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PUBLIC RECORD OFFICE

Reference :-

CO885/25

PUBLIC RECORD OFFICE, LONDON

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

SIR,

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Enclosure 1 in No. 14.

B10, Exchange Buildings, Liverpool, 30th November, 1917.

I BEG to submit the following report on the work done during the period from 1st November, 1916, to 31st October, 1917.

War Work-In October, 1916, systematic work was commenced on the examination of all malarial cases in the Liverpool district, and a report was sent out to each military hospital as soon as a diagnosis was made, and a printed slip with instructions for further quinine treatment was supplied for attaching to each patient's papers on discharge. Research work was at the same time conducted by Dr. Blacklock and myself.

In January, 1917, the School was asked by the War Office to undertake special research, especially in connexion with the treatment of malaria. This work was at once commenced.

In February, 1917, I was appointed Consultant in Malaria for the Scottish, Northern, and Western Commands.

About March, 1917, two malaria concentration hospitals were established in Liverpool, (1) at the Tropical School Auxiliary Military Hospital, of which Professor Yorke was in charge, and (2) at Belmont Road Auxiliary Military Hospital, of which Dr. Blacklock was in charge.

A portion of the salaries of some of the members of our staff, which had by now been extended, was paid by the War Office. Those engaged in research work comprised at this time Lieutenant-Colonel J. W. W. Stephens, Royal Army Medical Corps, Professor W. Yorke, Dr. B. Blacklock, Dr. J. W. Scott Macfie (seconded by the Colonial Office), Mr. C. Forster Cooper (Superintendent of the University Museum of Zoology, Cambridge), for whose services we are indebted to the Special Board for Biology and Geology, and Mr. H. F. Carter, who was lent for this purpose by the Professor of Entomology.

Publications.-Up to the present time five papers, embodying the results of our researches, have been published in the Annals of Tropical Medicine and Parasitology (five others are ready for press).

1. Intravenous Injections of Tartar Emetic.-By Lieutenant-Colonel J. W. W. Stephens, W. Yorke, B. Blacklock, J. W. S. Macfie, C. Forster Cooper. Annals of Tropical Medicine and Parasitology, Vol. XI., No. 1, pages 91-112.

As a result of our work it was shown that tartar emetic was of no value in the treatment of malaria.

2. Intramuscular Injections of Quinine Bihydrochloride in Simple Tertian Malaria.--Lieutenant-Colonel J. W. W. Stephens, W. Yorke,

B. Blacklock, J. W. S. Macfie, C. Forster Cooper. Annals of Tropical Medicine and Parasitology, Vol. XI., No. 1, pages 113-125.

An intramuscular injection of quinine bihydrochloride, 15 grains, in two cubic centimetres of water on each of two consecutive days, is an efficient mode of treating simple tertian malaria.

3. Intravenous Injections of Quinine Bihydrochloride.-By Lieutenant- Colonel J. W. W. Stephens, W. Yorke, B. Blacklock, J. W. S. Macfie, C. Forster Cooper. Annals of Tropical Medicine and Parasitology, Vol. XI., No. 2, pages 149-164.

Conclusions: In simple tertian malaria intravenous injections of quinine bihydrochloride in the doses used (10-15 grains)—either one or a series of six- effect a temporary cure (i.e., cessation of febrile paroxysms and disappearance of parasites from the cutaneous blood). Relapses occur after approximately the same period from the end of treatment, whether one or six injections have been given.

In malignant tertian malaria, neither a single nor a series of six injections, in the doses used (10-15 grains) causes the disappearance of parasites (trophozoites or gametes) from the cutaneous blood.

4. Intramuscular Injections of Amylopsin and Trypsin in Simple Tertian Malaria. By Lieutenant-Colonel J. W. W. Stephens, W. Yorke, B. Blacklock, J. W. S. Macfie, C. Forster Cooper. Annals of Tropical Medicine and Parasitology, Vol. XI., No. 2, pages 165-172.

This method is of no value in the treatment of malaria.

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5. Intramuscular Injections of Quinine Alkaloid in Simple Tertian Malaria. -By Lieutenant-Colonel J. W. W. Stephens, W. Yorke, B. Blacklock, J. W. S. Macfie, C. Forster Cooper, and H. F. Carter. Annals of Tropical Medicine and Parasitology, Vol. XI., No. 2, pages 173-182. An intramuscular injection of quinine alkaloid, 15-30 grains, is as efficacious as a similar injection of a quinine salt.

None of these methods effect a radical cure, i.e., an eradication of parasites from the body. Our further researches were then directed to this end, and, short of attaining this, to the securing of an efficient treatment which will keep the patient free from relapses. All experimental work on treatment has been con- trolled by daily microscopical examinations of blood specimens from all the cases treated, the only accurate method when dealing with a disease like malaria in which parasites are present in the blood. Consequently this work and that involved in the diagnosis of malaria cases in the Liverpool district has been of a burdensome nature.

I have, &c.,

J. W. W. STEPHENS, Professor of Tropical Medicine.

The Secretary,

SIR,

the

Incorporated Liverpool School of Tropical Medicine,

B10, Exchange Buildings, Liverpool.

Enclosure 2 in No. 14.

The Incorporated Liverpool School of Tropical Medicine,

Department of Medical and General Economic Entomology,

B10, Exchange Buildings, Liverpool, 30th November, 1917.

I HAVE the honour to submit a report of the work of this Department for year ending 31st October, 1917.

Students. (1) Three courses of instruction were given to the students attending this School for the Diploma in Tropical Medicine. The total number of students attending was sixteen.

(2) Three special short courses of instruction were given to officers of the Royal Army Medical Corps who were proceeding to the Eastern armies. About eighty students attended.

(3) Two courses of lectures and demonstrations were given to the students of the Medical Veterinary School.

War Office: Dysentery and Malaria.--Mr. H. F. Carter, Lecturer in Entom ology, has devoted most of his time to this work under the direction of the Pro- fessor of Parasitology; but during my absence, through illness, he was granted permission to deliver lectures to the students.

Imperial Bureau of Entomology (Colonial Office).-Eight small collections of insects were received for determination and report. These collections represented the following families:-Phlebotomina, Coccidæ, and Aleurodidæ, and were sub- mitted by eight different correspondents distributed as follows:-British Guiana (4), Jamaica (2), Southern France (1), Mombasa (1), British East Africa (1), West Africa (1).

Royal Society Grain Pests (War) Committee.--The President and Council of the Royal Society allotted a suni of £100 as salary for an assistant to investigate the problems connected with the damage caused to grain and flour during transit and in store. Miss H. M. Duvall, B.Sc., was appointed to carry out the investi- gation under the direction of the Professor of Entomology. This research has bsen undertaken with a view to ascertaining, if possible, (1) the nature of the injury resulting from mite infestation in stocks of grain and flour; (2) the condi- tions under which these creatures live and multiply; (3) the sources of infestation: (4) practical methods of prevention and destruction of the pests. The inquiry is as vet far from complete, but the results show (a) that flour suffers more deteriora- tion than wheat from mite attack and that the effects of such attack are less readily combated; (b) that moisture content is, at the temperatures at which in this country flour and wheat are stored, the primary factor determining their presence in harmful numbers. A memorandum on this subject has been prepared for publica- tion and will shortly be circulated by the Royal Society.

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