That often only a few parasites are found in hospital or cases of even advanced and well marked Ankylostomiasis is easily accounted for when it is remembered that these cases, probably for some time before, and certainly during, their stay in hospital or jail, have been removed from the infected place where formerly they used to swallow the larval Anchylostoma, and thus the adult parasites that meantime have been passed out in th i fasces have not been replaced by new arrivals, and of course the greater the length of time since leaving the last infected place, and the greater the diarrhoea and the more effective the anthelmintics used (if any), the fewer may be the number of parasites left in the intestines, though, as experience shows, some may retain their hold aud remain there even for years.
jail
ANCHYLOSTOMA DUODENALE* Is it
in India, Assam and Ceylon, and is it harmless or a harmful parasite?
widespread,
a
I would also quote the following from a paper on " Iron in the Liver in Anchylostomiasis" by the late Dr. Bevan Rake, vide page 109 of the Journal of Pathology for November 1894 : "
By Hayman Thornhill, m.b., Senior Medical Officer, North? Western and Sabaragamutva
The intense antemia associated with anchylostomiasis is due to loss of blood from the intestine, aud is not caused by any toxic blood destruction in the liver."
(Continued from page 341.) Male fern is certainly a most disagreeable medicine, bat my experience is that it is less objected to than thymol, and that the giddiness, fainting, vomiting and collapse which it produces are milder and far less frequently produced by it than by thymol. It is much to be hoped that some less dangerous and disagreeable but equally efficacious drug will be discovered for the treatment of this disease, i.e., such a ckug as could safely be sold or issued to the public and to superintendents of estates for use in these cases. Dr. Braddon, of the Straits Settlements, suggests oil of peppermint. Dr. Schokman, of Ceylon, says he used kerosine oil in 30-drop doses twice a day in mucilage with marked success in one case, and Dr. Macdonald suggests that carbonate of guiacol ought to be efficacious. All are worthy of a trial. I attach a summary showing the chief signs, symptoms, and complications observed in 783 cases of this disease :?
I would also refer to the works of Lutsz and Leichenatern translated by Dr. Macdonald, and published in the Ceylon Medical Journals of April 1890, October 1891 and January 1892, from which I attach extracts, and to Dr. Giles' article in the Indian Medical Gazette of July 1892, aud to an article on " The Nature and Treatment of Pernicious " Anaemia by Ralph Stockmaii in the British Medical Journal of May 4th, 11th and 18th, 1895.
Provinces, Ceylon.
Table
of
Prominent Svmptoms
and
Complications. On admission.
On admission, Emaciation
or
debility Earth, brick,
or
Diarrhoea
Constipation
general ..
..
..
..
..
Blood in motions
..
Skin, yellowish-green Conjunctiva} & sclera pale Do. rusty or blackish Tongue and palate pale Do. with black patches Finger nails pale (Edema of eyelids & face ..
..
..
..
of extremities
Do.
..
..
tile-eating
..
Ascites Formication Numbness of extremities Burning of palms or soles of feet Malaria Phthisis Chronic indolent ulcers Epistaxis or other has
|
557 75 316 212 43 120 448 214 384 84 403 109 280
..
..
..
morrhages Spleen enlarged Dimness of sight, night ..
blindness Skin dry and harsh
40 82 92 213 239 13 124 42 144
simply
Anchylostomiasis. Particulars of 109 cases that were specially observed by Drs. Swan and Nell in the hospitals at Badulla and Alutnuwera : ?
Prognosis. On admission. Cured.
Favourable Unfavourable
Adults Children
67
=97 =12
Sex. | Sinhalese =85 Male Indian Tamils Female =27
|
long ill before admission. 1 3 months to 3 to 12 months Over 1 year
symptoms
and
75 21
that the anaemia was caused by the Anchylostoma, or that the punctate haamorrhages in the intestines were the result of their bites, and that they might be the capillary hasmorrhages of pernicious anasmia, I would remark that the same objections were taken and settled years ago when the same opposition wa< raised regarding the claim by Wucherer and Perroncito. that the Brazilian and St. Gothard anaemias were caused by Anchylostoma (see Cobbold's article, page 1398 of Quain's Dictionary of Medicine, 1886).
complication.
On
admission.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
h.? Do. rusty or blackish i. Tongue and palate pale j.? Do. with black patches It.?Finger nails pale I.?CEdema of eyelids and face vi.? Do. of extremities n.?Ascites ...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
?
...
...
...
...
..
...
...
p?Numbness of extremities q.?Burning of palms or soles ...
...
...
...
of feet
...
...
...
...
s.?Phthisis t.?Chronic indolent ulcers u.?Epistaxis or other haamorrhages ...
v.?Spleen enlarged w.?Dimness of sight, night x.?Skin dry and harsh y.?Paresis ...
Read at the Indian Medical Congress, Dec, 1894.
47 ,, ? 5 ,, ? Ambcea eoli ,, 8 ,, No other parasites in 47 cases.
Oxyuris
/.?Skin yellowish-green g.?Conjunctivas and sclera pale
r.?Malaria
found
cases.
Asearis
e.?Blood in motions
o.?Formication
Race. = 2 54 | Ceylon Tamils =10 43 I Moors
Trieocephali in 34
=39 =33 =37
a.?Emaciation or general debility b.?Earth, brick, or tile-eating,.. c.?Diarrhoea
d.?Constipation
= =
Othei? intestinal parasites in these cases.
How
Prominent
Died.
improved.
42
...
ADDENDUM. In reply to the criticisms that it had not yet been 'proved,
*
Not
z.?Cardiac weakness
...
...
...
...
...
...
...
...
...
..
...
...
...
...
...
...
...
...
???
...
...
...
