CO885-(23-24) — Page 375

PUBLIC RECORD OFFICE

Reference :-

ITT CO. 885

23 PUBLIC RECORD OFFICE, LONDON

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

156

The people do, without doubt, realize the benefit that is to be obtained by treat- ment with salvarsan, and many would willingly come forward for such treatment were it found possible to provide the finances for such general treatment, and I go further and say that if some of the money at present spent on education were to be spent on increasing medical facilities in this island the results would be very much to the advantage of the peasantry and labouring classes, many of whom for want of early treatment find their way into the poorhouses and become a charge on parochial

revenues.

With regard to paragraph 4 of the despatch :-

(a) It may be said that yaws exists in every district, but not [to] the same extent in each by any means.

(b) Treatment of yaws in the ordinary way by mouth and by ointment has been going on in this island for many years, but I may [mention] that it has only been seriously taken in hand during the last few years and since the passing of the Yaws Law, while treatment by salvarsan has not been pushed in many districts simply Jue to financial stringency. Were funds at hand, of course, every district would be given opportunities for treatment with salvarsan.

(c) A travelling dispensary (which was His Excellency's suggestion) has been instituted with a view to treating yaws; and between 7th February, the date on which the dispensary made a start, and 2nd May some 1,604 cases have been treated compara- with salvarsan by the Medical Officer in charge, and this is a district of tively small area.

It is the duty of the Medical Officer in charge to follow up his cases and report the cures by personal observation, a thing that most distinctly was often not done under the old system of treatment by mouth and by ointments with the usual drugs, the verification of treatment having been frequently left to the district constable, as I found out by inquiry.

The dispensary will move from place to place as a district is cleaned up, and owing to the good work done I have already had a request from another parish to allow it to go there as soon as possible.

(d) The replies from the District Medical Officers of Richmond, Balaclava, and Christiana are herewith attached, and my opinion is that, inasmuch as salvarsan is a new drug and at times followed by unfortunate results, some District Medical Officers are not very keen on beginning the treatment until they see how it acts elsewhere quite a natural feeling where one cannot watch one's patients closely.

With regard to paragraph 5 of the despatch, please see Dr. Joslen's explanation as to why he had not employed the intravenous method. It was due to his not quite understanding the working of the salvarsan outfit sent him.

I would like to point out that most of the Medical Officers employ the intra- muscular method as being easier and safer, but in some cases, such as at Port Antonio Hospital the intravenous method has also been made use of. I might add that, due to the need for retrenchment, the amount provided on the Estimates for the year 1915-16 under heading Yaws has had to be cut down from £2,800 to £1,000.

SUPERINTENDing Medical OFFICER,

J. E. KER,

Superintending Medical Officer.

Mile Gully (Christiana).

I HAVE the honour to acknowledge the receipt of Circular 75, No. 2580, dated 10th September, 1914, and in reply beg to state that the use of salvarsan in parts of my district is quite impossible. The majority of the cases live in mountainous dis- tricts almost inaccessible. They are, as a rule, poorly nourished and could not stand the treatment. Might I suggest a middle course, a combined treatment of yaws with salvarean and medicines those cases that are strong enough and easily located be treated with salvarsan and the others with drugs. I have always found Nearly all the cases improve, and the treatment of medicines highly efficacious. many are quite cured. Before receiving the last circular I visited several cases. suppose I can charge for these.

W. G. FARQUHARSON,

12th September, 1914.

I

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HONOURABLE SUPERINTENDING Medical OFFICER,

Richmond.

AFTER receiving the circular referred to I had an interview with the acting Superintending Medical Officer, who advised me that the treatment of yaws with salvarsan would be safer carried out in the hospital districts, where patients treated can be kept under observation. For this reason I did not treat any cases with sal- varaan. I am, however, not still of the same opinion, and think the treatment of salvarsan can be carried out, in selected cases, with reasonable safety in outdoor patients. If you will require me to treat them with the drug this year I shall be pleased to do so.

FRED A. RITCHIE,

District Medical Officer.

1st April, 1915.

Balaclava, 24th July, 1914. SIR,

I HAVE the honour to acknowledge your Circular 63, No. 2003, dated 21st July, 1914, informing me that I should treat cases of yaws in this district with salvarsan.

1 have no hospital nor any suitable place in which to detain persons to be so treated, and in view of the fact that occasional accidents do follow the treatment by salvarsan, and also considering the distances which those persons treated will in many cases have to travel on the journey home (in some cases 15 to 20 miles), do you advise me to go on with the treatment by salvarsan under these circumstances?

I have, &c.,

W. O. LOFTHOUSE, District Medical Officer.

The Superintending Medical Officer,

Kingston.

SIR,

Annotto Bay, 16th April, 1915.

REPLYING to your minute No. 589/1083, dated the 9th April, 1915, I beg to say that I have been unable to administer salvarsan by the intravenous method because my outfit is incomplete in that it has no cannula.

I have reported this matter on one or two occasions. Not long ago I sent in a request for one, but it has not been sent.

The Superintending Medical Officer,

Kingston.

I have, &c.,

H. JOSLEN,

District Medical Officer.

DR. JOSLEN,

I HAVE looked through two Martindale outfits and can find nothing in them that was not sent to you. Please say what you mean when you say cannula. see no cannula mentioned.

27th April, 1915.

THE SUPERINTENDING MEDICAL OFFICER,

I can

J. E. KER.

THIS was due to a misunderstanding on my part. I did not know that the Martindale Record syringe formed part of the Martindale outfit and that the needle of the former was made for use with the latter. complete.

The outfit is therefore

H. JOSLEN, District Medical Officer.

31504

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No. 121.

STRAITS SETTLEMENTS.

RETURN OF MALARIAL FEVER, BLACKWATER FEVER, YELLOW FEVER, FILARIASIS, AND DENGUE DURING THE YEAR FROM 1ST JANUARY TO 31st DECEMBER, 1914.

1. Name of Colony

2. Total area

(Received 9th July, 1915.)

3. Estimated population

(a) Total

(b) Europeans

Chinese

Other races

Malays

Straits Settlements. 1,560 square miles.

759,105

4.

Births during the year :-

Total births

5. Deaths during the year :-

6.

7.

(a) Total deaths

(b) Deaths ascribed to fever :—

(1) Unspecified fever

(2) Malarial fever

(3) Typhoid fever

(4) Dengue fever

Deaths ascribed to blackwater fever

(d) Deaths ascribed to yellow fever

(e) Deaths ascribed to kala azar

Government hospitals :-

Number of such

(6) Total during the year

Admissions

Deaths

(c) Malarial fever :-

Admissions

Deaths

(d) Blackwater fever :-

Admissions

Deaths

(e) Yellow fever :

Admissions

Deaths

() Filarial diseases :-

Admissions

Deaths

(g) Dengue:-

ཡ་

Admissions

Deaths

Government dispensaries :-

(a) Number of such dispensaries

:

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::

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