Publications from 1948-1969

@article{ChenCY1969-1,

title = {Health Care for the Developing Countries of Southeast Asia},

author = {Paul CY Chen},

year  = {1969},

date = {1969-12-31},

journal = {World Hospitals},

volume = {5},

pages = {93-98},

abstract = {An outline for the planning of medical and health services on a regional basis is presented. Emphasis is placed on integration of curative and preventive services. It is suggested that this may be partially achieved if health units and hospitals share a single administrative secretariat even at local levels. The training of multi-purpose medical and health auxiliaries is discussed.},

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pubstate = {published},

tppubtype = {article}

}

@article{ChenCY1969-2,

title = {Spirits and Medicine-men among Rural Malays},

author = {Paul CY Chen},

year  = {1969},

date = {1969-12-31},

journal = {Far East Medical Journal},

volume = {5},

pages = {84-87},

abstract = {Many rural Malays are reluctant to use modern scientific medicine but prefer traditional Malay medicine. The life of the rural Malay is shrouded by a whole body of beliefs and ritual acts pertaining to spirits. Illness is believed to be the consequence of the behaviour of malevolent spirits and healing is achieved by exorcism carried out by the bomoh. The various elements in rural Malay culture form strongly coherent culture patterns, and supply an internally consistent explanation for all that happens, which is reassuring to the rural Malay. Modern scientific medicine, based on materialistic beliefs and knowledge, does not form coherent patterns with rural Malay culture, and the resultant conflict leads to "cultural disorganization" of the rural Malay. The extent to which the crucial culture elements of a group and a system of medicine form the coherent culture patterns is one of the important determinants of acceptance or rejection of that system of medicine by that group of people.},

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pubstate = {published},

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@article{ChenCY1969-3,

title = {The Method of Disposal of Human Excreta used by 177 Rural Malay Households},

author = {Paul CY Chen},

year  = {1969},

date = {1969-12-31},

journal = {The Medical Journal of Malaya},

volume = {23},

pages = {159-168},

abstract = {In the more remote rural community all households use the traditional method of "bush" disposal of human faeces. With time, other methods, such as the pit latrine, come to be introduced. In recent years, however, as part of the Rural Health Plan, the water-seal latrine has come to be a satisfies all sanitary and aesthetic criteria, is simple to build and cheap. The water-seal latrine differed significantly from the other methods of disposal, observed in the community studied, in that it was associated with prestige in the community - education, high official village position, wealth and the presence of elders in the household.},

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pubstate = {published},

tppubtype = {article}

}

@article{GaleGW1968,

title = {The "Great Stink" of London and the Cause of Cholera},

author = {GW Gale},

year  = {1968},

date = {1968-12-31},

journal = {Bulletin of the Public Health Society},

volume = {2},

pages = {14-17},

abstract = {The miasmata of central London, 1858, is recounted and the role played by Dr. John Snow in elucidation of the cause of cholera is reviewed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ChenCY1968,

title = {The Water-seal Latrine in a Rural Malay Community},

author = {Paul C Y Chen},

year  = {1968},

date = {1968-12-31},

journal = {Far East Medical Journal},

volume = {4},

pages = {386-389},

abstract = {A study was carried out in two areas in the State of Kedah, West Malaysia, involving a total of 134 Malay households, in an effort to examine the acceptability of the water-seal latrine to rural Malays. It was found that, as a device, the water-seal latrine is acceptable to rural Malays as it is inexpensive, is easily installed, and is compatible with their traditional practice of using water for anal cleansing and their cultural abhorrence of the handling of human faeces. Furthermore, it is associated with social prestige, is physically safe and is sanitary. However, it was noted that unless modifications are incorporated into the design, it cannot be used in areas subject to a dry season.},

