CO885-(18-19) — Page 637

PUBLIC

RECORD OFFICE

Reference :-

C.O.885

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO

19 PUBLIC RECORD OFFICE, LONDON

1

160

(a) There are no sanitary measures in force in this Colony for dealing with the disease to my knowledge.

(b) As far as my experience goes there is no latrine accommodation provided for labourers on estate. Those for the staff, busha, bookkeepers, &c., are generally open cesspits.

In this town there is no regular system. Amongst the lower classes of dwell- ings the latrines are simply open cesspits, but with the better class for the most part the bucket system is in use.

(c) As far as my experience goes the best drug for the treatment of the disease is thymol, which I administer as follows: I order a dose of castor oil to be given over night. The next morning on an empty stomach, three doses of about 20 grains in each, for adults, are given at intervals of one hour (6, 7 and 8 a.m.). After this the patient is kept without any food or drink, except water, until 12 o'clock, when another dose of castor oil is given. All food is withheld until the bowels have acted after the second dose of oil. This generally brings-away the worms in large quantities.

This dosing is repeated once a week until no more worms appear in the motions after a dosing.

1. I cannot suggest any improvement on the treatment above mentioned. 2. For the treatment of ankylostomiasis en masse, the following suggestions might be useful: First, by means of pamphlets and notices the general mass of the population might be acquainted with the nature and symptoms of the disease and the modes by which the worms gain access to the human intestines, and the method to be adopted to prevent the eggs of the worms from being taken into the mouth and swallowed, and also the methods to be adopted to prevent the eggs which pass out with the fæces from contaminating water and food. Then, thymol might be distributed free to all those suffering from the disease, with instructions how to use it, how often to use it, and the precautions to be observed in its use. A description of the worm should be given, with instructions to search carefully for it in the fæces after taking the drug.

3. As regards sanitary measures, open cesspits should be disallowed, and all privy trenches should be regularly and systematically disinfected. All drinking water should be boiled and all ground food and provisions should be thoroughly cooked. Instructions should be given and impressed on all, especially agricultural labourers, the necessity for thoroughly washing and cleansing the hands before partaking of food.

The Superintending Medical Officer,

Kingston.

I have, &c..

H. JOSLEN

Spanish Town, P.O., 11 April, 1908.

Reply to Circular on the subject of Ankylostomiasis.

In reply to your circular on the above subject, I have to state that (a) no special sanitary measures are in force for dealing with this disease; (b) the latrine accom- modation provided for indentured immigrants, namely, deep trenches, is seldom resorted to by the coolies. The pit system is adopted in the principal centres of population. A Sanitary Inspector is appointed in each of the chief towns in this parish, who looks after the proper cleaning of the latrines along with other sanitary work; (c) The method of treatment employed by me is giving thymol in doses of 3 to 4 grains after a saline purge the previous day, and following up by saline purges. Ferruginous preparations are also given in the intervals.

For the proper treatment of the disease both preventive and curative—(1) A law should be enacted making it compulsory that privies be supplied for labourers working on the estates-these may be of a permanent or portable kind. (2) The treatment of ankylostomiasis en masse can only be undertaken under special sanitary rules and regulations entailing an expenditure of money for establishing stations in the affected areas, proper inspectors to carry out the treatment, and strict observance of all sanitary laws. (3) Simple hygiène should be taught in all schools.

161

The future generation will then become to some extent acquainted with the proper habits of cleanliness and preservation of health.

J. H. PECK,

SIR,

District Medical Officer.

Balaclava, 13 February, 1908. I HAVE the honour to acknowledge your circular letter dated 31st January, 1908, with regard to the subject of ankylostomiasis in this Colony.

(a) I am not aware of any sanitary measures being in force for dealing with this disease in particular.

(b) There is to my knowledge no special latrine accommodation provided on estates or in the country towns for the use of the people.

(c) The chief and most satisfactory treatment which has been adopted here has been that by thymol, as much as one drachm and a half being given internally in one day. This is given on a fasting stomach in the following way: the first dose of 30 grains is given at 5 a.m., the next dose (of 30 grains) is given at 7 a.m., and the third dose (of 30 grains) is given at 9 a.m.; this treatment is followed in one hour by a mug of hot, strong bovril or beef tea, or milk. The patient must be kept on a slop diet while under treatment. The above treatment is repeated every three or four days until the ova of the worms have ceased to be passed in the stools. Male fern is also used with much success in the treatment of this disease.

With regard to the next questions asked, they are very difficult to answer, particularly Nos. 2 and 3.

1st. All plantations should have a special house, or range of rooms, where the employees suffering from ankylostomiasis could be treated as in a hospital. (This, of course, could only apply to those estates or plantations where indentured labour is used.) Weekly examinations of the stools should be made to ascertain the presence or not of the ova, and treatment continued until a cure is effected: for it is well known that from the habits of the labourer he will relieve nature at the most convenient spot to him, and if his excretal matter still contains the ora of the worms, then fresh infections are likely to be the result, and a further spread of the disease take place.

The water used should in every instance be boiled, or filtered through a reliable germ-proof filter, such as the Pasteur filter, and the people advised to wash their hands and faces thoroughly before handling their food. There is even the chance of the ova Leing carried to the mouth through the contaminated water, if used to wash with before being boiled, &c., but this is, of course, only a chance, I say, of infection through this way. At any rate this precaution of observing personal cleanliness before eating should be strictly carried out; but here, again, the carelessness of those chiefly concerned will add greatly to the burden of the task of stamping out this disease, if such were possible! Special latrines should be erected for the use of the employees on the estates and plantations, and the excretal matters thoroughly disinfected and then buried deeply. Disinfectants should be used freely in the latrines.

2nd. For the treatment of this disease among the masses, they can only be advised and informed as to the preventive measures to be adopted, and then trusted to do as advised. Then, should any be found to be suffering from this disease (either by private practitioner or Government medical officer), and such person not be in a position to carry out the proper treatment, that person should be sent to the hospital of his, or her, district and there treated until cured. If found necessary to do so, an infected person should be, if possible, compelled to undergo the cure.

3rd. With regard to general and special sanitary measures for the prevention of this disease, until special laws and arrangements are made all will be unavailable,

I have, &e..

W. LOFTHOUSE,

District Medical Officer.

The Hon. Superintending Medical Officer and Doctor.

Kingston.

32655