PUBLIC RECORD OFFICE
Reference :--
TILLICO. 885
24 PUBLIC RECORD OFFICE, LONDON
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I have not yet seen a case with dropsy. One case was greatly emaciated, and ankylostomiasis was the only disease he suffered from.
All the cases were treated with thymol, 80 grains given in two doses. 4. It would appear from the foregoing reports that, normally, natives har- bouring the parasite are not sufficiently incommoded by it to seek medical treat ment. A few cases exhibiting pronounced symptoms are recorded, but in the majority it was only after careful examination that conditions such as anæmia and disturbances of the alimentary tract were found to be associated with the infection. And this is not to be wondered at, since the native of West Africa under normal conditions acts as the intermediate or definitive host from infancy onwards to a number of parasites, and the deteriorated and debilitated survivors probably attach little importance to the physical and mental phenomena resulting from they know not what unknown factor, which we label ankylostomiasis.
Nevertheless, there can be no doubt that ankylostomiasis is both widespread and frequent amongst the natives of this Colony, and that its general prevalence constitutes a serious menace to the public health.
5. Judging from the figures given in the attached table, the incidence of the disease appears to vary in the different districts, and, although this may to soINE extent be true, I am inclined to think that the returns are somewhat misleading on this point, inasmuch as my experience in other Colonies has taught me that in work of this description the personal factor very largely influences the quality of the returns. In short, some Medical Officers do not like this work and will only do it in a perfunctory manner (the technique is unpleasant), especially under the con- ditions usually obtaining at out-stations, where even a clinical room is not provided in connection with the hospital or dispensary.
For instance, in the report submitted by the Acting Principal Medical Officer in September last, Dr. Arbuckle states that, during a former inspection of the Bo School, he found 56 per cent. of the boys to be infected.
The Medical Officer, Bo, in the report now submitted records the finding of one case only in 80 boys examined from the same school.
Again, the Medical Officer, Pujehun, has sent in a "nil" return both for this and the previous half-year, but I do not, therefore, infer that the Ankylostomum duodenale is not to be found in the Northern Sherbro District.
6. A striking feature of the returns included in this report, as well as of that previously submitted by Dr. Collett, is the failure to record the finding of the Necator americanus, which is widely distributed in the old world and has been fre- quently noted on the Gold Coast, as well as by G. Blin in the inhabitants of Maroni in French Guiana, when it was found in association with the Ankylostomum duodenale.
7. The prophylaxis and cure of this disease open up a wide subject in a primi- tive community such as this, and there can, I think, be no doubt that the former is the more important.
With regard to prophylaxis it cannot be disputed that in Freetown, where the conservancy problem has not yet been dealt with, and wells exist within a few feet of cesspits, the purlieus of which are frequently fouled, the conditions_obtaining are highly favourable to the spread of infection, although it may be, as Dr. Collett has pointed out, that the risk is somewhat lessened by the circumstance that many of the inhabitants wear boots.
These conditions will doubtless be ameliorated when, with the augmented water supply, the wells are closed, and eventually, no doubt, the inauguration of a sewer- age system will do much to eradicate the disease.
In the Protectorate it will take many years to convince the inhabitants that their traditional habits of soiling the purlieus of the village and contaminating the water supply constitute a menace to their health. Already, however, a move is being made in the right direction by the framing of the Protectorate Public Health Ordinance, which is shortly to receive the enactment of law, and I think it will be largely on the lines laid down in the wise provisions of this Act that a solution of the problem will eventually be found.
As regards curative medicine, I look forward to a period when each head- quarters station in the Protectorate will be provided with a hospital constructed in accordance with modern ideas on the subject, including a properly equipped clinical room.
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The natives will then realize the importance attached by the Government to the treatment of disease, the status of the Medical Officer will be raised, and they will seek his administrations with greater hope and confidence.
20th March, 1915.
(Circular No. 37/1913.)
THOS. E. RICE,
Principal Medical Officer.
From THE PRINCIPAL MEDICAL OFFICER to ALL MEDICAL OFFICERS.
I SHALL be grateful if you will do your utmost to give effect to the recom- mendations contained in the attached despatch* from the Secretary of State, and make the matter the subject of a careful report at the end of each half-year.
2. In order to determine the extent to which the disease is prevalent in your district you should make a point of examining microscopically the stools of all the inmates of any hospital, prison, or other institution of which you may be in charge, and the information thus obtained should be supplemented by examining the stools of patients attending the dispensary, whenever possible.
3. Your attention is especially directed to sub-paragraphs (3) and (4) of paragraph 2, and I shall be pleased to supply you with any drugs or other assistance you may need in order to give effect to the recommendations embodied in sub- paragraph (5).
THOS. E. RICE,
Principal Medical Officer.
Colonial Medical Department,
Freetown, Sierra Leone,
Bo
30th December, 1913.
TABLE SHOWING THE NUMBER OF PERSONS EXAMINED BY MEDICAL OFFICERS DURING THE LATTER HALF OF 1914, and the percentage found to harbour THE ÁNKY- LOSTOMUM DUODENALE.
Kaballa
Batkanu...
Moyamba
Station.
Description of Persons examined.
Percentage infected.
| | | | | | | 8
Number
Examined.
Government
8choolboys.
80
86
90
41
50
288
Total examined
585
Bontlie
Darn
19188
Dispensary
Patienta.
41
24
288
No. 94.
Prisoners.
183│
26
Children.
MALAY STATES.
||||||
Government
Schoo:boys.
311
Dispensary
Patiente.
Prisoners.
T
Total percentage
Infected.
Children.
0-8
0.8
100
66-6
72-2
47
18-18
40.0
7.81
7-81
64.88
58
89-58
89.58
85.72
18881
1
THE INTERNATIONAL HEALTH COMMISSION to MR. H. R. COWELL
DEAR MR. COWELL,
(COLONIAL OFFICE).
(Received 26th April, 1915.)
61, Broadway, New York, 14th April, 1915.
We have received the following cable from Dr. Heiser, who has charge of our
work in the East:---
Send Government nominates Hacker. "Arrangements completed. Barber and Darling with complete laboratory equipment via Suez Canal. Cable me Singapore dates arrival and ports en route.'
No. 515 of 1913: not printed.
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