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pubstate = {published},

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@article{Gale1965,

title = {Some factors affecting rural health services in developing countries},

author = {GW Gale},

doi = {https://doi.org/10.1016/S0140-6736(65)91846-5},

year  = {1965},

date = {1965-01-01},

journal = {The Lancet},

volume = {285},

number = {7387},

pages = {696-697},

abstract = {The industrial revolution in developing countries differs from that in Europe in various ways. In the latter it was caused by the fiee play of economic factors and private enterprise, and the pace of scientific discovery and technological progress was slow. In developing countries now the revolution results from political and governmental pressure, and this has resulted in a fear of neo-colonialism and the rejection of help from the former colonial power. A policy of non-alignment tends to produce a multiplicity of advisers and conflicting advice, with dissipation of limited resources. In Europe rapid urbanization was associated with epidemic disease, but in the tropics now, better hygiene and public health measures prevent this. Better communications make medical facilities available to rural areas and reduce isolation. In towns the clash of a variety of cultures causes much psychogenic illness. An agricultural revolution coincided with the British industrial revolution, so that food production and population growth matched until exports paid for imported food, but in developing countries food production is being outstripped, and emigration is no longer a practicable solution. In these countries provision of further medical facilities without sufficient forethought can do little for the total good of the rural areas. It is recommended that dispersed rural populations should be concentrated into villages, each with its health centre. Subjects for health education are proposed, some involving changes in traditional customs and beliefs},

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}

@article{RN16170,

title = {Survey of sickness in Singapore with notes on births, deaths, handicapped persons, puberty, menopause, immunisation, incidence of cough and adoption},

author = {T A Lloyd Davies and R Mills},

url = {https://www.ncbi.nlm.nih.gov/pubmed/14466048},

issn = {0025-7303 (Print) 

0025-7303 (Linking)},

year  = {1961},

date = {1961-01-01},

journal = {Med J Malaya},

volume = {15},

pages = {117-56},

abstract = {A medical survey was carried out in three districts in Singapore, a large village consisting of shop-houses and houses with palm-leaf roofs, a densely inhabited part of China-town composed entirely of shop-houses and a Malay-pattern village with some " high class houses " on the periphery. The population of the whole area was about 7, 000. 

In May, June and August 1958 all the houses were visited by three female investigators who made a census and took details of water supply and latrines. Monthly visits started in September 1958 and continued until July 1960. 

Questions were asked about sickness in the previous month, the type of treatment received and absence from work due to sickness. 

The results are given in 20 tables and 4 figures. 

A comparison is made between the survey area and Singapore as a whole. Demographic and occupational details are given. Over half the population is under 18 years of age. The causes of death in Singapore in 1958 are very similar to those in England and Wales in 1906. 

The sickness survey revealed that men between 25 and 54 years of age lost from 5 to 9 days' work a year owing to sickness; the figure for European countries is 14. The causes of sickness and the type of treatment received are given in considerable detail. 

The number of questions that could be asked at the time of the survey was obviously limited but the opportunity was taken to obtain information about a variety of subjects. The use of facilities for vaccination and prophylactic inoculation was disappointing. Details are given of the age of puberty and the onset of menopause, of the number of handicapped persons, of the ages at which children became " dry " at night and of persistent cough in persons of 45 years of age and over. A section is devoted to family structure and adoption; it seems that the habit of adoption in Singapore is not changing.},

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pubstate = {published},

tppubtype = {article}

}

@article{RN16169,

title = {Flies in aeroplanes as vectors of faecal-borne disease},

author = {J H Hale and T A Lloyd Davies and W K Hin},

issn = {0035-9203 (Print) 

0035-9203},

year  = {1960},

date = {1960-01-01},

journal = {Trans R Soc Trop Med Hyg},

volume = {54},

pages = {261-2},

abstract = {Cholera occurred in Bangkok in May 1958 and spread to 31 of the 7, 1 provinces of Thailand, all in the south. During the epidemic two of the authors, during an air flight from Bangkok to Singapore, noticed flies in the passenger cabin and, later, in the restaurant and waiting rooms at Bangkok airport: 12 flies were counted on a piece of fruit provided as refreshment in the airport. 

