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PUBLIC RECORD

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EXTRACT PHom a SanitaARY REPORT OF THE PAROochial Medical Officer OF ST. GEORGE FOR THE Quarter ended 30th SEPTEMBER, 1914.

THE note of warning that I' sounded last quarter about pellagra I have to accentuate in this report. This quarter I have had 32 new cases, the largest number I have ever had in three months. The Almshouse might easily become a pellagra hospital to the exclusion of equally deserving cases. Many cases of need, especially among women, have had to be refused admission, from want of room. We have at present ten cases of pellagra undergoing treatment.

EXTRACT FROM A SanitarY REPORT OF The Parochial Medical Officer of ST. GEORGE FOR THE QUARTER ENDED 31ST DECEMBER, 1914.

PELLAGRA continues unchecked. I reported 32 cases last quarter, and I add for this quarter 26 more.

This is certainly the next disease we must tackle seriously, and, considering that in nearly all cases improvement, often to a considerable extent, can be effected by better feeding and surroundings, I don't see why we should wait to ascertain the cause of the disease before we make a start to grapple with it.

EXTRACT FROM A SANITARY REPORT OF THE PAROchial Medical Officer OF ST. JOHN FOR the Quarter ENDED 30TH SEPTEMBER, 1914.

ADDED to the usual run of diseases, there have been several cases of the No remedies disease known as pellagra, most of which have proved rapidly fatal. of which we are at present pommessed appear to have anything like a curative effect It is a fact to be regretted that one on this troublesome and loathsome disease. has not as yet solved the mystery of the appearance and recrudescence of pellagra and the proper method of its treatment

All that we can hope for, under the present state of our knowledge, is that there will be soon established some institution for the segregation in general of this kind of disease, where some systematic work of observation and treatment may be carried out with the hope of discovery of the best methods of proper treatment and the causes at work in producing this disease.

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Enclosure in No. 103.

HONOURABLE THE COLONIAL SURGEON. SIR,

Colony Hospital, Grenada, 28th January, 1915. In accordance with your instructions I have the honour to submit the follow- ing report on the treatment of yaws with salvarsan during the year 1914.

method employed was that of injection into the buttock, and the dose used varied with the age of the patient. Immediately after injection the patients were returned to bed, where they remained until the temperature was normal.

In all cases only a milk diet was allowed during confinement to bed.

Fifty-five cases were treated at the Yaws Hospital, and, in the Colony Hospital, ten cases of syphilis in one or other of its stages. The results have been excellent, and in nearly every case a cure was rapidly effected as compared with the old method of treatment. The few who remained in hospital for any length of time was due to the fact that the dose given was insufficient.

The

One case of syphilis treated in the Colony Hospital is worthy of mention. man, a labourer, aged 45, suffering from syphilitic pachymeningitis, was sent in for treatment by a District Medical Officer. He had been suffering from intolerable and persistent headache of seven months' duration, and was quite emaciated and worn from pain and want of sleep. I might mention that a diagnosis had been made by the District Medical Officer, who had previously treated him for syphilitic iritia

A full dose was injected into the buttock, and the patient at once collapsed, but he rapidly recovered on the administration of stimulants. This was the only case in which any alarming symptoms occurred. The patient was put to bed and carefully watched. Within forty-eight hours there was complete absence of head- ache, and although it is now five months since he has been treated there has been no recurrence, and he is now able to follow his usual employment.

I cannot refrain from speaking in the highest terms of the efficacy of this drug in the treatment of yaws, and it behoves me te utter a word of warning to those who are every ready to point out the number of cases of recurrency of this loathsome disease after treatment with salvarsan. We at the Yaws Hospital have had thres recurrences in those treated during the previous year, but, în, sach caso, reinfection has occurred from some member of the house in which the patient resides. It menst be remembered that those afflicted invariably conceal the fact, unless the eruption is situated on some exposed part of the body, rendering it impossible to evade the vigilance of the sanitary inspectors.

In conclusion, I am pleased to be given an opportunity to report on the treat- ment employed at the Yaws Hospital, as in last year's medical reports there was a disposition on the part of one Medical Officer to severely criticize our methods, without ever having taken the trouble to inquire the nature of the treatment employed or to have visited the institution during my tenure of office.

I have &c..

W. S. MITCHELL,

Reference :-

HC.O. 885

23 PUBLIC RECORD OFFICE, LONDON

ALLY WITHOUT PERMISSION OF THE COPYRIGHT PHOTOGRAPH-NOT TO BE REPRODUCED PHOTOGRAPHIC-

No. 103.

WINDWARD ISLANDS: GRENADA.

THE GOVERNOR to THE SECRETARY OF STATE. (Received 23rd February, 1915.)

(Granada. No. 28.)

Grenada, 3rd February, 1915. SIA

WITH reference to your despatch* No. 144, of 27th November, 1914, I have the honour to forward a report by Dr. W. 9. Mitchell, the Acting Resident Surgeon, Colony Hospital, on the treatment by selvarmaa of syphilis and yawn

2. I have inspected the Yaws Hospital and was very interested in the work undertaken by Dr. Mitchell. This was my first experience of the special treatment of yawn, and had I not been informed that the caawo I saw were yaws. I should have pas them down as syphilitic. In conversation with Dr. Mitchell be informed me that a large number of medical men were of opinion that the disease was virtually one and the same thing, or very closely allied.

1 have, &c.,

G. B. HADDON-SMITH,

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SIR,

No. 104.

Acting Resident Surgeon.

LEEWARD ISLANDS: DOMINICA.

THE ACTING GOVERNOR to THE SECRETARY OF STATE. (Received 23rd February, 1915.)

(No. 48.)

Government House, 4th February, 1915.

WITH reference to my despatch No. 210, of the 13th May last, I have the honour to enclose copy of a further communication received from the Acting Administrator of Dominica on the subject of the distribution of quinine in that Presidency.

*41878: not printed; it asked for a report.

Governor.

I have, &c.,

T. A. V. BEST,

Acting Governer:

*20095: not printed; refers, in reply to No. 25, to No. 26.

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