Sessional_Paper_1904 — Page 528

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6o. In no less than 7 cases no cause was discoverable and of these two were fatal. May they be sporadic cases due to bacillus dysenterica?

Paramecium Coli, mentioned by TREILLE, as a cause of dysentery in Cochin China I have never met with.

As regards treatment there is nothing new to mention. The local condition being the same, the same treatment seems to suit most cases. Here salines have long been favourites and they give us good results, quinine of course being used in cases with malaria. Ipecacuanha we seldom now use and in our experience it is not of much use if salines fail. If used at all the best results seem to be obtained by using it as an enema. I found carbolic acid (grs. 20 ter die) useful in the cases with cercomonas intestinale. Enemata of potass: permanganat: were also useful in 2 or 3 obstinate cases.

If dysentery is a cause of liver abscess it is surprising this latter is not inore frequent.

Of the cases treated 20 were amongst Europeans, 24 Indians, 3 Chinese, and 3 Japanese.

Parasites.-The more important of these were (a) Guinea Worm-two cases. This disease is, I believe, unknown in China and both our cases were in Indians. For preserving the embryos permanently I found a saturated solution of erythrosin most useful though LEISHMAN, to whom I sent some specimens, recommends his own stain which is certainly the best for filaria. He suggests overstaining and quickly washing in water slightly acidified with acetic acid.

(b.) Filaria Nocturna.—Several cases have come under our notice but none of them with any very special symptoms. This is strange for they are of fair size, as compared with malaria, and teem in the blood stream without seemingly doing much harm as most of them were only found in the routine blood examination. It is interesting to note that in the cases (plague, malaria, and leprosy) the parasite showed up by day as well as by night. It may be of use to mention that Ross' method for malaria is the best way to get them in number and LEISHMAN'S stain the best for preserving them permanently.

(c.) Distoma Ringeri-A case of this interesting disease occurred in a Japanese sailor, the only symptom being haemoptysis. I was not able to get eggs to stain so as to preserve the specimen permanently nor was I able to get them to develope after any of the recognised methods. This is the first case we have ever had here.

(d) Ankylostoma Duodenale.-Several cases have occurred in which the eggs were found in the stools but none of them with any very pronounced. symptoms. One case, a Japanese, was a small pathological museum as his stools showed amceba, eggs of this parasite, tricophalus dispar and ascaris lumbricoides.

Poisons. Of the 12 cases 7 were due to datura alba and five to opium. None of the foriner were fatal but two of the latter succumbed.

Hepatic Abscess.-Five cases-one European, three Indian and one Chinese. They were all operated upon and of the number four died. Three were cases of multiple abscesses, a hopeless condition, and the fourth was in a patient the sub- ject of malaria Soon after the operation he had profuse hæmorrhages from the abscess cavity, the rectum and stomach and gradually sank. The Chinese case was interesting in that it occurred in a woman--a rare event.

Tetanus.--Two cases occurred both as the result of wounds the incubation. period in one case being a month and the other a fortnight. They were both treated with carbolic acid 20 minims every four hours, morphea and chloroform when necessary.

One recovered from the tetanus and the other died on the 8th

day.

life.

Injuries.-Bullet wounds.-8 cases were under treatment, none fatal. Dynamite Explosion.--5 cases, one fatal and all the others badly maimed for