During June-July, 43 aeroplanes arriving in Singapore from Bangkok were examined for flies in passenger and crew cabins after disembarkation and flies were found in all. The flies (Musca domestica) were trapped either alive or after pyrethrum spraying. In the first 4-day collections (9 aeroplanes) the flies were cultured individually for the presence of (1) Vibrio cholerae, (2) Shigella, (3) Salmonella, (4) faecal Escherichia cali, (5) Streptococcus faecalis. The subsequent 16 collections were grouped in daily collections and examined for (1), (2) and (3) only. The flies were incubated in peptone water and subcultures were made thereafter on appropriate selective media. 

Flies were recovered from the flight deck, crew and passenger cabins, kitchen and pantry and closets. Faecal organisms were recovered from 9 of 34 flies in the first 4 collections, but cultures for (1), (2) and (3) were negative. In the second period 94 flies were recovered from 32 aeroplanes but no pathogenic organisms were isolated. 

Thereafter, airline companies were asked to spray aircraft between Bangkok and Singapore and this was done during flight within 24 hours of reaching Singapore by means of pressure aerosol bombs containing pyrethrum and DDT. In the 3 following weeks, 48 aircraft were searched. 20 did not contain flies and 64 flies were caught in the remainder. 

Evidently the flies had been in contact with faeces, but contamination in aeroplanes is unlikely as all employed well-designed chemical closets. The risk of flies carrying pathogenic organisms is clearly increased during an epidemic, but " whether flies become contaminated with V. cholerae is a numerical function ". The fact that all the aircraft contained flies increases the risk of flies acting as aeroplane-borne vectors across international boundaries. The risk was not abolished by special spraying during the flight from Bangkok to Singapore. Flies are difficult to kill, except by knock-down sprays, but as these are not suitable for aircraft when passengers are present, the authors suggest that strict control of flies should be enforced at all international airports.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16241,

title = {A Note on Visual Non-Literary Methods of Communication Among the Muruts of North Borneo},

author = {Ivan Polunin},

issn = {0025-1496},

year  = {1959},

date = {1959-01-01},

journal = {Man},

volume = {59},

pages = {97-99},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16168,

title = {An investigation of absenteeism in selected groups of employees of H. M. Dockyard, Singapore},

author = {J Glass and T A Lloyd Davies},

url = {https://www.ncbi.nlm.nih.gov/pubmed/13828363},

issn = {0025-7303 (Print) 

0025-7303 (Linking)},

year  = {1959},

date = {1959-01-01},

journal = {Med J Malaya},

volume = {13},

pages = {331-4},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16163,

title = {Ethnic group differences in coronary heart disease in Singapore: an analysis of necropsy records},

author = {T J Danaraj and M S Acker and W Danaraj and H O Wong and B Y Tan},

url = {https://www.ncbi.nlm.nih.gov/pubmed/13813926},

issn = {0002-8703 (Print) 

0002-8703 (Linking)},

year  = {1959},

date = {1959-01-01},

journal = {Am Heart J},

volume = {58},

pages = {516-26},

abstract = {Coronary disease formed about 50 per cent. of all heart disease in Indian, but only from 10 to 20 per cent. in Chinese, men over 20 years of age. There was little difference in percentage incidence of non-coronary forms. Differences in coronary atheroma were small and thus the higher prevalence of coronary disease among Indians was attributable to coronary heart disease. Data for women also are presented but the number of Indians was considered too small for study. Further investigation is advised, particularly since the Chinese and Indians are culturally distinct groups living in the same physical environment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16246,

title = {Muruts of North Borneo},

author = {Ivan Polunin},

url = {http://www.sciencedirect.com/science/article/pii/S014067365990529X},

doi = {https://doi.org/10.1016/S0140-6736(59)90529-X},

issn = {0140-6736},

year  = {1959},

date = {1959-01-01},

journal = {The Lancet},

volume = {274},

number = {7091},

pages = {65},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16216,

title = {Work preferences of adolescent boys and girls in Penang},

author = {T A Davies and R Mills},

url = {https://www.ncbi.nlm.nih.gov/pubmed/13666190},

issn = {0025-7303 (Print) 

