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No. 156.

COLONIAL OFFICE to CROWN AGENTS.

GENTLEMEN,

Downing Street, September 8, 1904. I AM directed by Mr. Secretary Lyttelton to inform you, with reference to the letter from this Department of the 26th of July,* that Hong Kong should be added to the list of those Colonies which have agreed to make contributions to the Tropical Medicine Fund, and that the amount of its first annual contribution, viz., £100, should now be transferred to the credit of the fund.

2. The Hong Kong Government have promised a contribution of £100 annually for five years.

3. The amount of the donation of the Bermuda. Government to the fund is £100 and not £250 as stated in the letter from this Department of the 26th of July.* The accounts of this Colony and the fund should be adjusted accordingly.

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No. 157.

FEDERATED MALAY STATES.

I am,

&c.,

C. P. LUCAS.

HIGH COMMISSIONER SIR JOHN ANDERSON to MR. LYTTELTON.

(Received September 12, 1904.)

[Answered by No. 169.]

(No. 416.) SIR,

Government House, Penang, August 18, 1904. WITH reference to your despatch, No. 120, of the 3rd of May last, † on the subject of the staff of the Institute of Medical Research at Kuala Lumpor, I have the honour to submit copies of further correspondence with the Resident-General on the matter.

2. On receiving the Resident-General's despatch.of 9th June, I discussed the matter with Dr. McDowell, the Principal Civil Medical Officer of the Colony, and decided to defer any action until I had the opportunity of seeing something of the work of the Institute and of discussing the matter personally with the Resident- General and the Director during my visit to the Federated Malay States.

3. During my stay in Kuala Lumpor, I visited the Institute with the Resident- General, the State Surgeon, the Director, and went carefully through the building and tried, so far as a layman can, to ascertain what was the work upon which it was engaged. I found, as you are already aware, that since the arrival of Dr. Daniels, the special investigation of beri-beri has been intermitted, and that Dr. Daniels, rightly, I think, did not propose to resume it until he was in complete possession of the results of the work of his predecessor Dr. Hamilton Wright, for which unfor- tunately he is still waiting. In the meantime he had been making various examinations and investigations in connexion with the water supply of Kuala Lumpor and other places and also into the outbreak of rinderpest which had occurred in the Federated Malay States.

4. So far as I could ascertain, these investigations the value of which is unquestionable were such as in the ordinary course would form part of the usual work of a medical officer of health, and were scarcely of a nature which could properly be described by the more ambitious term "research."

5. For this I do not in any way blame Dr. Daniels. The matters were pressing and he undertook them at the request of the Government, and, I need not say, carried them through far better than anyone else available could have done. But it points to the conclusion that at the present stage of development of the Federated Malay States the treatment and resolution of the novel problems of public health, more especially from the administrative point of view, must perforce take precedence of continued special research in regard to any particular disease. The memorandum

• No. 129.

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of Dr. Daniels of 17th May appears to point to the same conclusion-that research must be incidental and subordinate to the treatment of current and pressing questions, and it will be seen that the arrangements he proposed as to the future staff of the Institute were on those lines. In his previous memorandum of 28th April, 1903, in which he had pressed for the appointment of permanent assistants, he had pointed out that, for the investigation of tropical disease, there are well-equipped laboratories and abundant material in Egypt and for more purely tropical work, ten to fourteen days from England, British Guiana, Barbados and Trinidad offer a larger amount and greater variety of clinical and pathological material than we do, though not our laboratory accommodation.

6. It will be seen from paragraph 6 of his despatch of 9th June the Resident- General states that Dr. Daniels' proposals for the future staff of the Institute were:-

(1) A Director as at present on deputation from the London School of Tropical Medicine, one assistant, a bacteriologist, an entomologist, a mycologist and a chemist, and from paragraph 11 of the memorandum enclosed in that despatch it appears that it was contemplated that these specialists should do work for the Medical, Forests, Veterinary and Agricultural Departments while their main function would presumably be to assist the Director in his work of research.

7. I agree that with the establishment of an Agricultural Department, as to which

I am still waiting for the report of Mr. Willis, the appointment of the three last named specialists will be necessary, and the appointment of a bacteriologist and Medical Officer of Health has only been avoided hitherto because a great part of the duties of such an officer have been performed by the officers of the Institute.

