1. Three series of cases of oedema in an internment camp are described.
2. The first series of cases consisted of those diagnosed as beriberi. They were much less common than cases of oedema from other nutritional causes. Most of the beriberi cases occurred in a period when the supply of vitamin B1 was low. The other patients developed their disease while outside the camp. The clinical features are described and the diagnosis discussed.
3. The second series of cases occurred at the same time as the beriberi, but the olinical appearances were sufficiently different from beriberi to lead to the diagnosis of nutritional oedema from some unknown cause.
4. The third series occurred towards the end of internment and were probably due to hypoproteinaemia.
European standards on height, weight, centres of ossification and date of onset of puberty are not applicable to Asiatic girls in Malaya. " Asiatics " could not be grouped together, racial groups showed differences, especially the three main groups-Chinese, Indians and Malays. Nine tables are furnished showing the average and maximum and minimum heights and weights of the four main groups examined, as well as of some of the minor groups, arranged according to ages from 5 years to 19 years. The conclusion is drawn that the European standard of height and weight is higher than that of any of the Asiatic races in Malaya; a greater difference is noted in the weight than in the height and there is a much greater range in the weight of Asiatics but a smaller range in the height. Onset of menstruation tended to be earlier in the local Asiatic groups than in Europeans. The date of eruption of permanent teeth appeared to be earlier among Asiatic races. No deciduous teeth were found at the age of 12-13 years, the lower second molar was seen in all those examined at that age and the whole lower set was present, excluding the third molar. Earlier efuption of the canine teeth was also noticeable. Details should be consulted in the original by all those interested in medico legal work in tropical countries. P. A. Clearkin.
MeSH terms: Adolescent; Age Determination by Skeleton; Age Factors; Body Height; Body Weight; Child; Female; Humans
The author carried out a rapid survey of coastal and inland malaria in Sarawak in December 1946. Before recording the results of that survey, he summarizes previous reports concerning malaria in that country. [For information concerning malaria in Borneo, see this Bulletin, 1946, v. 43, 516 & 1, 000.] From May till November 1946, simultaneous epidemics of malaria occurred along the coast of Sarawak at the mouth of the Kuching River, Bintulu, Miri, Lutong, and at Kuala Bêlait and Seria in Brunei. These were aggravated by migrations of population. The epidemics were severe in type; the Kuching area had to be evacuated. In Miri and Lutong, malaria was epidemic to some degree in 1945 but the incidence fell to a low level in December and remained low until April 1946. Thereafter there was a very rapid rise until October, when the disease was reported as being out of control; the entire population was sick. The epidemic here was almost entirely due to P. falciparum. In the Kuala Bêlait and Seria epidemics, P. vivax was most in evidence. The Malay communities suffered much more than the Chinese; the latter are said to have become ' mepacrine conscious ' to the extent that they are willing to purchase the drug. Malays made no attempt at self protection. Spleen and parasite rates of Malay school children were found by the author to be more than twice as high as the Chinese school rates. Low rainfall in July, August and September allowed brackish water to infiltrate far up the Miri and Lutong Rivers and their tributaries; intense A. sundaicus breeding resulted. Moreover in 1946 spring tides flooded an area ravaged by war, with defective drainage, broken tidal gates, ponds and swamps. It is suggested that while A. leucosphyrus and A. umbrosus may transmit malaria along the coast, A. sundaicus is responsible for epidemic manifestations and this by reason of intense breeding rather than of its high infectivity. Further investigation is necessary to determine the importance of A. leucosphyrus and A. umbrosus as vectors. Norman White.
The data here published were collected [presumably in Malaya] in 1941. The average diet of South Indian labourers was found to be ill-balanced and deficient in protein, especially animal protein, vitamins, especially fatsoluble, Ca and P. Many conditions generally accepted as being due to dietary deficiency were prevalent, particularly among children and pregnant women. Suggestions for improving the diet include the increased use of millet, maize, legumes, leafy vegetables, fruit and red palm oil. The value of milk is stressed, and it is suggested that the estate should supply this. Dietetic education of the labourers is considered essential.-A. Synge.
The history of malaria and its control in Kuala Lumpur between 1890 and 1941 is summarised. The disease increased in the early years, largely owing to clearing of valleys without adequate draining, but nevertheless the incidence has been low in relation to the population of the town. Outbreaks are stated to have occurred in 1930 and 1937-38. Lists are given of the Anophelines found in Kuala Lumpur, showing their usual breeding places in that locality and their importance as vectors of malaria as recorded in the literature. The commonest vector is Anopheles maculatus, Theo., though the outbreak in 1930 was associated with A. hyrcanus var. nigerrimus, Giles, and A. h. sinensis Wied. [R.A.E., B 20 276; 21 192]. The methods used to control Anophelines are discussed.
Eight caaes of this condition are described, the patients being four Ceylonese, three Indians, and one Chinese, all males except one. Symptoms consisted of breathlessness and cough, sputum being sometimes purulent and occasionally blood-stained. Six of the patients complained of loss of weight, and in one, a Ceylonese schoolboy, this was the only presenting symptom. The authors found the most troublesome complaint to be a paroxysmal cough which was always worst at night. On clinical examination rhonchi were heard scattered throughout both lung fields in five cases, the lungs being clear in the other three. X-ray examination showed characteristic mottling of both lungs in four cases and of one lung in one case; another showed increased vascular markings, while in two the lungs were clear. Sputum was examined for tubercle bacilli and mites but none were found. The technique used for searching for mites is not described. A marked eosinophilia was found in all cases, the highest count recorded being 33, 264 eosinophils per cmm.Treatment consisted of arsenic, given in the form of neoarsphenamine, six injections of 0.3 gm. in six cases, and stovarsol 4 grains t.d.s. for seven and ten days respectively in the other two. Four of the patients were cured, three were improved, while one was showing a favourable response although treatment had not been completed.The author emphasizes the importance of performing repeated blood counts in order to avoid missing this condition. Out of the eight cases which he describes, one had been wrongly diagnosed as pulmonary tuberculosis and three as bronchial asthma. One of the latter had an initial eosinophil count of 4, 092 which rose to 17, 700 three weeks later. H. T. H. Wilson