0025-7303 (Linking)},

year  = {1959},

date = {1959-01-01},

journal = {Med J Malaya},

volume = {13},

number = {3},

pages = {222-36},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16166,

title = {Comparative health. Industrial medicine in changing societies},

author = {T A Lloyd Davies},

url = {https://www.ncbi.nlm.nih.gov/pubmed/13554721},

issn = {0033-3506 (Print) 

0033-3506 (Linking)},

year  = {1958},

date = {1958-01-01},

journal = {Public Health},

volume = {72},

number = {2},

pages = {61-9},

abstract = {This is an unusual essay. The author is Professor of Social Medicine and Public Health in Singapore, and he writes with primitive and developing societies in mind, pointing out that religious and traditional beliefs affect attitudes towards illness. Early industrial development of a country has usually meant removal of work people from their accustomed haunts to places where the whole form, and content of life are different, and has resulted in detribalization and loss of old standards and security. It has also meant conflict between government and employers on the subject of responsibility for the health of employees. Industrialization usually results in a raised standard of living, but in the period of transition, which may last for several generations, there are in the industrial field certain needs which should be borne in mind. Established procedures to secure the health, safety and welfare of workers should be introduced, on the basis of what is possible rather that what is ideal. Efficiency should be increased by improving health and by substituting machine power for muscle power. Social security schemes should be developed, along with a properly directed trade union movement, but this is not easy since education, which leads to high office in a trade union, may seriously separate the official from the worker in a developing community, and the developing trade union leader may chase " out-dated shibboleths" (of which colonialism is the most convenient to hand) at the expense of the true needs of his people. Finally, none of these industrial needs can be secured, or even approached, without universal education. 

The author ends by remarking that where aid is given to these countries it should be in a form which acts as an incentive to self help, and it should be given for need, not for political advantage.},

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pubstate = {published},

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@article{RN16238,

title = {The influence of maternal age and birth order on the outcome of pregnancy in poor Chinese women},

author = {Jean Millis},

url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1469-1809.1958.tb01430.x/abstract},

issn = {1469-1809},

year  = {1958},

date = {1958-01-01},

journal = {Annals of human genetics},

volume = {22},

number = {4},

pages = {362-369},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16167,

title = {Young mothers in Singapore},

author = {T A Lloyd Davies and R Mills},

url = {https://www.ncbi.nlm.nih.gov/pubmed/13577151},

issn = {0025-7303 (Print) 

0025-7303 (Linking)},

year  = {1958},

date = {1958-01-01},

journal = {Med J Malaya},

volume = {12},

number = {4},

pages = {585-601},

abstract = {The annual report of the Singapore medical department drew attention to the fact that the babies of mothers under the age of 21 years were at greater risk than those of older women. 

This article is the result of an investigation of all mothers under the age of 16 years who gave birth to a live baby in Singapore in 1955. Of 228 mothers registered, 50 could not be traced and 72 were actually over 16 years of age at the time of delivery. Of the remaining 106 mothers all but 2 were in good health but 15 of the babies had died. (This gives an infant mortality rate of about double that of the Singapore average.) 

There is an interesting account of the reasons and the varying traditions behind these early marriages. 

The racial distribution was as follows: 

[img 1T348.tif] 

The large number of Malaysians in this group reflects the conservatism of this group. 

[The small infant mortality among the Tamils probably indicates not only their willingness to use hospitals and clinics, but also their superior ability in breast feeding.]},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{RN16244,

title = {The relation between birth weight and weight gain throughout the first year},

author = {JEAN MILLIS and TYE CHO‐YOOK},

url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1469-1809.1972.tb00289.x/abstract},

