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.
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 invasion of Singapore and Malaya was delayed because of the reduction in the period of service in the Far East. The atom bombs were then dropped and plans for all services including medical ones had to be altered, their main aim becoming the treatment and repatriation of surviving prisoners of war. The ending of the war did not occur abruptly on V-J day; many Japanese troops had to be convinced that the war was over. Meantime the treatment of diseases in British and other service men continued; reference is made to some experiences in Rangoon. The morale of personnel who now were anxious to return to their homes was low and efforts were made to raise their spirits. In India it was accepted that the days of British rule were over.
Resistance to insecticides in Culex pipiens fatigans has already been reported from two areas in Malaya. In Penang two years' use of BHC as a larvicide resulted in the development of a strain which was found to have acquired a tenfold resistance to BHC, and also to dieldrin to which it had not been exposed. In Singapore, when larval control became unsatisfactory after 6 months' use of a dieldrin emulsion, laboratory experiments confirmed that active resistance to dieldrin had developed. The present observations report the finding of two further dieldrin-BHC resistant strains of C. p. fatigans in Malaya, but differ from the previous reports in that resistance, in one strain at least, was developed as a result of house-spraying with dieldrin against adult mosquitos. In this strain resistance to dieldrin was about 100 times in both adults and larvae, resistance to gamma-BHC in larvae was about 20 times, while resistance to DDT was slight.
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.]
A prospective study of 102 children with bacteriologically confirmed typhoid fever, admitted to Hospital Universiti Sains Malaysia over 5 years was conducted. The average age at presentation was 91.3 (range 6 - 159) months. Fever (900%), abdominal pain (56%) and diarrhoea (44%) were common symptoms. Findings included: hepatomegaly (85.3%), splenomegaly (27.5%), anaemia (31%), leukopenia (15%). thrombocytopenia (26%), positive Widal (62.5%) and Typhidot test (96%). Patients were treated with ampicillin (n = 54) or chloramphenicol (n = 49) and 1/3 developed complications like hepatitis (n = 19), bone marrow suppression (n = 8) and paralytic ileus (n = 7). A patient with splenomegaly, thrombocytopenia or leukopenia was at higher risk of developing complications.
Iban categories of hot and cold are examined in the context of humoral medical systems in southeast Asia. These categories are more than binary and oppositional: they are also contradictory and can only be understood in terms of their capacity for transformation in 'depth'. Analysis of the Iban epistemology of temperature sensation reveals the limitations of reductionist empirical approaches to hot and cold. Illness is apprehended, at one level, in terms of unusual conjunctions of opposite temperatures which signify a deeper disturbance in the relationship between body and soul, humans and spirits. Iban therapy redefines and relocates these categories in their proper place and at their appropriate level. It progresses from hot lay treatments to cool ritual treatments, yet cannot be accounted for within a limited framework of homeostatic balance. This paper develops an ethnographically grounded definition of humoralism which emphasizes non-reductive logic, cultural practice and transformation. The key element, transformation, is defined as a transition between categories and a shift in the level of interpretation which fundamentally alter the Iban experience of body and illness.