CO885-(7-8) — Page 5

145.

PUBLIC RECORD OFFICE

Reference :-

C.O.885

PUBLIC RECORD OFFICE, LONDON

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

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blackwater fevers. Your Lordship will see from the pamphlet* which has been drawn up at my suggestion by Dr. Gray (copy of which is enclosed), and also from the monthly return of sickness and diseases (copy of which is also enclosed), that every medical officer of the Protectorate will send in to Head-quarters, Zomba, a return of the various diseases which may come under his notice each month. He will also make special notes of every case of blackwater or other diseases which he may treat. These reports will be printed and sent round to the various medical officers for their informa- tion and for any further notes which they may see fit to make. Month by month these notes will be collected and printed in pamphlet form, and circulated amongst our medical, officers. I trust that by this means we shall have some reliable data to go upon, the result of the collective observations of medical men who have had an oppor- tunity of treating various tropical diseases. If considered advisable it would be pos- sible to send these printed notes as they come out to the hospital which is to be estab- lished for the treatment of tropical diseases in London, and the specialists there might be able to give us further information, or, at any rate, they might be of use to those studying tropical diseases.

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The question of sending out a specialist to Central Africa who would devote his time to studying blackwater fever has lately arisen in the Protectorate. I have on two occasions been asked by residents to give my opinion as to the advisability of suggesting this course to Your Lordship. I have replied that I do not consider the present time would be suitable to send out a specialist or a bacteriologist, for the reason that I do not consider that we ourselves, i.e., the Medical Department, have yet done all we can in studying and obtaining information regarding blackwater fever.

As it is, in the Protectorate, we have now seven medical officers, the majority of whom are thoroughly well-trained doctors, and I do not consider that we should be doing them justice unless we first allowed them to endeavour to study and, if possible, discover something of the nature of blackwater and other fevers.

If, after the present scheme of Medical Intelligence has been working for some time, and after we have collected a considerable amount of data and information upon tropical diseases, the medical officers are still of opinion that they are in the dark as regards the nature and treatment of these diseases, then I think possibly the time may have arrived when we might suggest the appointment of a specialist for their study to Your Lordship.

We should then have a large number of observations to go upon, and the specialist, on arriving in this country, would be able at once to commence working with a certain amount of data at his disposal and, at any rate, the ice would have been broken for a specialist's researches. As it is, I consider that a specialist or, rather, a bacteriologist, would have considerable trouble in meeting with cases of blackwater unless he were continually travelling up and down the country, in which event, while watching one case, he might miss several others, as the unhealthy season is from December until May, and it is not as if in any one part of the Protectorate a large number of cases were present together as in a hospital-cases as a rule are spread throughout the Protec-

I have, &c.,

torate.

W. H. MANNING,

Lieutenant-Colonel, Her Majesty's Acting Commissioner and Consul-General. The Secretary of State for Foreign Affairs,

Foreign Office.

26144/97.

No. 95.

COLONIAL OFFICE to the GENERAL COUNCIL OF MEDICAL EDUCATION AND THE MEDICAL SCHOOLS..

SI

[Answered by No. 132.]

Downing Street, November 9, 1898.

1. In the 5th paragraph of the letter from this Department of the 11th of March last, it was stated that Mr. Secretary Chamberlain, with a view to supplementing the instruction afforded by the medical schools, was endeavouring to make arrange- ments for giving to Colonial medical officers special clinical instruction in tropical medi-

• Not printed.

† No. 12.

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cine such as is given at Netley and Haslar in the case of medical officers of the Army, Navy, and Indian Medical Services, and which, from lack of the necessary material, cannot invariably be given at the medical schools.

2. These arrangements have now been made. The Directors of the Seamen's Hospital, at the Albert Docks, which offers exceptional opportunities for studying cases of tropical disease, are providing the necessary buildings and teachers for the accom- modation and instruction of the medical officers who may hereafter be selected by the Foreign Office and the Colonial Office for appointments in the tropics. A sub- stantial contribution towards the initial cost of the buildings is being made by the Government, and it is hoped that, by the 1st of October, 1899, it will be possible to receive medical officers at the hospital for purposes of instruction.

3. It is proposed that, as is at present the case, candidates for medical ap pointments in the British Colonial Possessions shall be fully qualified before they can be put upon the Secretary of State's list; that from this list a certain number shall be selected annually to fill the vacancies which may occur in the Colonial Medical Service; that the selected candidates shall be trained for a period of at least two months at the Seamen's Hospital; and that they shall then be sent to the Colonies or Protecto- rates to which they have been allotted, where, when practicable, they will be attached in the first instance to the Head Quarters' Hospital for the purpose of gaining additional experience. In estimating the respective merits of candidates on the Secretary of State's list, regard will be had to the fact whether or not they have already received in- struction in tropical medicine.

4. Judging from the replies which have been received from the General Medical Council and the medical schools, Mr. Chamberlain believes that the above arrange- ments will prove acceptable.

5. Although the school at the Seamen's Hospital is designed for the training of medical officers for the Government Service, doubtless there will be many other medical men, such as the medical officers of missionary societies and trading corporations, and private practitioners who propose to settle in tropical countries, who will be glad to avail themselves of the advantages which such a school can offer.

6. The Colonies are being asked to make pecuniary contributions, to collect pathological material for use in the school, and to support the scheme in every possible way. So far, then, as this Department is concerned, no effort is being spared to make the school a success, and Mr. Chamberlain feels confident that the medical schools of this country will also do what is in their power to assist the development of an institu- tion which is likely to be of general service, and to benefit medical science not only by giving a stimulus to the investigation of tropical disease, but also by qualifying a body of men to become investigators.

7. Mr. Chamberlain is so impressed with the importance of this subject as affect- ing the administration and well-being of the tropical colonies that in addition to this scheme for providing a thoroughly efficient Colonial medical staff, he wishes to en- courage by every means in his power scientific enquiry into the causes of tropical diseases. Accordingly, he has already, after correspondence with the Royal Society, instituted a Commission to study the subject of tropical malaria on the following lipes.

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8. The Royal Society has nominated two competent observers who have already proceeded to Italy for a short preliminary study, and will afterwards go to some place in Africa, probably in the first instance to Blantyre, in the British Central Africa Pro- tectorate, where it has been ascertained that there exist good opportunities for carry- ing out the purpose in view.

9. In addition the Secretary of State has nominated an experienced medical officer of the Colonial Service to aid in the investigation. This officer will, in the first place, proceed to India in order to study under Surgeon-Major Ronald Ross for about two months so as to make himself acquainted with the result of that gentleman's researches. He will then join the other two observers in Africa, where they will together pursue their studies, which will probably occupy about two years, and report from time to time to a committee in England nominated jointly by the Royal Society and the Secretary of State.

10. Mr. Chamberlain has been glad to learn from the replies which have been sent to the letter referred to above that arrangements already exist, or are about to be made, for giving special instruction in tropical medicine in upwards of twelve British

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