issn = {1469-1809},

year  = {1957},

date = {1957-01-01},

journal = {Annals of human genetics},

volume = {21},

number = {3},

pages = {289-292},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16210,

title = {A study of the medico-social needs of old people living in Singapore},

author = {T A Lloyd Davies},

year  = {1956},

date = {1956-01-01},

journal = {Medical Journal of Malaya},

volume = {11},

number = {1},

pages = {1-19},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Danaraj1956,

title = {Lead Encephalopathy},

author = {W. Danaraj},

year  = {1956},

date = {1956-07-01},

journal = {Proceedings of the Alumni Association},

volume = {9},

number = {2},

pages = {107-20},

abstract = {A series of 4 cases of lead encephalopathy is reported here with clinical particulars, the results of blood, urine and X-ray examinations and the investigations which were carried out to discover the source of the lead poisoning. In 2 of these cases the investigations were unsuccessful, but in the other 2 cases lead storage batteries were discovered to be the cause of the poisoning. One of the patients had supplemented his earnings as a farmer by taking part in the recovery of lead from accumulator plates which were broken up and melted down in a kuali over an open wood fire. Evidence of lead intoxication was also found in the 3 other individuals who had worked in the same place. The other patient, an 11-year-old Chinese boy, lived with his parents, a brother and a baby sister in the ground floor of a shop-house where his father had been engaged for years in storage battery repair. This repair, which consisted in scraping, repasting and soldering the leaden plates, was carried out under very insanitary conditions in the room that was used for eating, sleeping and living. X-ray photographs of the brother and baby sister are reproduced to show the lead lines in the bones which were demonstrated. Of interest is the mention of sources of lead other than occupational, which have caused plumbism in reported cases in Malaya, viz. : -(1) Chinese face powders which were found to contain up to 50 per cent. of lead carbonate [this Bulletin, 1930, v. 5, 891] and in one instance 70 per cent. of red lead oxide, and (2) a sample of chu sha, a Chinese medicine powder adulterated with up to 34 per cent. of lead. Reference is made to the possibility that black market chandu (opium prepared for smoking) and chandu dross may cause lead poisoning through adulteration with lead to increase the weight.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16208,

title = {The Employment of Elderly Persons},

author = {T A Lloyd Davies},

year  = {1955},

date = {1955-01-01},

journal = {Bulletin of the World Health Organization},

volume = {13},

pages = {595-603},

abstract = {Not every old person is fit for employment, and consequently employment agencies must reserve the right of selection. Retirement at the customary age with, if desired, re-employment for defined periods seems to offer the best method of employing old people, avoiding damaging loss of dignity and the blocking of promotion of younger people. 

 

Under suitable conditions, old persons are capable of a high level of employment. The possibilities of employment, however, vary very much with different types of industries and industrial regions. The elderly usually have a higher sickness absenteeism than young people, but have fewer absences for other reasons than sickness. Elderly workers seem to be able to carry out manual labour with efficiency if they are put into jobs without time-stress. If retraining is necessary, the utmost possible use should be made of already established skills. Heavy work does not seem to be necessarily harmful for old people. 

 

Little knowledge is yet available on the health problems of professional workers or executives at increasing age. Lack of decisiveness, failure of critical judgement, and increasing irritability -resulting from difficulty in organizing new information-will call for transfer to less responsible positions. 

 

Many more studies of old age are needed before the circumstances under which they may best be employed in present-day industry can be determined. Full employment and the need for production make this problem still more urgent.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16247,

title = {A study of growth in the first year of life of southern Indian infants born in Singapore},

author = {Jean Millis},

issn = {0022-3476},

year  = {1954},

date = {1954-01-01},

journal = {The Journal of pediatrics},

volume = {45},

number = {6},

pages = {692-696},

abstract = {Sixty-four male and sixty-threefemale Southern Indian infants were selected from the “normal full-term” infants born in the Kandang Kerbau Maternity Hospital, Singapore, in 1951. They belonged to the lower income sections of the community. 

 

Home visits were made to collect 1,980 measurements of weight and 456 measurements of length at regular intervals in the first year. 

