Sessional_Paper_1904 — Page 524

416

The following diseases caused the greatest number of deaths :----

Diseases of Respiratory System,

Diseases of Digestive System,. Typhoid Fever, Dysentery,..

Injuries,

30 cases. 17

6

17

12

11

27

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Dengue Fever.-123 cases of this uninteresting disease; were admitted as against 422 in 1902. The epidemic started in August and was practically over in October. The blood of all patients was examined in many ways but without any result nor were cultivation experiments more successful. The Government Bacteriologist (Dr. HUNTER) attended on several occasions with a view to examining the blood but his results were also negative. Several of the nursing staff suffered and we were at times hard pushed in the nursing line.

The cases were much the same as in other epidemic, varying in severity and none fatal. Diaphoretics, salicylates, yeast (according to the French method), and carbolic acid in 20-minim doses were all tried but without any very marked result. Next to morphia, hypodermically, salicylates were most useful. The disease was rarely associated with malaria (two cases only) and the parasites found by Dr. GRAHAM of Beyrout and which he claims as the producer of the disease must have been either vacuoles or the ringformed non-pigmented malaria. The epidemic moreover is very unlike a disease conveyed by mosquitoes.

Malarial Fever.-346 cases have been under treatment as against 349 in 1902, and 787 in 1901. There were only two deaths due directly to this disease.. The varieties of malaria met with were:-

Malignant, Simple Tertian,.

Quartan,..

Mixed infection,

71.6 per cent.

16.9

5.9

5.4

One case of mixed infection was interesting as the two simple forms were associated, a rare occurrence in our experience. The diseases associated with malaria were :—

Injuries,

Beri-beri,

Pneumonia,

Heart Disease,

Phthisis,

Venereal Disease,

Plague,

Hepatic Abscess,

Dysentery,

Abscesses,

Necrosis of bone,

Rickets,

Dengue,

Cirrhosis of Liver,

Alcoholism,

Eye Disease,

7 cases.

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The influence of nervous shock, as seen in the association of injuries with malaria, is interesting; and needless to say all debilitating causes casily bring out an attack in a patient previously subject to the disease. The Maternity Hospital cases also exemplify this for most of the patients admitted have previouly had malaria and 4.41 per cent. had an attack shortly after the birth of the child.

At your request an investigation has been carried out as to the efficacy of methyl blue in destroying or removing from the blood stream the crescent forms. No one has as yet settled how long they remain without treatment and it was essential this should be ascertained. All patients with crescents had their blood examined daily and a record kept. The length of time varies directly as the number of crescents first seen and this gives such a wide limit that any drug vaunted as a specific must exercise its influence very rapidly to escape criticisin.. Of the untreated cases in which the crescents disappeared during their stay in hospital the average duration was 13 days, the shortest being 4, and the longest 30. There were also six cases which for various reasons it was not possible to detain in