126
diaphoretics, salicylate of soda in 10-grain doses is often useful; quinine appears to aggravate the headache and general symptoms; for bilious vomiting I consider calomel particularly useful; an alkaline mixture of soda bicarb., sp. am. aromat, tinet. nucis vomic. and calumba is often useful, especially where the stool contains undigested food; a mixture of liq. hydrarg, perchlor., min. 20, and soda bicarb., grains 10, in chloroform water given every four hours may relieve gastric distress; one case which was apparently hopeless, with haemorrhage from the nose as a com- plication, recovered under the temporary treatment of saline enemas.
When there is some improvement and no marked symptom beyond the anæmia, I give arsenic usually with cinchona and in increasing doses if possible. In any case of anchylostomiasis I consider arsenic is to be preferred to iron preparations. I have used several preparations of iron, but with the exception of the carbonate and the dialysed iron I cannot say the result is satisfactory, and even these pre- parations generally are not so good as arsenic. With regard to diet, this is given according to their general condition.
The Honourable
The Surgeon-General.
Yours, &c.,
C. P. KENNARD.
127
villages; &c., &c., and the extension of the latrine system, I have the honour to inform you that this matter has been carefully gone into by the Board, who decided to submit to the Government an approximate estimate of the cost of providing the 21 incorporated villages with vats and latrines to all buildings which have now no such accommodation-the estimate, as far as the water supply is concerned, is arrived at on the basis of Table II. of the First Schedule of the Public Health Ordinance.
The cost of providing the necessary vats or tanks would be, say Ditto, for latrines
$90,000 46,000
$136,000
2. In view of the large expenditure which would be required, the Board du not consider it advisable to call upon the various local authorities and others responsible to have the law on the subject carried out, but the local authorities would be urged to impress upon the villagers who have not done so, the advisability of gradually supplying their residences with fresh water vats and latrines.
I have, &c.,
J. E. GODFREY,
Chairman, Central Board of Health.
T:།། །
PUBLIC RECORD OFFICE
77 7 7 7
6
Reference :-
C.O.885
19 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
E.
REPORT by Dr. W. J. VON WINCKLER on the Prevalence of Anchylostomiasis in Rainy Seasons and the Treatment usually employed in Severe Cases.
Peter's Hall District, 10 January, 1908. HON. SURGEON-GENERAL,
In reply to circular, 2143/07, I beg to submit the following remarks re anchy- lostomiasis.
(A) There is an increase in severity of anchylostomiasis in rainy seasons on sugar estates, marked mostly in cases of ground itch. These cases of ground itch usually occur in rainy seasons and in immigrants working in fields where labourers defæcate and generally near buildings.
In villages. I can offer no definite opinion, but from experience know that labourers (blacks and coolies) returning from the interior from goldfields, wood- cutting grants, and charcoal-burning, at all times of the year, are generally infected with anchylostomes and are an abiding source of infection to the villages and the villages to neighbouring sugar estates.
(B) Method of treatment.-Severe cases, as I understand them to be, may be classified as: (1) recent acute (severe) infectious, amenable as a rule to the official thymol, cucalyptus, or beta-napthol treatment with iron and arsenic tonics. Severe cases. (2) Chronic anchylostomiasis, commonly mistaken for Bright's, and not to be distinguishable in many cases, and fairly prevalent in this Colony where the treatment is at most palliative, thymol and eucalyptus do positive harm and are in my opinion contra-indicated, as toxic symptoms manifest themselves on administra- tion, especially of thymol; iron in the form of perchloride or pernitrate with a generous milk diet has been the treatment adopted in my practice.
A class of cases which may be called neglected, but not running into the chronic, are frequently met with; here with cautious use of thymol, or eucalyptus for choice, with iron and arsenic and a generous diet, these cases generally recover.
I can only again add that chronic anchylostomiasis is very refractory to treat- ment and generally ends fatally from renal complications.
SIR,
G.
W. J. VON WINCKLER,
Government Medical Officer,
Barrister-at-Law.
CHAIRMAN, Central Board of Health, to the GOVERNMENT SECRETARY,
14 March, 1907.
In reply to your letter, No. 4699, dated the 8th August, 1906, with regard to the practicability and cost of ensuring supplies of uncontaminated water in
CHAIRMAN, Local Government Board, to Government SECRETARY.
(Minute.)
The Honourable
The GOVERNMENT SECRETARY,
THE question of whether local authorities should enforce the provisions of the Local Government Ordinance as regards the providing of suitable vats and latrines for cach new dwelling that may be erected in the villages, has been sub- mitted to the different Councils for an expression of opinion from those bodies.
Of the replies received nearly 80 per cent. were of opinion that to force those who may propose to erect new buildings to provide vats would not be advisable, for the reason that in many instances they could not afford the extra expense, while it would tend to prevent the building of houses in the areas under their control. They were, however, in favour of enforcing the erection of latrines.
2. In most of the villages there is an ample supply of water from the different water supply schemes. In the opinion of the Villages Committee it would not be advisable to call upon the authorities to have the law upon the subject of water supply rigidly enforced.
The Councils are making every effort, compatible with the state of their finances, to improve the sanitary condition generally.
A. G. B.,
15 November, 1907.
II.
Chairman, Local Government Board.
re the Treatment of Anchylostomiasis on REPORT by Dr. A. T. OZZARD
(1) Plantations; (2) "En Masse": and the General and Special Sanitary
Measures.
HONOURABLE SURGEON GENERAL,
Public Hospital. Suddie, 26 January, 1908. SUGGESTIONS re anchylostomiasis in accordance with minute paper, No. 2143/07, of January 21st, 1908.
1. Treatment on plantations.-Insist on all new immigrants, whose stools show presence of anchylostomum duodenale ova, to undergo a course of thymol treatment. Similarly, any other cases showing anchylostomum duodenale ova in stools should be admitted to hospital for a course of treatment.
As frequently as possible have stools of immigrants examined for anchylostomum duodenale ova.