PUBLIC RECORD OFFICE
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Reference :-
C.O.885
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19 PUBLIC RECORD OFFICE, LONDON
SIR,
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The Hospital, Annotto Bay, 12 April, 1908. In reply to circular dated 31st January, 1908, I beg to state that very few cases of ankylostomiasis among the East Indians have come to my notice.
(A.) There are no special sanitary measures for dealing with the disease. (B. As far as I am aware, no latrine accommodation is provided for coolies
on the estates.
(C.) Treatment of the disease in hospital:
Low diet on admission. At bed time of calomel gr. V.; santonin gr. V.; next morning Ol. Ricini oz. to 1 oz., followed by thymol. 10-30 grs. in water a few hours after. Three or four hours after another dose of Ol. Ricini.
The stools are disinfected before being finally disposed of
I do not think that ankylostomiasis can be satisfactorily treated on plantations. All patients suffering from the disease should be admitted to hospital. As the diagnosis can only be positively made with the aid of a microscope, cach hospital should be supplied with one. Or, as an alternative, the District Medical Officer might be allowed to send specimens of stools, in suspected cases, to the Bacterio- logist (when he is appointed) for examination.
I have, &c.,
Hon. Dr. J. Ker,
Superintending Medical Officer,
Kingston.
SIR,
FRED. A. RITCHIE,
District Medical Officer.
Spanish Town, 11 February, 1908.
In reply to the circular on the subject of ankylostomiasis, I have the honour to state-
1. No statistics are available as to the prevalence of the disease in St. Catherine. The affection is uncommon in this district, the reason being, in my opinion, on account of the good water-supply. The only cases I see are second- term coolies from Portland, Vere, and other districts. I have no experience of any marked increase in rainy seasons.
2. No sanitary measures other than those practised by local physicians are
in use.
3. I know of no latrine accommodation on any estate. It is generally a difficult matter to get decent habitations for the labourers to dwell in, but the general practice is to contaminate the soil with fæcal matter in close proximity to the dwelling.
4. All the cases which I treat are admitted to hospital. Two or three doses of thymol (1 gramme) are administered at intervals of two hours, followed by a saline purge, depending on the strength of the patient. The thymol is repeated at the end of four days or a week; this also depending on the general condition.
Suggestions.
A. The treatment in plantations would be difficult unless under medical supervision. Thymol, which I regard as a specific, is, under certain circumstances a most dangerous drug, causing fatal collapse. It could not, therefore, be used by persons having no knowledge of medical matters. However, male fern, or emulsion of kerosene oil, in suitable doses might be used on estates as routine treat-
ment.
B. The sanitary measures would include the conservancy of the water-supply, carefully guarding against fæcal pollution. Better latrine accommodation is essential. District Medical Officers on their official visits should inspect all the indentured immigrants, and those suffering from anæmic conditions, particularly in localities where the disease is prevalent, should be treated as suspects.
Leaflets might be distributed urging the dangers of polluting waters. With reference to this I may remark that Leuckart and Kynsey are of opinion that the infection is through water, while Sansino states that the ova are introduced by
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soiling the hands and nails with infected mud, and so passed into the system with food. I regard both methods of introduction as possible.
The Honourable
SIR,
Superintending Medical Officer, Kingston,
I have, &c.,
W. D. NEISH,
Stony Hill, 14 February, 1908. WITH regard to your circular of 31st January, 1908, I beg to reply as follows:-
I have had cases of ankylostomiasis in all parts of this district.
I have not remarked any increased severity in rainy seasons-the number of cases is not so great as to render such increase, or otherwise, noticeable.
(a) I am not aware of any sanitary measures in force-except as mentioned in (b).
(b) I have had cases in the Reformatory coming from outside. The dry-earth and bucket system is in use: the dejecta of any boy known to have ankylostomiasis are burnt.
(c) I usually employ a milk purge and low diet for two days; 30 grains of thymol early in the morning, given in divided doses of 5 grains each every half- hour; a purge of black draught in four hours; grain or -grain doses of quinine in liqordi ferri perchlor. three times a day, and a nourishing diet. After some weeks a re-examination of the stools is made, and if ova are found the process is repeated.
With regard to the last paragraph, the first appearance of a case of anæmia on a plantation should be reported; then, if it be settled that ankylostomiasis is present, arrangements could be made for cure of infected cases, and for destruction of stools. It would be difficult, involving constant intelligent supervision, but it could be done.
2nd. My present practice, on discovering a case of the disease in a family, is to explain as far as I can its nature, and advise the destruction of the stools by fire-besides treating the case. I do not see any other way of dealing with the
matter.
3rd. If necessary, the District Medical Officer could deal with ankylostomiasis as is now done with yaws-subject to such modification in procedure as may be necessary, the principle remaining the same. Notification should be made neces. sary, and the other steps would follow.
SIR,
I may say that usually severe cases only come under observation.
I have, &c..
R. S. TURTON,
District Medical Officer.
The Hospital, Chapelton, 3 March, 1908.
WITH reference to the circular on the subject of ankylostomiasis I have the honour to report, for your information, the following facts:-
1. The records for the past fifteen years (1893-1907) show that eleven cases of ankylostomiasis were treated in this hospital, and since satisfactory treatment can only be carried out in a hospital. I presume this number represents all the cases which came under observation.
So far as the small number of cases serves there is nothing to note as to increase or severity in rainy seasons. Only one case occurred in an indentured immigrant during his second term.
The cases were admitted from all portions of the district, the extremes being Richmond Park by Porus and Bella's Gate.
2-(a) So far as I am aware there are no sanitary measures in force dealing with this disease, nor do I think that in this neighbourhood its incidence demands any special notice, quite apart from the fact that any measures formulated would not be carried into effect.
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