 

A geometrically progressive increase in weight was observed; the rate of increase was less than that of Chinese infants in Singapore and of infants of Northern European stock in America and Australia, but the increase in length was comparable.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16240,

title = {Extreme Anaemia with Recovery},

author = {Peter Tasker and Ivan Polunin},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2079910/pdf/brmedj03629-0043.pdf},

year  = {1954},

date = {1954-01-01},

journal = {British Medical Journal},

volume = {2},

number = {4902},

pages = {1465},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16236,

title = {Extreme anaemia with recovery, associated with pigmentary changes in the hair},

author = {P Tasker and I Polunin},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2079910/pdf/brmedj03629-0043.pdf},

issn = {0007-1447 (Print) 

0007-1447 (Linking)},

year  = {1954},

date = {1954-01-01},

journal = {Br Med J},

volume = {2},

number = {4902},

pages = {1465},

abstract = {This case shows that a haemoglobin level of 0.7g% (5% Sahli) is compatible with life and moderate activity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16209,

title = {Medicine, society and health},

author = {T A Lloyd Davies},

year  = {1954},

date = {1954-01-01},

journal = {Medical Journal of Malaya},

volume = {8},

number = {3},

pages = {207-216},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16164,

title = {Studies on the chemotherapy of malaria. II. The treatment of acute malaria with proguanil (paludrine)},

author = {J W Field and J H Strahan and J F Edeson and T Wilson},

url = {https://www.ncbi.nlm.nih.gov/pubmed/13193268},

issn = {0025-7303 (Print) 

0025-7303 (Linking)},

year  = {1954},

date = {1954-01-01},

journal = {Med J Malaya},

volume = {8},

number = {4},

pages = {303-17},

abstract = {During the period 1947-53, 709 Asian patients suffering from acute malarial attacks (538 P. falciparum, 150 P. vivax, 21 P. malariae) were treated with proguanil in Kuala Lumpur. All were of Malay, Chinese or Indian race and were classed as semi-immunes. Two hundred and forty-seven patients were given single-dose treatment with 100 mgm., 250 mgm. or 300 mgm. proguanil; 436 received a full course of 300 mgm. daily for 5 to 7 days; 26 patients suffering from severe P. falciparum malaria were given proguanil by intramuscular or intravenous injection. 

In P. falciparum malaria the clinical response was often slow, but for the first 2 years clearance of asexual parasites was satisfactory, even with a single dose of 100 mgm. Late in 1948 the first failure with single-dose treatment was noted, and early in 1949 the first failure with a full course of 300 mgm. daily for 5 to 7 days. [The criterion of failure was persistence of asexual parasitaemia 7 days after beginning treatment, or where therapeutic intervention with another drug was found necessary before the 7th day.] By 1950 about half the patients treated with a full course of the drug failed to respond and this continued to be the case during the remainder of the period under review. 

In P. vivax malaria clinical response and clearance of parasites were slow, but no actual failures were noted till early in 1951; the proportion of failures continued to remain at a low level. 

P. malariae infection has become increasingly rare in Malaya in recent years. In the few cases treated the response was slow with the single-dose treatment used; no failures were noted. 

Artificial feeding experiments with Anopheles maculatus indicated that sporogony in the mosquito is arrested at an early stage. 

In a discussion on the problems associated with proguanil resistance, it is noted that resistant strains are not confined to any one part of Malaya but can be found in various parts of the country if looked for; their natural transmission despite regular prophylactic doses of proguanil is now known to be possible. Chloroquine, amodiaquine, mepacrine and quinine all proved effective in the treatment of proguanil-resistant infections. It is noted that quinine is a poor suppressive drug, but that any of the others named above can be relied upon should a serious decline in the efficacy of suppressive proguanil occur.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16248,

title = {Studies of blood groups in South-East Asia},

author = {Ivan Polunin and PHA Sneah},

issn = {0307-3114},

year  = {1953},

date = {1953-01-01},

journal = {The Journal of the Royal Anthropological Institute of Great Britain and Ireland},

volume = {83},

number = {2},

pages = {215-251},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16239,

title = {Tinea imbricata in Malaya},

author = {Ivan Polunin},

url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1952.tb15801.x/abstract},

