CO885-(18-19) — Page 640

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SIR,

166

Claremont, 16 February, 1908.

I AM in receipt of your Circular, and, in reply, beg to give as far as I can the information asked for :-

A. The only sanitary measures practised in the two villages in my district, as far as I know, are the sweeping of the streets and market places and the cleaning out of latrines occasionally.

The people, at least the great majority of them, are agricultural and live on their holdings; few of them have latrines. When nature calls they go to the bush or the cultivation near their homes. My district is naturally a very healthy one. Its one great defect is the absence of a proper water supply. The better classes use rain water stored in tanks; the others as a rule depend on catch water from their roof or else on the ponds in the different pens used for the watering of stock, with the result at times of severe outbreaks of dysentric diarrhoea.

The drainage of the district is an underground one, water appearing above the surface in but one place, viz., near Moneague.

The providing of a healthy water supply would mean the giving of a water tank to each household unprovided with one, and that could not be done, speaking from a financial point of view.

For the treatment of ankylostomiasis-there is no call for it in my district.

The Honourable

Your, &c.,

V. FF. MULLEN,

District Medical Officer.

167

rainy seasons; in fact, my experience is that the cases are fewer in the rainy than in the dry seasons.

(a) The sanitary measure in force is the only one possible by the providing of trenches on the estates for the coolies to use as Tatrines; this, how- ever, is useless, as the coolie prefers to utilise the first convenient spot.

(b) Nature of latrine accommodation-trenches on estates. No supervision

is exercised, as they are never used.

(c) The method of treatment I always employ is the thymol treatment, as recommended by Sir Patrick Manson. The results have always been satisfactory.

No further sanitary measures can be taken or are required on plantations than the providing of trenches to be used as latrines. What is required is to compel the people for whom they are made

to use them.

In my district no treatment for ankylostomiasis en masse is called for; if

it were I could not do better than recommend the system of prophylaxis recommended by Sir Patrick Manson.

The general and special sanitary measures required are the two by the pre- venting of fæcal contamination of the soil and water.

I have, &c.,

H. J. GEORGE.

PUBLIC RECORD OFFICE

61

Reference :-

TITLC.O.885

19 PUBLIC RECORD OFFICE, LONDON

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

SIR,

J. Errington Ker,

Superintending Medical Officer..

Gordon Town, St. Andrew, 14 February, 1908.

In reply to circular from the Secretary of State for Colonies I have to say that the disease known as ankylostomiasis is not of frequent occurrence in this Island as far as my observation goes, as there may be ankylostomum without consti- tutional symptoms.

I have seen one case in this district which came to my notice in January, 1908, which I cured by the thymol treatment.

1. The course adopted on plantations might consist of isolation, the adminis- tration of eculayptus oil and pure chloroform, followed by a purgative; this treatment to be preceded by opening the bowels. This is the best, as thymol

in large doses produces great depression, with brachycardia.

2. Thymol in moderate doses in capsule with castor oil.

3. The earth-cating habit should be avoided; impure water from muddy pools;

eating fod with hands improperly washed.

Summary of prophylaxis:-

(a) Deep trenches or latrines for the reception of fæcal excreta, with or

without the use of disinfectants.

(b) Sanitary conditions of the body, particularly the hands.

(c) Pure drinking water.

(d) Isolation of all cases under treatment.

(e) Food thoroughly cooked.

(f) Sanitary condition of houses and vicinity.

The Honourable

Superintending Medical Officer.

I have, &c.,

JOHN ROGERS,

District Medical Officer.

SIR.

Buff Bay P.O., 13 April, 1908. I HAVE the honour to acknowledge receipt of circular dated 31st January, 1908, re ankylostomiasis, and, in reply, beg to report as follows:-

During the three years that I have been Medical Oflicer here there has been no marked increase either in the number of cases or in the severity during the

SIR,

Richmond P.O., 18 February, 1908.

I HAVE the honour to acknowledge receipt of your circular, dated 31st ultimo, on the subject of ankylostomiasis in this Colony.

During a period of nearly twelve years in this district I have not come across more than a dozen cases of the disease, and nearly all of these were in indentured immigrants. From such small data I cannot express any opinion on the effect of the rainy seasons on the disease.

With regard to the particulars asked for I beg to say that—

(a) I am not aware of any sanitary measures for dealing with the disease

in this Colony.

(b) There is no latrine accommodation provided for the use of the coolies on the estates; and, in the few instances in which trenches were made for their use, I am told that the coolies could not be induced to use them. In the other centres of population but very few yards have a latrine of any sort, the people preferring to go to the "bush" indis- criminately whenever the necessity arises. Such latrines as do exist are usually put on a steep hillside and left open at the back for the benefit of the pigs and fowls.

I

(c) As regards treatment, I find, in my limited experience, thymol to be rapidly efficacious in the milder cases. The more aggravated cases go to hospital, where, I believe, they are treated in the same way. notice in a recent issue of the "British Medical Journal" that beta- naphthol is very highly spoken of in this discase, but I have had no opportunity of using it.

If any measures of prophylaxis are to be desired they must be directed towards keeping the drinking water from fæcal contamination, and teaching all agricul tural labourers (and others who have to handle soil) the absolute necessity of their hands being scrupulously clean before eating (knives and forks not being, of course, regularly used). It will not be difficult to provide blind trenches for latrine use in convenient spots, and these could be filled up and others dug from to time, but the problem will be to induce the coolies to use these trenches. Suitable legislation strictly enforced might meet this need to some extent, but I do not know by what means, other than education, it will be possible to get labourers to exercise the needed care and cleanliness in eating and drinking.

It has been stated that the embryo of the ankylostoma are able to penetrate the unbroken skin, where they set up a peculiar dematitis. It is a matter of common observation that a great many of the newly-arrived coolies get an intrac-