The Straits Settlements medical report.

  • Straits Settlements. Medical Department.
Date:
[1912]
Catalogue details

Licence: Public Domain Mark

Credit: The Straits Settlements medical report. Source: Wellcome Collection.

    29/184 (page 27)
    From recent results I should say that B. Naphthol in 30 grain doses the first thing every morning is likely to prove more effectual than eucalyptus or thymol. Now regarding the question of starving patients while the treatment is being carried on I cannot say that I can see the necessity for it especially if the drug is given the first thing in the morning. It is true that large doses given frequently of these drugs are apt to irritate the mucosa of the stomach and intestines, but I do not see why that should keep us from giving them. All the more likely are we to get at the worms and I have never seen any ill effect follow the use of large doses. I do not think that much food will be found in the upper part of the small intestine five hours after a meal, so that if the drug is given, as I say, the first thing in the morning there is no necessity for starvation. Some Notes on Dysentery in Tan Tock Seng’s Hospital. By Dr. W. M. Scott, Acting Government Pathologist. Exceptional opportunity is afforded of studying dysentery both clinically and at autopsy in Tan Tock Seng's Hospital. During the past year 706 cases were treated here for this disease, while in the mortuary 334 cases had it ascribed as the immediate cause of death and in 482 the lesions old or recent were present. The patients are drawn almost entirely from the coolie class and as a pauper hospital it receives the poorest of these, individuals of feeble physique, obviously diseased, whom employers cannot consider worth spending money on in the hope of their becoming fit and among whom as with debilitated people in general dysentery is very prevalent and severe in type. There is no striking seasonal incidence in the returns but the second half of the year furnishes rather more cases than the first. Most of the observations which follow depend on a study throughout the year but the cases admitted suffering from dysenteric symptoms during the four months from August to November have been subjected to a special analysis from which the following facts emerge. Number of cases and Mortality.—There were during this period 142 cases of which 66 died or improved sufficiently to be discharged, a case-mortality of 46*5 per cent. Nationality.—Of these 117 were Chinese with a mortality of 50 per cent and 25 Tamils with 36 per cent mortality. Duration of illness before admission.—Among the fatal cases the average duration of the disease before admission to hospital was 49 days : only 4 of them had a history of only one week or less while 36 had been ill for a month or over. Among those cured or relieved 32 days was the average length of illness before admission while 21 of these entered hospital within one week and only 21 had had symptoms for a month. Duration of stay in Hospital.—The fatal cases were in hospital for an average of 13 days; 10 died within 48 hours and 27 or nearly half the number within a week. Among those who recovered 14 days was the average stay in hospital. Many of these insisted on being discharged from hospital before recovery could be regarded as complete. Classification.—Of the 142 cases 85 or 60 per cent were purely amoebic in origin. There were in addition 19 cases in which the amoebic infection was complicated by the presence of ankylostomes and five cases in which a bacillary infection co-existed. Pure bacillary cases numbered 14 or 10 per cent only. There wrere n cases in which the dysenteric symptoms were ascribed to malaria and three cases in which the Trichomonas Hominis was the only parasite found. In the remaining 5 cases the diarrhoea with blood and mucus was found post-mortem to be due to such causes as Tuberculosis of the gut or severe Syphilis. The case mortality in the amoebic variety was 37 per cent, when complicated by Ankylostomiasis 74 per cent. Of the bacillary cases only 3 recovered out of 14, a mortality of nearly 90 per cent. Of the malarial cases one died or 9 per cent. Post-mortem examination was performed in practically all the fatal cases. The great mortality in the bacillary variety is probably partially due to some of the cases which recovered being really bacillary although the presence of a few amoebae caused them to fall in this group. The statistics at autopsy extending in the past 6 years to some thousands of cases show that instead of 10 per cent 25 per cent of all cases of dysentery acute and chronic are bacillary in origin. There can be little doubt, however, that acute bacillary dysentery is at least twice as fatal as acute amoebic.