1. (1) The injection of serum prepared especially against strains of typhoid bacilli strong in "O" and "Vi" antigens appeared during the epidemic at Singapore to be of value in the treatment of serious cases of typhoid fever, even at a comparatively late stage of the disease. The time for the routine use of such serum in treatment has perhaps not yet come, but strong indications for its use are severe toxaemia, or failure to improve with general treatment. 2. (2) The absence of eosinophil cells in a differential white blood count is of value in the diagnosis though it is not an absolute sign in either a negative or positive direction. 3. (3) Congenital immunity against typhoid fever appears to be powerful for several years of childhood, in Malaya and presumably elsewhere also. 4. (4) Compulsory inoculation is advocated as a public health measure of protection against typhoid fever in countries where the disease is endemic, but not earlier than the 5th year of age. c 1941
This presidential address delivered at the Annual Meeting of the Malaya Branch of the British Medical Association deals with the history of the impact of western medicine on Malaya. In the early years curative medicine monopolized attention. A Port Quarantine Service was established in 1900 but serious attention to preventive medicine had to wait till 1911 When the Health Service of the then Federated Malay States was founded. Rubber had brought amazing prosperity and disease prevention yielded increased dividends. The address provides much interesting information about Malaya, its peoples and their diseases, and the efforts made by research workers and health departments to control disease prevalence during the last 28 years: this does not lend itself to summary. For the future, outstanding tasks include the application of recently acquired knowledge and techniques to the control of malaria; an allout attack on tuberculosis; much more attention to nutrition and deficiency diseases, and an orientation of the work of the Health Services towards social medicine. Norman White.