CENTURY IMPRESSIONS OF BURMA. 241
39 are astate-speciala for treatment of police ;
4 are maintained by Government for special and unclassified purposes. Ninety hospitals are maintained by local funds for the general public, and 18 by the Burma Railways Company. The latter hospitals are an inheritance from the period when the Burma Railway was first inaugurated under State control. The company at present managing the railway will, however, soon have a complete staff of their own ; so that they will shortly be independent of control by the Government Civil Medical Department.
The total permanent medical establishment of the province consists of 38 commissioned medical officers, 19 military assistant-surgeons, 29 civil assistant surgeons, 7 uncovenanted medical officers, 2 contract private practitioners, and 348 hospital assistants. As the term hospital assistant is not employed west of Port Said, it may be explained that these are qualified medical men of Indian or Burmese nationality, who have been trained specially for occupying subordinate posts in hospitals, and for independent charge of minor rural hospitals. They are subordinate to all officers of and above the grade of civil and military assistant surgeons.
Nurses (European and Eurasian females) are educated at the Rangoon General Hos-
pital, and in the Dufferin Maternity (Burmese females) at Rangoon. A scheme has recently been sanctioned by Government for the training of male nurses. The Lady Minto
Nursing Association has a branch, which successfully supplies subscribers with private nursing facilities.
The total expenditure, during the year 1908, on hospitals and dispensaries amounted to Rs. 20,64,964. Of this the somewhat small contribution from private funds in the form of subscriptions amounted to Rs. 46,829, thus affording a sharp contrast to methods of supplying medical aid in Great Britain, where voluntary contributions are practically fully relied upon.
In 1908 a total of 1,320,939 patients were treated by the Medical Department of the province. Of these 185,744 were out-patients. A total of 31,706 surgical operations was performed during 1908. These include a very large number of operations of the highest class.
Of diseases, those of malarial origin occupy an important place ; although in connection with jails and military police various anti-malarial measures by drainage, quinine prophylaxis, and mechanical protection from mosquito bites have resulted in recent years in a marked diminution of malarial fevers. Venereal diseases bulk largely, whilst tubercle threatens to become of vast importance in its influence upon the population. On the whole, cancer, although present, is not
alarming in frequency. Leprosy is common ; whilst yaws, beri-beri, and goitre are confined to certain localities. Typhoid fever is found in several of the large towns, whilst
Malta fever has recently been distinguished at Magwe. Black-water fever occurs occasionally in the Myitkyina district.
The Burman, although subject to the influence of the mild dictates of Buddhism,
LIEUT.-COL. CASTOR, M.B., I.M.S., CIVIL SURGEON, MANDALAY.
and, as a rule, of a singularly happy and generous disposition, is liable to sudden and evanescent outbursts of temper, which result in assaults with the usually handy dah, or dagger. There is thus furnished a considerable amount of surgical practice to the medical officers, irrespective of the ordinary demands of voluntary operations. Of course, all wounds are not admitted into hospital, nor are they necessarily followed by police proceedings ; but it is significant of the amount of both surgical and medico-legal work to be done in the hospitals of the province that, during 1908, out of a total number of 80,291 ainjuriesa admitted and requiring surgical treatment, 13,788 of these were the subject of police inquiry.
MAJOR ERNEST REINHOLD ROST, I.M.S.,
of the General Hospital, Rangoon, can claim the credit of having started the first bacteriological laboratory in Burma, and of having been the first to establish the connection between beri-beri and iice. Some seven years ago, too, he commenced the investigation of leprosy, and his labours were rewarded by the discovery of leproline, a substance analogous to tuberculine. Although injections of the serum were followed by beneficial results in the Leper Hospital, the discovery was condemned by the Government of India upon the ground that the cultivation of the bacillus of
CIVIL HOSPITAL, RANGOON.CIVIL HOSPITAL, RANGOON.