Five cases of generalized peritonitis secondary to perforating lesions of the gastro-intestinal tract were benefited by treatment with aureomycin. Four of these received the drug postoperatively: the fifth recovered withoLut surgical intervention.
Among the losses sustained by the Institute for Medical Research in Malaya during the Japanese occupation were the portraits of several of the former directors. The loss is unfortunate, as we had hoped to make use of a fifty-year series of portraits for a historical rne'noir planned for the Institute's half-centenary this year. The missing portraits are those of Dr. Hamilton-Wright, M.D. (McGill), and Dr. Henry Fraser, M.D., M.R.C.P. Dr. Wright retired to America after leaving Malaya in 1903 and died in Washington, D.C., in 1917. Dr. Fraser was born, I believe, in Aberdeen. He retired from Malaya in 1916 to live in Scotland, where he died in 1930. I would be grateful to any of your readers who could put me in touch with surviving relatives.
A general survey has been made of tuberculosis in the Jesselton – Tauran area. Climatical, living, and occupational conditions tend to favour the spread and advancement of the disease. The death rate is high, but has been influenced by conditions attributable to the war. The native population, due to their mode of life, succumbs more easily to the disease that do the Chinese. Cases are usually seen in the late stages, mainly due to ignorance.
This paper records some interesting findings of anophelines resting by day in vegetation In' Malaya. Anophëles maculatus was the commonest species and the majority of specimens were found to have had a recent blood meal, In general few Malayan anophelines are endophilic, so the author instituted systematic searches of vegetation in the vicinity of labourers' lines and cattle sheds on a rubber estate, where breeding sites of A. maculatus in the form of small streams and ravines abounded. Searching was carried out by trained assistants using hand catching with cyanide tubes, and catches on different occasions yielded results varying from 1 to 13 anophelines per man-hour. It was found that the densely shaded banks of streams had a relatively small population of anophelines. Rather they favoured the more open type of vegetation under trees, represented mostly by the common Malayan bracken fern. A. maculatus was by far the commonest anopheline found under these conditions, usually within a few inches of the ground where the bracken was 1-2 feet high and sheltered but reasonably free of access. Of the other 8 species of anophelines found, A. hyrcanus and A. barbirostris were usually found at a greater height from the ground, A. aconitus in more secluded spots and A. philippinensis in vegetation where ferns were replaced by sedges and small bushes. Analysis of the specimens captured showed that there were more than six times as many females as males of A. maculatus. Of these females approximately two-thirds contained fresh blood while the remainder were gravid or unfed indicating that adults in all stages of development make use of the same daytime harbourages. Dissections showed that maturation of the ovaries was complete 48 hours after a single blood meal and this same period appeared to hold good for several other of the species concerned. A. vagus, however, probably completes the whole cycle in 24 hours. Precipitin tests showed that 20 per cent. of A. maculatus had fed on man and nearly all of the remaining 80 per cent. on cattle. Of the other species only 7 per cent. of A. hyrcanus and a single specimen of A. karwari had fed at all on man.
The prospects in Malaya in the immediate future may be briefly summarized as follows : For residual sprays, DDT and gamma BHC, unless some outstanding new compound appears, will continue to be the most widely used. Both kill the principal malaria carrier. Anopheles maculatus and gamma BHC for a short period after application also kills the common nuisance mosquito, Culex fatigans. Though DDT does not kill C fatigans it prevents them from resting in rooms and reduces the number of biting. Both insecticides should eliminate bed bugs Cimex hemipterus during the course of spraying and reduce cockroach infestation. For the elimination of cockroaches and ants from houses gamma BHC is superior to DDT but the effect is short lived. The other residual insecticides, Chlordane, Toxaphene, Methoxychlor and the newer products Aldrin and Dieldrin are not likely to be used extensively in Malaya. They cannot yet be purchased locally and on present indications have no outstanding advantages to recommend them instead of DDT or BHC. Personal protection against scrub typhus infection is now satisfactory. Either DBP or benzyl benzoate rubbed into clothing should prevent the attachment of mites for several days, and DMP is also effective if applied daily to the skin or clothing. The mite population in an infective area can probably be reduced effectively by spraying BHC on the vegetation, but this method of control is not likely to be attempted in many areas. DMP is a good mosquito repellent and forms the main ingredient of several commercial preparations; it is not as effective when incorpora ted in a cream as it is when pure. Of the several simple, efficient remedies now available for head louse and scabies control, gamma BHC in coconut oil is probably the most useful because of its cheapness, ease of application, and effect on both parasites.
1. Several experiments were carried out in the field and in the laboratory with various insecticides against A maculatus. 2. Almost all the mosquitoes that came into contact with surfaces sprayed with DDT preparations died in less than 30 hours but the length of life varied with the preparation and depended on various factors that are mentioned. Control mosquitoes lived almost twice as long. 3. Gammexane Dispersible Powder (P 520) killed in a much shorter time than the DDT preparations and holds out a greater hope of success in controlling ‘A maculatus’ malaria with insecticides. 4. It is difficult to assess the value of insecticides in any one year in areas where breeding of the vector is intense. The results of long term field experiments, under strict control, are awaited. 5. Meanwhile, Mass Suppression with drugs still remains the method of choice – in this area.
