Triennial report on the hospitals and dispensaries in Burma.

  • Burma.
Date:
[1919]
Catalogue details

Licence: Public Domain Mark

Credit: Triennial report on the hospitals and dispensaries in Burma. Source: Wellcome Collection.

    15/62 (page 9)
    It is difficult to say whether the increase in admissions for venereal disease, indicates a real or only an apparent increase in its incidence. The numbers coming to hospitals have increased largely, but this mav mean greater confidence in European methods of treatment especially as regards Syphilis. Anchylostomiasis is very prevalent in the Arakin Division. In the: Akyab Jail 27 per cent, and at the Civil Hospital 24 per cent, of those examined, and who showed no obvious symptoms, were found infected. It is only at an advanced stage of the disease that patients seek relief in hospitals. Throughout the remainder of Burma, the disease is much rarer, but its incidence has never been properly investigated and many cases returned as Anaemia, etc., are really cases of Anchylostomiasis. Investigations in India showed that latrine users were almost •free from this disease, a strong argument in favour of an efficient conservancy system in every town. Small-pox and Vaccinal Condition.—In 1919 the admission rate rose to about five times what it was in the previous two years. Rangoon Town furnished 72 per cent, of all cases and 76 per cent, of all deaths. The majority of these were either imported or arose from contact with imported cases. Rangoon is in fact the chief distributing centre for small pox in this province, and until effective means are taken in the form of vaccination and re-vaccination of all arrivals from India, it will continue to distribute this loathsome disease. A great deal might be done by bringing the legal definition of a ‘‘protected person” in the Vaccina¬ tion Act into line with the present scientific conception of what constitutes a “protected” person. At one time, no doubt the two ideas were more or less identical, but since then they have diverged greatly. It is now recognised that the immunity conferred is a limited one, it does not last throughout life, and an adult vaccinated in childhood only, is in reality an “ unprotected ” person. The advantages of vaccination are clearly brought out by a study of the statistics of patients admitted for small-pox in 1919. Out of 1,553 cases, 380 or 24*4 per cent, died, but the death rate amongst the vaccinated was 15 per cent, while amongst the unvaccirated it was 36 per cent. The vaccinated class includes all doubtful cises, where the patients stated that he or she had been vaccinated, but no marks could be found. Practically all the vaccinated adults who contracted small-pox had been vaccinated once only in infancy, and this, though it reduces the incidence and death rate of the disease, is not sufficient to confer complete immunity from either. 16. Investigation of Diseases.—Investigators of Tropical Diseases in Burma will find a ripe field awaiting them. There is an enormous amount of material at hand, which would richly repay investigation not only in respect of well known common diseases, but of rarer and sometimes even wholly unrecognized morbid conditions. For instance, a disease called by the Burmans “ Athama ” was described by the Civil Surgeon, Toungoo, in 1898, and his observations were confirmed by the Civil Surgeons of Pakftkku, Shwebo and Myingyan. The characteristic feature of the disease was a malignant sore, followed by septic fever and in many cases death. In 1905 and 1906, the Civil Surgeon, Meiktila* described a similar condition said to be due to the bite of a poisonous spider and called by the Burmans “ Pengoo Na.” There is no doubt all these officers have described the same disease which is widespread in distribution and very fatal in character. A disease known as the “ Hton Yawga” has been described by Civil and Medical Officers in Bhamo District, most prevalent during the rains, bearing some resemblance to Beri-beri and with a death rate of 50 per cent, or over. A somewhat similar disease known as “ Hton Swai ” has caused a heavy mortality in the Upper Chindwin. A number of blood slides taken from patients suffering from this disease were examined by Lieutenant-Colonel Pearce. Malarial parasites were not found, but marked eosinophilia was present in all. Lieutenant-Colonel Pearce hazards the suggestion that the disease may be Anchylostomiasis or Bilharziosis. A disease called “ Mak Hkaolam ” by the Shans is said to be very prevalent in some parts of the Southern Shan States, causing heavy mortality, and characterized by a curious peri-anal eruption. The Civil Surgeon, Taunggyi, thinks it may be due to a parasite, Schistosoma Mansonii, but nothing definite has been proved. These few instances show the need of scientific investigation carried out by specialists. t