PUBLIC RECORD OFFICE
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Reference :-
C.O.885
19 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC-
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would not be more correctly returned as due to anchylostomiasis. Whether this be so or not, of one point I think we may be sure, and that is-the existence of this disease is the source of the loss of a considerable amount of labour on sugar estates— hence it is most important for the employers of labour that these cases be correctly diagnosed and treated in the early stages; they could then be rapidly restored to health and become useful labourers, whereas, if neglected, they steadily become more and more debilitated and ultimately become hopeless invalids, fit only for the
almshouse.
4. As the disease is a preventable one and eminently curable when treated in the early stages, it is our bounden duty to do everything in our power, not only to cure individual cases, but to endeavour by all means to stamp it out.
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not exceed 30 dollars. I shall be pleased at any time to recommend or advise as to the sort of microscope that would be suitable.
I have, &c.,
To all Government Medical Officers and
Managers and Attorneys of Sugar Estates.
5. With this view, therefore, I take the opportunity of bringing the matter again before your notice and of asking your hearty co-operation:
SIR,
In order to facilitate the work. I beg to make the following suggestions:-
(a) The chief indication of auchylostomiasis is anemia with its attendant
symptoms.
(b) After the removal of the parasites this anæmia usually disappears rapidly,
even without further treatment.
(c) To diagnose anchylostomiasis with accuracy, especially in its early stages, it is necessary to make a microscopic examination of the stools, in order to search for the ova. This is a most simple matter, requiring only an ordinary student's microscope with a magnifying power of not more than 150 to 200 diameters. The dispensers at the estates' hospitals can easily be taught to prepare and have in readiness for you specimens of fæces of suspected cases.
(d) This is quickly done by placing a very small quantity of the fæces on a slide, adding a little water if required, dropping the cover glass on it and gently pressing it down. A ring of vaseline may then, if neces- sary, be put round the cover glass to prevent evaporation.
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(e) Having found the ova (an excellent plate description of it is to be found in Davidson's work. "Diseases of Warm Climates ") the next step is to expel the parasite, and the following is the usual course adopted:
Place the patient for a couple of days or so on " milk " or " spoon
Then the diet, giving an alkaline bitter mixture to remove mucus. night before the thymol is given a dose of calomel is administered and on the following morning 60 grains to 75 grains of thymol divided into three doses-say at 6 a.m., 7 a.m., and 8 a.m., and followed at noon by a full dose of castor oil. Thymol is best given in cachets or wafer papers.
(/) All stools passed for 43 hours after administration of thymol should be carefully washed through muslin. This is done as follows:—A good sized hoop is made (a hoop from a flour barrel answers admirably) and muslin or very fine netting stretched over it. The fæces are then poured on to this, which is held over a bucket, and a stream of water kept gently flowing on them until practically all the fæces are washed away, when the worms are easily found and counted. This process can, with a little teaching, be done by the dispenser.
(g) The patient should then be placed on tonic treatment and at the end of a week or so the stools again examined and if ova are found the thymol treatment repeated.
5. As it has been found from experience that new immigrants frequently bring this disease with them, or acquire it very shortly after landing here, par ticular care should be taken to examine each at the monthly inspections for symptoms of this disease, and any found to be suffering from anæmia should be at once placed
under observation.
6. It will be noticed that the apparatus necessary for the detection of these parasites and their ova is.extremely simple; the principal and most expensive being a microscope with the necessary glass slides and cover glasses. I therefore appeal to the estates authorities for their assistance and co operation. This can best be given by supplying each hospital with a microscope, the cost of which should
(Circular. No. 249/427/1902.)
J. E. GODFREY,
Acting Surgeon-General.
Surgeon-General's Office, Georgetown, 9 May, 1902.
i. Anchylostomiasis.
ii. Monthly Return of Cases treated for Intestinal l'arasites.
REFERRING to my circular, No. 240, dated the 14th December, 1901, I have
the honour to attach, for your guidance, a “form "* which is to be regularly filled
and transmitted to me at the end of each month.
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2. In making the microscopic examination of the fæces you will take particular care to search for the ova of the three most common species of nematode worms found in the Colony, viz., ascaris lumbricoides, trichophālus dispar, anchylostomum duodenale.
3. A description of these will be found in Manson's book on tropical diseases. 4. With regard to the purgative to be used in the case of ancylostomiasis, it has been found advisable to use "Salines" instead of oil, as thymol is, to a certain extent, soluble in oils, and toxic symptoms might follow, due to absorption; for the same reason alcohol should on no account be given during the thymol treatment. 5. It is essential, in order to have the number of cases of anchylostomiasis properly returned, that every case should be diagnosed; and I must again impress on you the necessity of examining the "stools" of all cases of anæmia.
6. It is well to remember that in the cases of anchylostomum duodenale the stools should be examined shortly after they have been passed, otherwise the ova develop rapidly and, the embryo having quitted the shell, the egg is no longer visible. 7. With regard to the form under the heading "Result of Microscopic Examination," you will state the variety of ova of nematode worm found; if none, enter "Nil."
8. The fæces should be washed to search for the mature worms from time to
column. time, and the result entered in the proper
9. Under the heading "Remarks" give anything of interest.
To all Government Medical Officers.
SIR,
(Circular. No. 395/33/06.)
I have, &c.,
J. E. GODFREY,
Acting Surgeon-General.
Surgeon-General's Office, Georgetown. Demerara, 26 January, 1906.
Anchylostomiasis.
WITH reference to the treatment of anchylostomiasis I have the honour to draw your attention to a paper by Dr. L. P. Philips published in the Journal of Tropical Medicine of December 1st, 1905.
2. In this paper Dr. Philips suggests the treatment of these cases with cucalyptus and chloroform as being safer, more efficacious, and cheaper than thymol.
3. The formula he suggests is:-
Eucalyptus oil
Chloroform Castor oil
2.50 grams.
3.50
40.00
• Not reprinted.
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