issn = {1365-2133},

year  = {1952},

date = {1952-01-01},

journal = {British Journal of Dermatology},

volume = {64},

number = {10},

pages = {378-384},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16242,

title = {An Industrial Dermatosis due to Enzyme Action},

author = {Ivan Polunin},

issn = {1476-4687},

year  = {1951},

date = {1951-01-01},

journal = {Nature},

volume = {167},

number = {4246},

pages = {442},

abstract = {LABOURERS in factories in South Malaya who cut up pineapples by hand for canning invariably show an abnormality of those parts of the body which are exposed to slight pressure and pineapple juice, notably the palmar surfaces of the fingertips and the periphery of the palms. At the beginning of the canning season, the left hand, which comes more into contact with the fruit than the knife-holding hand, becomes sore and small superficial raw areas on the fingertips are often seen. Within several days, however, these heal, and the skin ceases to be sore. The labourers state that this tolerance to the pineapple juice is due to the development of an abnormality of the skin, which in the affected area becomes bluish-white and so smooth that fingerprints may be completely lost. Deep cracks are sometimes seen in the region of the skin creases. These often stay raw and bleeding for a long time, and show no clinical signs of infection, presumably because of removal of dead tissues by enzymatic action.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16243,

title = {Pineapple Dermatosis},

author = {Ivan Polunin},

url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1951.tb13682.x/abstract},

issn = {1365-2133},

year  = {1951},

date = {1951-01-01},

journal = {British Journal of Dermatology},

volume = {63},

number = {12},

pages = {441-455},

abstract = {Workers in Malayan pineapple canning factories who cut up raw pineapples suffer from skin lesions of unusual type on those parts of the body exposed to the fruit. A preliminary note on this condition has already been published (Polunin, 1951). The pineapple is remarkable among fruits, for, as it well known, it can be used in cooking to soften tough meat. Over-indulgence in the raw fruit would appear to have a similiar effect on the buccal mucosa, for it may be followed by a most unplesant sensation in the mouth and lips, which feel as if they had been burned with hot liquid, or as if a new pipe were being broken in. In Malaya, the existence of a labour force which works with hands always wet with pineapple juice provides a situation for the study of the response of the skin to noxious agents of a special type.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16165,

title = {Quinine by continuous intravenous drip in the treatment of acute falciparum malaria},

author = {J H Strahan},

url = {https://www.ncbi.nlm.nih.gov/pubmed/18912196},

issn = {0035-9203 (Print) 

0035-9203 (Linking)},

year  = {1948},

date = {1948-01-01},

journal = {Trans R Soc Trop Med Hyg},

volume = {41},

number = {5},

pages = {669-76},

abstract = {During the Japanese occupation of Malaya, the author was able to observe the records of nearly 2, 000 cases of acute Plasmodium falciparum malaria in malnourished British, Australian and Dutch prisoners near Singapore. Treatment was based on quinine followed, so long as stocks lasted, by mepacrine and plasmoquine; severe infections were treated with quinine by intramuscular or intravenous injection-the latter almost entirely by standard methods. This paper records clinical and parasitological details of 15 patients treated by a continuous intravenous drip technique. 

Approximately 1, 000 cases were seen between February 1942 and September 1944; the majority were in 1942, one of the worst periods of malnutrition. No record of the number of intravenous injections is available, but it is small. Solution for injection contained 1 grain of the bihydrochloride in 2 cc. of saline, the rate of injection being 2 ce. a minute and the usual single dose 0.5 to 0.66 gramme. Four fatalities which were apparently due to this method, are recorded, namely: - 

1. Heavy infection with P. falciparum: intravenous injection, 0.5 gm. ; immediate epileptiform convulsions and death. 

2. Very heavy infection with P. falciparum: intramuscular quinine, 0. 66 gm. followed in 1 hour by 0.2 gm. intravenously 20 minutes later, collapse and death. 

3. Moderate P. falciparum infection: died during an intravenous injection (dose not given). 

4. Heavy P. falciparum infection: 1 .0 gm. quinine intravenously in 5 cc. water. Immediate epileptiform convulsions and death [a large and concentrated dose]. 

