found to be suffering from such disease.

Kindly send the return during the first week of each month.

(Circular 9: No. 2976/12.)

14.

I have, &c.,

J. E. KER,

Superintending Medical Officer.

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you are at liberty to send up to Dr. Scott, the Island Bacteriologist, any specimens of fæces that you are able to obtain from any person showing symptoms of, or who in your opinion may be infected by, ankylostoma, so that a definite and early diagnosis may be made.

I have the honour to request that special care may be exercised in the search for, diagnosis, and treatment of this disease, as it is one which unquestionably throws many labourers out of work and ruins their health unless early, efficient, and continued treatment is given to and accepted by them.

Kindly acknowledge the receipt of this circular.

I have, &c..

J. E. KER,

Superintending Medical Officer.

SIR,

Island Medical Office, Kingston, 20th January, 1913. REFERRING to my Circular, No. 69/2976, of 7th November, 1912, I have to ask that you would be so good as to inform me how many inmates in the poor-house under your charge have been individually examined for hookworm during the month of December, 1912.

I have also to ask that you will send in regularly-at the close of each month- a return, nil or otherwise, of the number of cases of hookworm in the poor-house, under your medical charge for the preceding month.

Kindly acknowledge the receipt of this circular.

15.

.J. E. KER,

I have, &c., Superintending Medical Officer.

SIR,

(Circular 13: No. 2976/12.)

17.

Island Medical Office, Kingston, 1st February, 1913. I HAVE the honour to ask that, with the view to the treatment of hookworm disease among the inmates of poor-houses, your Board would be so good as to cause instructions to be issued to the Resident Master or Dispenser in charge of the poor- house in your parish, to send up weekly half a dozen specimens of fæces of the inmates in the institution, until all have been examined, to the Government Bacte- riologist, Dr. H. H. Scott, for examination.

I have, &c.,

J. E. KER,

Superintending Medical Officer.

PUBLIC RECORD OFFICE

Reference :-

THCO 885

23 PUBLIC RECORD OFFICE, LONDON

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DR.,

(Circular 86: No. 3577.)

Island Medical Office, Kingston, December 27th, 1912. WHEN thymolising coolies and creoles on estates kindly see that at least three doses are given, and then regularly once a month after the third dose, so as to prevent recurrence of the hookworm as far as possible.

J. E. KER, Superintending Medical Officer.

SIR,

(Circular 3: No. 37.)

16.

Island Medical Office, Kingston, 6th January, 1913. I HAVE the honour to call your attention, at His Excellency the Governor's request, to the fact that the prevalence of hookworm disease amongst the native population has recently been found to be very considerable.

If you will be so good as to refer to the Annual Report of the Medical Depart- ment for the year ending March 31st, 1912, you will see that investigations have been made both at the Spanish Town Prison and General Penitentiary by Drs. Peck and Grabham with a view to finding out the percentage of prisoners admitted to those institutions who are affected with hookworm disease.

You will note that at the Spanish Town Prison some 73 per cent. of the prisoners -and that without microscopic examination of the fæces, a method that would in all probability have raised the percentage were found to be infected last year, while examinations made this year tend to show, in the absence of microscopic examination, that 72.5 per cent. are infected.

With regard to the General Penitentiary you will note in the Annual Report of the Department, that Dr. Grabham last year stated that 71 per cent. of the prisoners were (without microscopic examination) infected.

With the knowledge that the labouring classes of Jamaica may be infected with hookworm to the extent of 70 per cent. or more, I have the honour to request that you

should in your Government, and also in your private, practice, take special care that the history of every case suffering from anæmia or from other symptoms suggestive of ankylostomiasis is enquired into and thorough examination made, followed by the necessary treatment.

With a view to aiding you in making a diagnosis, and with a view to helping you to express an opinion as to whether a patient may or may not be free from "ova,'

(Circular 40: No. 1360.)

SIR,

18.

Island Medical Office, Kingston, April 19th, 1913. I HAVE the honour to request that you will in future, when sending to the Government Bacteriologist specimens of fæces for examination for the ova of hookworm, state whether the patients from which the specimens come have been already treated for hookworm by thymol or other such remedy, and, if so, be so good as to state the number of times that thymol was given.

I have, &c.,

SIR,

(Circular 54: No. 1581.)

19.

J. E. KER,

Superintending Medical Officer.

Island Medical Office, Kingston, May 15th, 1913.

I HAVE the honour to request that you would for the future have a specimen

of the fæces of each Indian immigrant admitted to the hospital under your charge either examined locally or sent up to Dr. Scott for examination and report.

2. All immigrants found to be suffering from hookworm infection should be at once treated with thymol, so that the infection may be arrested in as early a stage as possible.

3. You will be so good as to report monthly the number of specimens examined and the number in which the hookworm ova were found in the hospital under your charge.

4. These returns will be printed monthly in the Jamaica Gazette for general information.

33311

I have, &c.,

J. E. KER, Superintending Medical Officer.

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