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with very great interest, for, if his results are borne out with further experience in the treatment of ankylostomiasis by prolonged courses of thymol in small doses, he has hit on a method of controlling that disease of great practical value.

As thymol is a somewhat expensive drug and in certain cases irritant, and, it may be, toxic, I would suggest that a similar prolonged four months' treatment with beta-naphthol be given a trial. Beta-naphthol is much less expensive and is free from some of the objectionable properties of thymol.

I would further suggest that Dr. Ferguson's methods and results be made widely known throughout the tropical colonies, particularly Ceylon, where ankylos- tomiasis is very prevalent.

23425

No. 4.

I have, &c.,

PATRICK MANSON.

WINDWARD ISLANDS: GRENADA.

THE SECRETARY OF STATE to THE ACTING GOVERNOR.

(Grenada. No. 74.)

[Answered by No. 28.]

Downing Street, 9th July, 1914. SIR,

WITH reference to Sir J. H. Sadler's telegram of the 20th May,* I have the honour to inform you that I have selected Dr. A. Macdonald, Medical Officer of Health, Kingston, Jamaica, for temporary appointment as Medical Officer in charge to carry out the work which is being undertaken in Grenada, in co-operation with the International Health Commission, for the eradication of ankylostomiasis.

2. I enclose a copy of the lettert sent to Dr. Macdonald through the Governor of Jamaica, offering him the post, together with a copy of telegraphic correspon- dence with the Governor, from which you will see that Dr. Macdonald is prepared to leave for Grenada about the 7th August, and that I have agreed to his being allowed passages for his family by the cheapest route from Jamaica. In ordinary circumstances these passages would not be given, but, in view of the expense of maintaining a family in Jamaica by remittance from Grenada, Dr. Macdonald seems to be in a special position, and I approve of Grenada funds being charged with the excess cost over the sum of £25 provided for the passage of the Medical Officer in charge in the estimate approved by the International Health Commission. 3. The Assistant Medical Officer has not yet been selected, but efforts are being made to secure the services of a suitable candidate.

4. I have no doubt that you are taking the necessary preliminary steps for the selection and training of microscopists and for the provision of accommodation for the Medical Officers and staff, in order that the work may be begun without delay. The microscopes and lanterns provided in the estimate have been ordered by the Crown Agents, and will be shipped as soon as possible. The local Advisory Com- mittee will no doubt consider the question of the supply of drugs and microscopic sundries required.

I have, &c.,

25227

No. 5.

BRITISH GUIANA.

SIR R. ROSS to COLONIAL OFFICE. (Received 10th July, 1914.)

[Copy to Governor, 21st October, 1914. SIR,

L. HARCOURT.

No. 313. L.F. See 51327: not printed.] 18, Cavendish Square, W., 10th July, 1914. In reply to your letter, No. 20998, of the 7th July, 1914,§ asking me for observations on the methods employed in the treatment of anchylostomiasis and the results obtained, referred to in a report by Dr. Ferguson, Government Medical Officer in British Guiana, I have the honour to observe as follows.

2.

8

But

Dr. Ferguson's report appears to me to be an excellent one, and to be based upon long-continued observations, which must have cost him much time and trouble to make. The principal novelty suggested by him is the method of dosage of thymol in anchylostomiasis. Hitherto it has been customary to give 60 or 90 grains of the drug in two or three doses of 30 grains each, during one or two days. he suggests that doses of only 10 grains, given once a day, will be effective, if con- tinued for a long time. It will be observed that this method will in the end require the expenditure of much more thymol for each case, and, therefore, for the total population; and will also generally demand more attention in the dispensaries. On the other hand, the large doses of the drug cause a considerable amount of pain, and I might even be dangerous, while Dr. Ferguson's method removes these defects.

and am, therefore, of opinion that his method is quite worthy of close attention; may add that, when I was studying kala-azar for the Indian Government in 1898, a medical man in Assam informed me that he used thymol in a way closely similar to that adopted by Dr. Ferguson-though he did not publish his results, as Dr. Ferguson has so carefully done.

3. Dr. Ferguson's results appear to have been very carefully compiled, and I have no serious criticism to make of them. But I am of opinion that it would be worth while to have the method tried by an independent investigator and may suggest that the laboratory in Georgetown could undertake some experiments in selected plantations.

4. Perhaps, also, I may make the following suggestions :-

(a) AM coolies entering British Guiana might be examined for the presence of the parasites, and be treated on the large dose principle before being allowed to go to their respective plantations. As a matter of fact, this was done in Assam by Dr. Dobson, Indian Medical Service, many years ago, with most admirable results. The treatment might be made almost a part of quarantine on entry into a country.

It has

(b) Many writers appear to think that all that is needed for the prevention of anchylostomiasis is to develop a latrine system, without particular attention as to the form of the latrine used. This is a fallacy. been recently shown at the Hamburg School of Tropical Diseases that the young parasites can easily escape from the latrines and infect people I therefore think in the neighbourhood through the skin of their feet. that some additional experiments are now urgently required in order to discover the form of latrines which will prevent this kind of thing.

(c) I have suggested another method of prevention, which has received small attention-namely, to insist upon all coolies wearing boots and to advise villagers to do the same thing. Most of the infections occur through the I have recently had skin of the feet, and the boots would obviate this. several cases of anchylostomiasis amongst Europeans, but they all occurred in men who were fond of walking about their own gardens with bare feet in the morning.

(d) The administration of thymol amongst the civil population in Guiana and elsewhere can be done on the principle which I endeavoured to have adopted in Mauritius. I think that for many British Colonies itinerant native sanitary dispensers should be employed, to go from village to village in order to dispense certain drugs and advise on elementary sani- tary matters. Thus each dispenser. could give or sell thymol, quinine, santonin, and sulphur ointment (for skin disease) and possibly also At the same time he could give lectures and post notices mercury. regarding sanitation. In fact these men would fulfil the duties of sani- tary missionaries. Each man could visit a village in his district once a month or so; and the cost would not be large. The nearest hospital or dispensary would be the centre from which he would work; and I hope that the idea will some day be adopted as an experiment in certain Colonies.

I am,

&c.,

RONALD ROSS.

B 2

* No. 51 in Miscellaneous No. 304,

† 18584: not printed.

128425: not printed.

§ No. 2.

PUBLIC RECORD OFFICE

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