8. The question remains as to the direction and management of the Institute. The main part of its work will be necessarily medical and agricultural, and if it remains a separate institution, directed by an officer temporarily employed because of his special capacity for research work, it will be impossible to avoid the impression that the work required of it by the various departments mentioned will be regarded as subsidiary to the main object of special research for which the Director would be selected. But as I have already pointed out, in our present circumstances it is im- perative that research should be subordinated and subsidiary to the treatment of current questions and problems, and it appears to me that the direction of the Insti- tute with a staff of four specialists should rest with a Committee of the heads of the Departments interested, viz., Medical (including Veterinary), Agricultural, Forests and, possibly, Mines, with the head of the Medical Department as Chairman and immediately responsible for the administration.

9. The appointment of a special Director and an assistant would not be required, but the services of the specialists would, of course, be available for the assistance of Dr. Daniels till the termination of his engagement next year.

10. It will, no doubt, frequently be found desirable to secure the services of a highly trained and qualified scientist to undertake special investigations, and the permanent staff of the Institute will be available to render him the necessary assistance in prosecuting his research, but I do not at present contemplate the appointment of a successor to Dr. Daniels.

SIR,

Enclosure in No. 157.

I have, &c.,

JOHN ANDERSON.

RESIDENT-GENERAL to HIGH COMMISSIONER.

(No. I.M.R. 3939/04.)

Resident-General's Office, Selangor, June 9, 1904. IN reference to H.C.O. letter, No. S. of S. 545, of 6th April last, forwarding, for my information, copy of the Secretary of State's despatch, No. 59, of the 2nd March, 1904, on the subject of the appointment of a permanent assistant for the Federal Institute for Medical Research at Kuala Lumpor, I should like, with Your Excellency's permission, to summarise briefly the position.

2. The proposals in my letter, No. 4572/03, 2nd September, 1903, were One permanent assistant-pensionable.

Salary-On agreement for three years at £360, with a prospect of being drafted into the General Medical Service on the expiration of agreement, unless services re- quired permanently at the Institute. In the latter case appointment after expiration

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of agreement period, to be made pensionable; service on agreement to count for leave and pension; salary £410, rising by four triennial increments of £50 to £610; no private practice.

Study leave for not less than three months in any three years, not including time spent in passages, to take the place of full pay ordinary vacation leave in Europe; full pay; fees (if any) and passages both ways to be paid by Government.

The Secretary of State agreed to these terms, with the exception of the grant of free passages to and from England (I may remark that I did not intend to propose that study leave should necessarily be spent in England), and enquired if the post could be given to either of the present assistants.

**

On the Director's advice I recommended that one of the present assistants, Dr. Milne, should be "tried " in the appointment; I submitted copy of a minute by the Director, dated 6th January, 1904.

The Acting High Commissioner doubted the desirability of appointing a perma- nent assistant and suggested the extension for one year of Dr. Milne's engagement.

I submitted copy of a letter from the Director, No. 2, of 15th February, 1904, giving his views further.

Dr. Daniels' letter had not reached the Secretary of State when the Secretary path, 69 af of State replied, approving the extension of Dr. Milne's engagement for a year instead 0.054504 of appointing a permanent assistant at present, and of a proposal that if at any future time one of the assistants is sent to study in any other tropical laboratories the time so spent should count as service, and the cost of passages be paid.

of 6/4/04. R.G.O.. 2:808/04.

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3. Dr. Milne has been asked if he will accept extension of his engagement on present terms, and has been informed of the conditions which would attach to the permanent post if it were conferred upon him. His reply has not yet been received.

4. I have now the honour to attach copy of a letter from the Director, No. 71, of 17th May, 1904, submitting a further expression of his views on the staff, work, and uses of the Institute.

In my opinion, as we have now progressed so far, is impossible to retrace our steps, and a definite policy should be laid down in regard to the Institute.

5. Your Excellency intends to visit Kuala Lumpor next month, and will, I trust, be able to discuss this matter, at the Institute, with Dr. Daniels and myself.

What Dr. Daniels will probably wish to propose to Your Excellency is a staff

of:-

Pensionable.

6.

(1) Director-on deputation as at present from the London School. (2) Assistant-one.