This work, carried out on a rubber estate in Malaya during 1949, was a Continuation of the trials begun in 1948 previously recorded [this Bulletin, 1949, v 46, 1116]. Full details concerning the terrain and the nature of the experiment were given in the previous publication. In 1949 the malaria rate in the area approached the rates which were customary in pre-war years, for the first time since the reoccupation of the country. The Indian population which was chosen for the experiment contains the survivors of the Japanese occupation; many had been in Siam and almost all had suffered from malaria. Treatment had been entirely lacking or very inadequate, with the result that the survivors had developed a high degree of immunity by the end of the war. These facts probably explain the low incidence of malaria in post-war years in spite of high prevalence of A. maculatus. No anti-larval measures have been carried out since 1941. Neo-premaline completely suppressed malaria in one group, the control group showing a high incidence. In other groups chloroquine, or chloroquine and pentaquine combined, given once a week, promptly brought to an end primary waves of malaria which were rising rapidly.
Field experiments have been made with DDT in oil as a larvicide on flowing water against Anopheles maculatus. 1. In unweeded drains and streams, 2 oz. DDT per acre applied evenly with a pipette as a 5% solution in Malariol, gave control 1 day later of over 900%. 2. The same dose in an oil (Malariol H S) with a very high spreading pressure (33 dynes/cm) when applied at intervals of 30 yards gave only 50% control. When applied evenly control was 98%. When applied at intervals of 22 yards (one chain) in a grassy roadside drain, control was 61% before the drain was weeded and 73% afterwards. The DDT in oil when applied at intervals was prevented from reaching all the larva e by strong surface films, obstructions and side pockets, and it is clear that to control A. maculatus application must be continuous and not at spaced intervals. 3. Continuous application by spraying with a Mish pump was compared with even distribution of the same dose with a pipette. Control by pipette was only 72% on this occasion, due probably to a heavy growth of weeds, but control by spraying was considerably less, only 56%, apparently because much of the fine spray was blown away before reaching the water. The sprayer was very tiring to use. 4. DDT in Malariol with a spreading pressure of about 20 dynes/cm was compared with DDT in Malariol H S (S P about 33 dynes/cm). Both solutions were applied at intervals of 30 yards at the rate of about 2 oz. of DDT per acre. Control 1 day later was 84% with DDT in Malariol H S and 78% with DDT in Malariol. It is concluded that under the adverse conditions of these experiments (drains not weeded or maintain ed, DDT applied at intervals), better control is obtained by using oil with a very high spreading pressure. 5. Doses of about 4 ounces and 2 ounces of DDT per acre were compared. Application was by even distribution with dropping bottles. The heavier dose gave somewhat better immediate control, and had a better lasting effect, delaying the reappearance of large larvae (4th instar), usually until later than the sixth day after treatment. 6. DDT in Malariol applied evenly with dropping bottle at about 4 oz. DDT per acre was compared with ordinary oiling with a knapsack sprayer at about 23 gallons per acre. The experiment was made in weeded and well maintained drains in the Kuala Lumpur oiling area. Both treatments gave complete immediate control, no larvae being found two days afterwards, but breeding recovered a little more rapidly after the DDT treatment, though there were no large larvae on the sixth day. 7. Numerous readings were made of the strength of natural surface films on the water of breeding places. The results show a fair measure of agreement with those obtained in West Africa by Toms. The commonest film strength was found to be 7.5 – 13.0 dynes/cm., but the proportion stronger than this varied from place to place. The readings from the breeding places of A maculatus suggest that for an ordinary anti malarial oil a spreading pressure close to 25 dynes/cm will usually be sufficient. 8. It is concluded that DDT in oil at about 4 oz. of DDT per acre (=½gal of a 5% solution) can give satisfactory control of A maculatus, especially in properly maintained drains. However, the solution must be applied evenly, and with such small quantities there seems as yet to be no method of doing so which would be suitable for general use. Possible ways of overcoming this difficulty are discussed.
Mixed salivary tumour is not confined to the parotid. It occurs also in the submandibular gland, and is the commonest cause of subepithelial tumour of the palate. It should be dissected out with its capsule through an adequate incision early, being insensitive to radiation. To shell it out of its capsule is to invite recurrence. It is a disease of young patients, onset at ages of 6 to 46 in this series, and grows slowly.
1. It is shown that in contradistinction to the marked stability of ascorbic acid in acid solution towards nitrate is its sensitiveness towards nitrite. 2. The primary major product of the action of the nitrite is dehydroascorbic acid, which appears to be relatively stable towards the nitrite. 3. The nutritional and other physiological implications of these findings are discussed.
The viability of three recently isolated local strains of Bact. typhosus has been studied on 20 specimens of local hawker’s syrup used for sweetening ice balls and ice water. Precise survival times cannot be stated and only relatively wide limits can be estimated differing possibly in every individual case. Survival is influenced by the following factors : 1. The character of the containing material 2. The presence of other bacteria 3. Temperature 4. The presence of bactericidal agents or substances Significant diminution of the number of bacteria in 2 to 5 days after inoculation to sugar solutions is an important observation although survival up to two weeks has been noticed in repeated experiments. The results of experiments conducted in market syrup samples and on control experiments with laboratory sugar solutions indicate that the survival of the organisms tends to be more prolonged in dilute solutions than in concentrated
1. The importance of the mental and physical reactions of the amputee. 2. Ideal sites and the technique of amputations are discussed briefly. 3. Rehabilitation and training of the amputee is important if the best results are to be obtained. 4. Some of the special reasons for amputation are considered. 5. The component parts of an artificial limb and their alignment are outlined. 6. Special features in fitting limbs for women and children. 7. Some complications resulting from the wearing of an artificial limb are described. 8. Limb fitting in Malaya has its own peculiar difficulties which time and experience will rectify.
The use of ‘Gammexane’ P 520 as a practical larvicide is briefly described. A suitable rate of application is indicated, and the need to train spray operators and supervisors is indicated. Results suggest that the cost of this larvicide for routine control is likely to be one third or less that of oil.