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C.O. 885
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8. I do not think that the number of cases found in the Belize hospital and jail at the beginning of this year reflects on the accuracy of Dr. Cassel's observa- tions between June and October. About Christmas and New Year Belize always has an influx of visitors from outside and a temporary increase in the number of prisoners. I think there must be very little Ankylostomum among the regular inhabitants of the Belize town and district.
4. Dr. Gann's report on Corozal coincides with that given by Dr. Woodman in a previous year.
5. Ankylostomum to a moderate extent exists in Stann Creek and Cayo districts.
8. The worst district is that of Toledo, and to Dr. Clements is due the credit of a serious attempt to combat Ankylostomum.
7. After Toledo, Guinea Grass, in the Orange Walk district, seems to be in the worst condition. I had hoped that on Dr. Woodman's being relieved of his magisterial duties he would be able to give especial attention to this matter; but he has been transferred to Hong Kong, and it may be a long while before a substitute can be found.
8. Dr. Harrison has for some time past been without an Assistant Medical Officer at Belize, and apparently will have to remain so. It is impossible for him to do more than deal with the cases he finds in the prison or the hospital. The Assistant Medical Officers in the districts are doing what they can.
9. I am of opinion that as a whole the Colony is less infected with Ankylos- tomum than might have been expected.
10. Dr. Cassel draws attention to the comparative immunity of bare-footed Caribs. I think this is because Caribs live near the sea-shore and use waterside Latrines.
COLONIAL SECRETARY,
I have, &c.,
WILFRED COLLET,
Governor.
Enclosure 1 in No. 88.
Up to end of September, Dr. Cassel examined the faces of 71 prisoners with negative results. With the patients his notes are not very clear, but there is evi- dence of abundance of Trichocephalus dispar infection.
I myself have no time to do miscroscope work, but amongst the patients have collected the ankylostomes from all suspected cases by giving thymol.
J. H. HUGH HARRISON.
17th December, 1914.
COLONIAL SECRETARY,
Trichocephalus dispar is not Ankylostomum. former is abundant and not the latter.
account of his investigations.
It is very interesting if the
I shall be glad if Dr. Cassel will give an
In how many cases during the present year has Dr. Harrison detected Ankylos- toma after giving thymol? Where did the patients come from?
18th December, 1914.
COLONIAL SECRETARY,
W. C.
SINCE October five cases, three cases from Belize (but all these have been resident outside of Belize: one had been in Yucatan), one case from Punta Gorda, ine a Weika.
23rd December, 1914.
Enclosure 2 in No. 88.
J. H. HUGH HARRISON.
SPECIAL REPORT on the PREVALENCE OF ANKYLOSTOMIASIS IN THE TOLEDO DISTRICT.
IN writing a special report on ankylostomiasis in this district, I feel it my duty to point out that my short residence here does not entitle me to give an opinion of scientific value as to the etiology of the disease, which factor to my mind is the most important one to grasp at the present state of our knowledge of ankylos- tomiasis.
J
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Young children Ankylostomiasis is very prevalent in the district of Toledo.
of age. from one to two years onwards seem to suffer from it, as well as adults well beyond puberty. I have so far not found the disease in people over thirty years Males and females seem equally well exposed to the infection, though my limited observations do not allow me to draw a definite conclusion. No doubt owing to the great demands made by the growing organism on the blood-producing organs, the ravages of ankylostomiasis are, above all, well marked in young children, and in those belonging to early adolescence. Judging from my experience in the hospital Next to this I'should and in my private practice, I feel inclined to think that the Indian race is the one upon which the infection with ankylostomiasis tells most. place the coolies and creoles, and last of all the Caribs. In fact, amongst the latter race I have so far not observed any case of ankylostomiasis, although I have found a great many suffering with infection of Ascaris lumbricoides. Amongst white people, Americans, I have had under my observation two cases only. I have so far Although I not found the infection in any case where boots were worn habitually. have no doubt that there exists a causal relationship between the puffy and swollen feet, covered with minute sores, which one so frequently finds in cases of ankylos- tomiasis and the disease itself, the fact that Caribe expose themselves under identical conditions, and yet, as far as I have observed, do not contract the disease, seems to point out that bare feet alone are not responsible for the infection. I have not found many instances of ankylostomiasis amongst the inhabitants of Punta Gorda itself. Most of the patients come from outlying districts, namely:-Monkey As so far I have not River, Sarstoon, Dolores, Temash River, and St. Antonio. visited these localities, I can only point out what I have gathered from lay informa tion, namely, that in most cases the sufferers of the disease seem to live on a loose, sandy soil.
If this has any direct bearings on the biological requirements of the Ankylostoma I am not in a position to say.
Out of twenty-three hospital cases whose fæces were systematically examined by me since 12th December, I found eight suffering from ankylostomiasis, two from Ascaris lumbricoides, and seven from Trichocephalus dispar. This means that practically one-third of all cases admitted to the hospital during the period men- tioned were suffering from ankylostomiasis. Very young infants and extremely weak patients are treated with a mixture of eucalyptus oil, chloroform, and castor oil. The majority, however, are given thymol in capsules, up to 60 grs. a day. In all cases I have on repeated examinations failed to discover ova of Ankylostoma. In the meantime, all patients take a mixture containing iron, which, together with the general hospital treatment, so far has always resulted in a cure. The actual treat- Unfortunately, however, owing to the ment, therefore, is highly satisfactory. poisonous qualities of the remedy, and the lack of intelligence of the patients, this treatment is only of avail in the hospital, which, of course, does not receive but a As stated very limited number of the sufferers. The unfortunate result therefore is this, that the cured patient returns home only to become reinfected once more. before, my observations are far too meagre yet to allow me to draw any definite con- clusions, far less to recommend anything to get at the root of the disease. I only wish to point out once more that, in my opinion, ankylostomiasis in this district is so prevalent as to seriously threaten the vital energy of a great portion of the inhabitants, and above all of the Indian population.
I may add, that I have found both the Ankylostoma duodenalis and Necator americanus in the fæces of hospital patients.
C. W. L. CASSEL,
Punta Gorda,
26th January, 1915.
Enclosure 3 in No. 88. (a)
Assistant Medical Officer.
From ASSISTAnt Medical OFFICER, COROZAL, to PRINCIPAL Medical OFFICER. Subject: Ankylostomiasis.
In reply to your telegram No. 5, of 25th January, I beg to report that no cases
of ankylostomiasis have been treated in this district during the year 1914. Fæces of hospital patients and prisoners have been systematically examined for ova from 20th June, 1914, with negative results.
25th January, 1915.
T. GANN, Assistant Medical Officer.