(3) Bacteriologist and Medical Officer of Health for the Federated Malay States with special duties as regards the town of Kuala Lumpor. (4) Entomologist.

(5) Mycologist.

(6) Chemist.

Posts (4), (5) and (6) will eventually be required, in all probability, in connection with the proposed Agricultural Department. I do not think we can go on much longer without the services of a Bacteriologist and Health Officer (No. 3).

Dr. Daniels' alternative proposal will be to proceed as at present, but with two permanent assistants for the Institute. A third alternative would be to abandon the policy for which the Institute has been equipped and to reduce the institute to a small laboratory such as that in Singapore (paragraph 10 of the Director's letter, No. 71, of 17th May, 1904).

His Excellency

The High Commissioner,

Federated Malay States, Singapore.

I have, &c.,

W. H. TREACHER, Resident-General, Federated Malay States.

(No. I.M.R. 71/04.)

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Institute for Medical Research, Kuala Lumpor,

Federated Malay States, May 17, 1904.

Re the Staff, the Work and the uses of the Institute.

SIR,

I HAVE the honour to submit the following points for consideration with reference to the uses of the Institute, the staff required for the Institute and the description of the work to be undertaken by the staff of the Institute. In doing so, I think it will make matters clearer if I recapitulate what appears to have been the original idea and the subsequent modifications as so many of these seem to have been decided at interviews and it is difficult to understand from the correspondence alone what changes occurred.

2. Originally the intention appears to have been to found a small well-equipped laboratory and provide a pathologist. The appointment was made of a man with special training in diseases of the nervous system as he was required specially to investigate beri-beri. He soon found it necessary to decline to do either public health or general pathological work as this would have taken the whole time and would prevent the investigations for which he had been specially selected.

3. Instead of the small laboratory suggested originally it was decided to make a much larger building with accommodation for a large number of workers, and there seems to have been an idea that with good and free use of laboratory and appliances unpaid workers would resort to Kuala Lumpor and aid in the investigation of tropical diseases. I have elsewhere given reasons for believing that no reliance can be placed on a sufficient staff of voluntary workers, as the class of men of independent means 'who wish to undertake the investigation of disease is very small, and few of these are specially interested in tropical diseases and the materials available are not more than can be found nearer England as West Indies, Egypt, West Africa, &c.

It has been shown that some workers will come, but so far only two (Drs. Durham and Tuck) have aided in the investigation of disease. The others came to receive information on special points.

4. Dr. Hamilton Wright later advocated the appointment of two trained medical men as assistants at higher salaries than the ordinary medical officers and with special qualifications for the work. This was refused, but two medical men at the same salaries as the Government medical officers were appointed and these were here on my arrival.

5. As it appeared to me that these men to be of real use required additional experience and training and that this would be required with each such new officer and also to preserve a continuity in the work, I advocated that in case these or sub- sequently appointed officers showed special aptitude for the work, the Government should at the end of the three years' agreement, instead of drafting them into the medical service, retain them at the Institute at a higher increment than officers in the medical service (as compensation for the absence of private practice) and with a 102'03. provision for special study leave to be spent at such places as the Resident-General might approve.

The recommendation was supported by you for one assistant.

I.M.R.

6. The matter has been referred to the Principal Civil Medical Officer, Straits Miscella- Settlements, and to the Medical Adviser to the Colonial Office, with the result that neous the Secretary of State for the Colonies has decided to extend the period of Dr. Milne's 4572(03. probationary services from three years to four years, and that occasional study leave at other tropical places may be granted from time to time. I have not thought it advisable at present to inform Dr. Milne, but I have no doubt that he will decline to accept the proposed extension of his probationary period. I have also reason to believe that after experience of the larger income, more independent position, and better housing of a district medical officer he will in any case prefer to be drafted into the medical service as provided for in his agreement at the end of his period of probation or earlier.

7. Much pressure was brought to bear on the Tropical Schools to provide the two assistants for the Institute and you have not been provided with the full corre spondence at home on the matter. The agreements were clear that the appointments were special and distinct from the medical service for the three years covered by the agreements. It was, however, ruled by the then High Commissioner that (Sel. 7037/03) paragraph 6. "I should have no hesitation whatever in ordering the assis- tants at the Research Institution to temporarily discharge other duties, and I can

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