PUBLIC RECORD OFFICE
Reference :-
C.O.885
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table pustular dermatitis which has hitherto been put down to ant-bites, but I should not be surprised if a certain number of these cases do not prove to be an ankylostomum dermatitis." If this be so, it will be another argument for taking steps to save the soil from indiscriminate fæcal contamination.
The Honourable
Superintending Medical Officer,
Kingston,
I have, &c.,
P. O. MALABRE,
District Medical Officer.
Ankylostomiasis.
SUPERINTENDING Medical OFFICER,
Kingston, 17 February, 1908. As far as my experience goes, I think there is a decided increase in the severity of this disease during the rainy seasons. I attribute this condition of things to the lowered vitality and diminished resistive powers of those who harbour the ankylostomiasis during the hot and enervating weather which generally accom- panies the rains. The same patient on whom the parasite would probably make little or no impression while in vigorous health would suffer and might even succumb when below par.
(a) There are no definite sanitary measures, as far as I know, in force in this Colony for dealing with ankylostomiasis. Some time ago a circular was issued by the Immigration Department, with the concurrence of the Superintending Medical Officer, calling upon the employers of indentured immigrants to provide proper latrine accommodation on the various estates for the coolics, but little or nothing was really effected in this direction.
(b) On the estates with which I am acquainted no latrine accommodation exists. In the centres of population the ordinary privies are generally in use and are subject to the usual supervision of Inspectors of Nuisances.
(c) The treatment usually employed is one having in view the double object of getting rid of the parasite and of curing anæmia caused by them. For the former purpose, thymol appears to be the most efficacious drug. Given in 20 to 30 grain-doses, on an empty stomach, on two or three occasions, followed each time by a brisk purge of castor oil, it is almost a certain cure. Afterwards, the anæmia can be treated with one or other of the preparations of iron.
(1) The treatment of ankylostomiasis on plantations should be strictly pre- ventive. It should be insisted on that proper latrine accommodation be provided and placed in such positions as to render the pollution of the water supply impos- sible. I know it will be difficult to get coolies to use the ordinary privy, but, if properly constructed trenches, lined with cement concrete, were provided, these would answer the purpose; and they could be flushed frequently with boiling water to destroy stray worms and ova. As it is not impossible that the ankylostomum in some instances finds its way into the host through cracks or abrasions on the feet, it seems only right that some attention should be given to this phase of the matter. Coolics, for instance, who have bruises about their feet should be prevented to work in proximity to latrines, and where possible the wounds or scratches should be protected from exposure. It seems not unreasonable to sup- pose that some oily preparation containing thymol as a basis might be useful as a local application in this connexion.
(2) With respect to ankylostomiasis and the general population, it seems that the great disideratum is a pure uncontaminated water supply, coupled with a regular systematic habit of boiling water used for drinking.
(3) The measures which appear desirable are already indicated in the above remarks.
LAWSON GIFFORD,
District Medical Officer.
Falmouth, April 13, 1908.
SIR,
In reply to circular re ankylostomiasis, I regret that there has been delay En replying. It has arisen from my not having any personal practical experience
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in the treatment of this disease amongst labourers on plantations or, so to speak,
en masse.
There are no indentured coolies in this district amongst whom one would look for cases.
I have treated, both in hospital and private practice, cases of anæmia in which I have suspected the presence of these parasites, and in some cases confirmed the suspicion by finding the eggs on examining the fæces. Two of these cases had lived on estate plantations in Portland; but in others there was no means of tracing the source of infection, and, in all cases, there were other parasites present.
I have found thymol in 15 grain doses, given in the morning and followed by a dose of oil, a speedy means of getting rid of them. I can only suggest that it should be given as a routine thing to all labourers on plantations where cases occurred, say, once a month. In those cases where there were other symptoms from the presence of these parasites, some easily assimilated form of iron should be given; preferably the scale compels (tinct. quin. cit.). I cannot suggest any special sanitary measures beyond the obvious close inspection of the sources of the water supply, and when possible having all water used for drinking boiled and filtered, the use of the dry earth system, and insistence on personal cleanliness.
I have, &c.,
The Honourable
The Superintending Medical Officer,
Kingston.
C. A. H. THOMSON.
SIR.
Morant Bay, 13 April, 1908. REFERRING to your minute, dated 31st January, 1908, in connection with the circular from the Secretary of State for the Colonies on the subject of ankylosto- miasis, I have the honour to state that my experience of this disease is very limited, having had to do with two or three cases only.
Since the recent introduction of coolies to this district there has been no reason to suspect the prevalence of the parasite among the labourers, and the question of making special provision to deal with it has not arisen. No latrine accommodation is provided on the only estate to which indentured immigrants are attached, and my experience of their conduct in hospital where constant supervision is necessary to ensure decency rather points to great difficulty in carrying out efficient sanitary arrangements on the estates. The trench or pit system where the fæcal deposits could be buried appears to me to offer most promise of successful precaution against the spread of the disease.
SIR,
I have, &c.,
T. M. BARTLETT,
District Medical Officer.
Christiana, April 13, 1908.
I HAVE the honour to reply to your circular re ankylostomiasis as follows:-- There is, as a rule, a limited number of cases of anæmia in the parts of the district with a clay subsoil, some of which appear to be due to ankylostomiasis, although I have not demonstrated the presence of the parasite associated with this anæmia; there is often the habit of eating clay, ashes, &c. For the most part it affects children and disappears when they attain puberty. The rainy seasons have no influence upon it. Marked improvement generally follows the administra- tion of santonin with a purge followed by a laxative iron mixture. No special sanitary measures are taken with regard to it.
I have, &c.,
Honourable Dr. J. Errington Ker,
Superintending Medical Officer,
Kingston.
32655
E. V. HALLIDAY,
District Medical Officer.
Y