In addition, there was a case of P. vivax malaria in which during mepacrine treatment a convulsion occurred and death followed immediately after 0.25 gm. quinine intravenously. 

Approximately 1, 000 other cases were admitted between October 1944 and September 1945. Usually all these with over 100 parasites per thick field (Field's method) were given a preliminary intramuscular injection of 0.5 gm. quinine. When the thick film showed considerably more than this number, a parasite count was made. Where this was over 300, 000 parasites per cmm. (estimated by total red cell counts and the number of trophoZoites per 100 red cells) intravenous drip quinine was given regardless of the clinical condition and also where cerebral or other pernicious signs were present. 

A Soluvac or Vacolite gravity flask, with drip regulator and tied-in cannula was used. The vehicle was sterile normal saline, sometimes with an intravenous preparation of thiamin added. In each case, 2 gm. of quinine bihydrochloride were given in 24 hours, 0.5 to 0.66 gm. per litre. The rate of flow was 30 to 40 drops per minute. The long saphenous vein at the ankle was chosen for injection, to allow use of the arms. The leg was placed on a back splint with a footpiece. The drip was continued for 12 to 96 hours, according to the severity of the case: 15 cases so treated are described in detail. The advantages of this method were: (a) ease of combination with other treatment; thus 2 patients received 600 cc. of blood for gross anaemia; (b) certainty of complete absorption; (c) certainty of a constant safe concentration of quinine without degeneration products producing inefficiency; (d) absence of unpleasant after-effects. 

The disadvantage was some mild phlebitis of the vein when the cannula was in situ for 2 or 3 days, with risk of severe septic phlebitis. 

Of the 15 patients so treated two died, one on the 3rd day from tonic spasm, 3 hours after starting the drip, the second from pyaemia due to sepsis at the site of the drip on the 28th day. This patient on admission had 1, 240, 000 parasites per cmm. of blood, while four had over 500, 000 and all were in very poor condition. 

FIELD and NIVEN [this Bulletin, 1937, v. 34, 615] in an analysis of 750 cases of P. falciparum malaria on the 1st day of treatment concluded that 750, 000 parasites per cmm. in the peripheral blood was about the extreme limit of tolerance in Asian adults for the Malayan strain and FIELD in a series of 2, 000 cases records no recoveries where the count exceeded this figurer (unpublished). A combination of starvation with a heavy malarial infection is, very dangerous; FERNANDO and SANDARASAGARA in Colombo [ibid., 1936, v. 33, 687] found that intravenous quinine was contraindicated when the systolic blood pressure was below 90. 

The author considers that the drip method of using intravenous quinine in a dilute form sufficient to secure administration of 2 gm. in 24 hours is a safe and efficient one. Recovery is recorded of 3 cases with a peripheral intensity of infection higher than has been hitherto recorded in Malaya (871, 000, 925, 000 and 662, 000 parasites per cmm. respectively).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN16220,

title = {Reflections on the Course of Preventive Medicine in Malaysia},

author = {J H Strahan},

year  = {1948},

date = {1948-01-01},

journal = {Medical Journal of Malaya},

volume = {2},

number = {4},

pages = {221-238},

abstract = {This presidential address delivered at the Annual Meeting of the Malaya Branch of the British Medical Association deals with the history of the impact of western medicine on Malaya. In the early years curative medicine monopolized attention. A Port Quarantine Service was established in 1900 but serious attention to preventive medicine had to wait till 1911 When the Health Service of the then Federated Malay States was founded. Rubber had brought amazing prosperity and disease prevention yielded increased dividends. The address provides much interesting information about Malaya, its peoples and their diseases, and the efforts made by research workers and health departments to control disease prevalence during the last 28 years: this does not lend itself to summary. For the future, outstanding tasks include the application of recently acquired knowledge and techniques to the control of malaria; an allout attack on tuberculosis; much more attention to nutrition and deficiency diseases, and an orientation of the work of the Health Services towards social medicine. Norman White.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}