...
blindness
76 21 45 50 12 41 58 42 50 18 75 32 44 3 46 45 54 66 3 17 3 23 27 6 1 13
Oct.
THORNHILL ON ANCHYLOSTOMA DUODENALE.
1895.]
Treatment to
Thymol Symptoms
followin
Thymol.
ti.?Excitement. I).?Giddiness ..
e.?Fainting
jail
ANCHYLOSTOMA DUODENALE* Is it
in India, Assam and Ceylon, and is it harmless or a harmful parasite?
widespread,
a
I would also quote the following from a paper on " Iron in the Liver in Anchylostomiasis" by the late Dr. Bevan Rake, vide page 109 of the Journal of Pathology for November 1894 : "
By Hayman Thornhill, m.b., Senior Medical Officer, North? Western and Sabaragamutva
The intense antemia associated with anchylostomiasis is due to loss of blood from the intestine, aud is not caused by any toxic blood destruction in the liver."
(Continued from page 341.) Male fern is certainly a most disagreeable medicine, bat my experience is that it is less objected to than thymol, and that the giddiness, fainting, vomiting and collapse which it produces are milder and far less frequently produced by it than by thymol. It is much to be hoped that some less dangerous and disagreeable but equally efficacious drug will be discovered for the treatment of this disease, i.e., such a ckug as could safely be sold or issued to the public and to superintendents of estates for use in these cases. Dr. Braddon, of the Straits Settlements, suggests oil of peppermint. Dr. Schokman, of Ceylon, says he used kerosine oil in 30-drop doses twice a day in mucilage with marked success in one case, and Dr. Macdonald suggests that carbonate of guiacol ought to be efficacious. All are worthy of a trial. I attach a summary showing the chief signs, symptoms, and complications observed in 783 cases of this disease :?
I would also refer to the works of Lutsz and Leichenatern translated by Dr. Macdonald, and published in the Ceylon Medical Journals of April 1890, October 1891 and January 1892, from which I attach extracts, and to Dr. Giles' article in the Indian Medical Gazette of July 1892, aud to an article on " The Nature and Treatment of Pernicious " Anaemia by Ralph Stockmaii in the British Medical Journal of May 4th, 11th and 18th, 1895.
Provinces, Ceylon.
Table
of
Prominent Svmptoms
and
Complications. On admission.
On admission, Emaciation
or
debility Earth, brick,
or
Diarrhoea
Constipation
general ..
..
..
..
..
Blood in motions
..
Skin, yellowish-green Conjunctiva} & sclera pale Do. rusty or blackish Tongue and palate pale Do. with black patches Finger nails pale (Edema of eyelids & face ..
..
..
..
of extremities
Do.
..
..
tile-eating
..
Ascites Formication Numbness of extremities Burning of palms or soles of feet Malaria Phthisis Chronic indolent ulcers Epistaxis or other has
|
557 75 316 212 43 120 448 214 384 84 403 109 280
..
..
..
morrhages Spleen enlarged Dimness of sight, night ..
blindness Skin dry and harsh
40 82 92 213 239 13 124 42 144
simply
Anchylostomiasis. Particulars of 109 cases that were specially observed by Drs. Swan and Nell in the hospitals at Badulla and Alutnuwera : ?
Prognosis. On admission. Cured.
Favourable Unfavourable
Adults Children
67
=97 =12
Sex. | Sinhalese =85 Male Indian Tamils Female =27
|
long ill before admission. 1 3 months to 3 to 12 months Over 1 year
symptoms
and
75 21
that the anaemia was caused by the Anchylostoma, or that the punctate haamorrhages in the intestines were the result of their bites, and that they might be the capillary hasmorrhages of pernicious anasmia, I would remark that the same objections were taken and settled years ago when the same opposition wa< raised regarding the claim by Wucherer and Perroncito. that the Brazilian and St. Gothard anaemias were caused by Anchylostoma (see Cobbold's article, page 1398 of Quain's Dictionary of Medicine, 1886).
complication.
On
admission.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
h.? Do. rusty or blackish i. Tongue and palate pale j.? Do. with black patches It.?Finger nails pale I.?CEdema of eyelids and face vi.? Do. of extremities n.?Ascites ...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
?
...
...
...
...
..
...
...
p?Numbness of extremities q.?Burning of palms or soles ...
...
...
...
of feet
...
...
...
...
s.?Phthisis t.?Chronic indolent ulcers u.?Epistaxis or other haamorrhages ...
v.?Spleen enlarged w.?Dimness of sight, night x.?Skin dry and harsh y.?Paresis ...
Read at the Indian Medical Congress, Dec, 1894.
47 ,, ? 5 ,, ? Ambcea eoli ,, 8 ,, No other parasites in 47 cases.
Oxyuris
/.?Skin yellowish-green g.?Conjunctivas and sclera pale
r.?Malaria
found
cases.
Asearis
e.?Blood in motions
o.?Formication
Race. = 2 54 | Ceylon Tamils =10 43 I Moors
Trieocephali in 34
=39 =33 =37
a.?Emaciation or general debility b.?Earth, brick, or tile-eating,.. c.?Diarrhoea
d.?Constipation
= =
Othei? intestinal parasites in these cases.
How
Prominent
Died.
improved.
42
...
ADDENDUM. In reply to the criticisms that it had not yet been 'proved,
*
Not
z.?Cardiac weakness
...
...
...
...
...
...
...
...
...
..
...
...
...
...
...
...
...
...
???
...
...
...
...
blindness
76 21 45 50 12 41 58 42 50 18 75 32 44 3 46 45 54 66 3 17 3 23 27 6 1 13
Oct.
THORNHILL ON ANCHYLOSTOMA DUODENALE.
1895.]
Treatment to
Thymol Symptoms
followin
Thymol.
ti.?Excitement. I).?Giddiness ..
e.?Fainting
