Vital statistics in Malaya are of limited value but annual reports show that the infant mortality in Penang Municipality is 125, in Singapore Municipality 172.2, in the Straits Settlements 165.28, and in the State of Kedah 137 per thousand births. The tables show a similarity to those of large English towns fifty years ago.
Poverty, ignorance and superstition account for many of these deaths and much maternal ill-health. Children are seldom taken out in infancy and houses are frequently dark, stuffy and closely-shuttered. Solid carbohydrate food is given to infants even during the first month. Congenital Syphilis causes a number of deaths and in an investigation in Singapore of mothers whose infants died in the first year of life 30.9 per cent. were Wassermann-positive.
Increasing use is made of maternity wards in the Hospitals and in Kuala Lumpur there is a Chinese maternity hospital with a Chinese woman doctor on the staff. The infant death-rate among Malays is much higher than that of other races, who are more willing to make use of the hospitals.
In the rural areas labour commonly takes place under the most primitive conditions with no help except that of an untrained handy-woman (bidan). A better midwifery service for these areas is gradually being developed and Malay women are being trained to replace the old "bidan" in the villages.
Education is doing something to inculcate modern views on the bringing up of children. The teaching of personal hygiene to teachers and pupils in the vernacular girls' schools is proving of value, and the Girl Guide movement has given an added interest to this.
Medical inspection of school children is more complete in the towns than in the rural areas. Dental caries, skin conditions, intestinal worms, and enlarged tonsils are common in the junior schools.
Tables are given of vital statistics and records of school medical inspection from the reports of the health officers of the Straits Settlements, Singapore, and Kedah. W. H. Peacock.
Lower Perak, an alluvial plain, much of it below spring tide levels, lies between tidal reaches of the large Perak and Bernam rivers. It has a mixed rural population, about 40 per cent. being Malaysians. Inspection, with individual card records, was made of 2, 388 boys in vernacular schools aged 6 to 16 years, local prejudice exempting girls. The diet, largely rice, of these children appears deficient in animal protein, and probably in calcium, iron, phosphorus, and vitamin B. They show few signs of deficiency diseases, have a dental caries rate of about 70 per cent., and one-third had poor muscular development. They suffer mainly from fever, anaemia and skin infections. * An asterisk denotes that the paper dealt with is thought to be of more than ordinary interest to tropical readers. As ages were quite unreliable, only the 513 presenting birth certificates were grouped to the nearest birthday. [img 1T161260A.tif] Comparisons are made with the Baldwin-Wood scale for American medium type boys, who at every age are of superior weight. Full correlation tables are given for the 513 and 2, 388 boys. To eliminate doubtful ages the, Baldwin-Wood tables were used to calculate the mean weights of Americans at the height of the Perak boys, and now the Americans only [img 1T161260B.tif] come out slightly higher than these. The essential difference therefore seems to be more a matter of size and physical development in relation to age, than any significant change in-ratios at different ages. Comparison was made with Kedah measurements. This is a similar district 120 miles north of Lower Perak. Curves are used which are not strictly comparable, as some girls were included, but Dr. J. H. STRACHAN took out the figures of 1, 018 Kedah boys. These are compared with the 2, 388 Perak boys, in weight for inches in height. Although the conditions and districts seem in all respects similar the Kedah boys are significantly lighter for all heights. No explanation has been found for this. The authors insist on the usefulness of correlation tables. " It is obvious that the medium American boys are much heavier than the Malaysian children. But the second American weight/height curve seems to show that if one selects for comparison boys of the same stature at each age, the American boys would be on the whole only slightly heavier than the Lower Perak boys." This investigation has got the utmost value from rather unpromising materials. Any school worker will gain some new viewpoints from its careful perusal. James Kerr.
In a Malay school, 150 school boys, all clinically positive for scabies, were divided into three approximately equal groups. The first group was treated with 0.5 per cent γ BHC [' Gammexane'] in coconut oil, the second with 20 per cent emulsion of benzyl benzoate and the third, as a control, with coconut oil. Each group received two treatments with a week's interval between. One week after the second treatment the patients were re-examined for clinical evidence of scabies. The percentage of cases recorded as cured after the two treatments was 48 for γ BHC, 39 for benzyl benzoate and 9 for coconut oil. [This paper is a good example of the danger of estimating the chemotherapeutic value of sarcopticidal drugs on purely clinical evidence.]