PUBLIC RECORD OFFICE
Reference :-
humimi
IC.O. 885
23 PUBLIC RECORD OFFICE, LONDON
ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO
16019
86
No. 47.
LEEWARD ISLANDS.
THE SECRETARY OF STATE to THE GOVERNOR. (Miscellaneous.)
Downing Street, 11th May, 1914. SIR,
WITH reference to my telegram of the 7th May,* I have the honour to inform you that Mr. E. S. Marshall, M.R.C.S., L.R.C.P., D.T.M. and H., has been selected for temporary appointment as Medical Officer, to carry out an investigation into the prevalence of ankylostomiasis in Antigua, on the terms specified in the accom- panying copy of a lettert from the Colonial Office.
2. The exact date of Mr. Marshall's departure will be reported to you as soon as it is settled.
3. I enclose, for your consideration, a copy of a letter from Mr. Marshall, and I shall be glad if you will inform me by telegram whether suitable arrangements can be made as regards laboratory accommodation.
4. I also request that all reasonable travelling expenses incurred by the micro- scopists may be met, either from the provision for "contingencies" or otherwise, as may seem best.
(16683.)
I have, &c.,
L. HARCOURT.
Enclosure in No. 47.
Lyncombe, 24, Willow Road, Hampstead, N.W.,
5th May, 1914.
DEAR SIR,
WITH reference to my conversation with you yesterday, I shall be glad to know if any laboratory accommodation is available in Antigua, or, if not, any quarters could be provided which might be temporarily and suitably converted into such.
If any laboratory is available I would suggest that the small laboratory equip- ment necessary should be temporarily loaned for the ankylostomiasis investigation, for otherwise it would be necessary to take this out from England. I would also be glad to know if it would be possible to arrange for travelling expenses for the microscopists, as it is possible that, in order to facilitate and expedite the work, it may be necessary to take at least one of the microscopists when visiting outlying plantations and districts.
Believe me,
H. R. Cowell, Esq.,
Colonial Office.
17395
No. 48.
Yours faithfully,
E. S. MARSHALL.
LEEWARD ISLANDS.
THE GOVERNOR to THE SECRETARY OF STATE. (Received 12th May, 1914.)
(No. 176.)
Government House, 24th April, 1914. SIR,
WITH reference to my despatch quoted in the margin, concerning the pre- valence of ankylostomiasis in Antigua, I have the honour to forward, enclosed, a copy of a report by Dr. McDonald, Medical Super- intendent of the Public Institutions, describ- boys in the St. John's Training School.
No. 14. 8th January, 1914.
ing the results of his treatment of 46
2. The fact that 46 out of 69 lads were found to be affected by hook-worms
* 16019: not printed.
† 15745: not printed.
† No. 10.
87
shows how widespread the disease must be among the inhabitants of this Island, and how erroneous are the views of those Medical Officers who have stated that ankylostomiasis is a matter of little importance in Antigua.
3. The remarkable results obtained by the use of thymol on the boys treated by Dr. McDonald give ground for believing that similar operations on a large scale would be of immense benefit to the labouring classes in these islands, and I trust that you will, at an early date, be in a position to authorize me to take advantage of the generous offer of help which the Rockefeller Health Commission has made in that connexion.
I have, &c.,
H. HESKETH BELL,
Governor.
Enclosure in No. 48.
REPORT ON THE RESULTS OF TREATMENT OF THE BOYS OF THE INDUSTRIAL SCHOOL FOR ANCHYLOSTOMIASIS.
THE boys, 46 in number, were treated in batches of six at a time in the hos- pital. The treatment was as follows:-At bedtime the night before admission, the At 11 a.m. next batch of boys that were to be treated were given a saline purge.
Came into hospital and put to bed at 4 p.m. At 7 p.m. day they had breakfast.
the same day they had a small cup of milk, having had no other food since 11 a.m. At 8 p.m. the same day they were given a saline purge of 1 oz. of sodium sulphate in 2 oz. of water.
Next day at 6 a.m. they were given 20 grs. of finely powdered thymol mixed with equal quantity of sugar of milk. At 7 a.m. the thymol was repeated as above. At 8 a.m. the thymol was repeated as above. At 10 a.m. 1 oz. of sodium sulphate in 2 oz. of water was given. At 12 a.m. an enema was given if the bowels had not already acted.
During this time the boys were kept strictly in bed and very carefully watched and not allowed to move, and were not allowed anything to eat or drink, not even a drop of water.
The bowels always acted after the enema. The stools were collected and washed and strained separately and carefully examined. In this laborious and unpleasant task I was greatly helped by Wilson, the male nurse.
The majority of the boys passed numerous hook-worms, some boys passed hundreds at a time.
The boys were kept in bed until 4 p.m., when they were allowed to get up and go back to the school for their ordinary dinner at 4.30 p.m., another batch of boys coming up at 4 p.m. to take their place and undergo the same treatment, except that alternate batches of boys were given 10 grs. of beta-naphthol instead of the 20 grs. of thymol.
The majority of the boys underwent three courses of the above treatment; the first course of treatment covering the period 15th to 25th November, 1913, the second course of treatment covering the period from 29th December, 1913, to 8th January, 1914; the third course of treatment covering the period 16th to 20th March, 1914.
None of the boys suffered any bad effects from either thymol or beta-naphthol, with the exception of John Martin, who became drowsy and had a weak pulse after the thymol. His was the most severe case treated, and he showed much improve- ment in clinical symptoms after treatment. (Case 30 on record).
Only 29 boys returned for the third course of treatment, so that 16 boys received only two courses of treatment. The physical improvement in these 16 boys is the result therefore of only one course of treatment, as their condition was noted on admission just before the second course of treatment. Similarly, the physical con- dition of the boys who received three treatments is really the result of two treat- ments, as the final record of their weight, &c., was taken just prior to their third
treatment.
One boy did not return after the first treatment, therefore it has not been possible to give any results in his case.
The results may therefore be classified into three groups: Group I. consisting of the boys who came in three times for treatment; Group II. consisting of the boys who came in twice for treatment: Group III. consisting of the five boys who were specially hunted up and examined and weighed at a later date.