238 



THE AGRICULTURAL NEWS. 



July 26, 1919. 



M^ 



chenopodium. Dr Howards experience is that thyninl is a 

 much better and safer remedy than chenopodium. 'J'bymol 

 is not so liable to produce toxic efiFects, and two doses usually 

 effect a cure in eight days. At the tinif of tnking thymol, 

 the patient must abstain from food, iind it is stated that the 

 drug when mixed with an equal quantity of milk sugar 

 is mote efficacious than when administered by it.'self. 



r/i£ CONTROL OF HOOKWORM DISEASE 

 BY THE INTENSIVE METHOD By H. H. 

 Howard, M.D., New Y'Tk City. The Rockefeller Foundation, 

 International Health Hoard, 1919. 



Dr. Howard, who is Director for the West Indies section 

 of the hookwortn campaign, desiribes in this booklet (issued 

 as Publication No. 8 of the I. H.'B.) the methods adopted, 

 the organization, and the results so far achieved, regarding to 

 th's highly important work in the interest of human welfare. 

 The publication is one that should be carefully read by West 

 Indians, and particularly by those who by reason of personal 

 prejudice or ignorance are antipathetic, or merely apathetic 

 towards intensive treatment. 



The author begins by pointing and that theoretically 

 the treatment and eradication of hookworm disease should 

 be a simple matter. There are few diseases which we 

 understand more fully. There are no diseases where we have 

 at least two certain specific remedies. The trouble lies in the 

 personal element. People, particularly in tropical countries, 

 fail to give perfect co-operation 



The intensive treatment of hookworm is an attempt to 

 approximate complete relief and control within a certain 

 definite area. Four things are essential: the inhabitants 

 must submit to a census and to an examination; those found 

 to be infected muat submit to treatment; the people must 

 a'so cooperate in the matter of preventing the hookworm 

 eggs from getting into the soil : this latter point is largely a 

 question of sanitation, the provision of public latrines. 



The organization required in carrying out the extensive 

 method of eradication is considerable. It needs a staff of 

 microscopists and nurses all of whom can be locally trained 

 men or woman. It also needs medical otlicera in charge, a 

 clerical staff, and a staff of sanitary workers. In the St. 

 Peters Hall destrict of British Guiana, the organization 

 on the above lines was notably efficient, and indeed in 

 all districts Dr. Howard is able to record most satisfactory 

 results. 



The table at page 122 shows the results in detail. To 

 give an idea of what has been achieved, we may refer to the 

 figures given for the whole of the West Indies. During the 

 years 1914 to 1917 inclusive, 165,86(i persons were ex- 

 amined for hookworm ; 97,G:i2 were found to be infected ; 

 73,711 were cured; 7,391 were removed from the areas 

 dealt with : hence the nuiuber remaining uncured was 

 16,.'J30, or only 169 per cent, of those infected. Of these 

 uncured over six thousand refused treatment, and about 

 five thousand were not treated for special medical reasons. 

 The average cost per person examined, treated, and cured 

 in this intensive work for the whole of the West Indies was 



^2'6.'3 surely a trifling atiiount when one considers the 



enormous benefit derived by the individual, and by the 

 colonies as a whole. 



Before concluding this review, attention may be called 

 t« what Dr. Howard says regarding the specifics thymol and 



THYMOL VERSUS CHENOPODIUM FOR 

 HOOKWORM DISEASE. 



Both the Ajowan plant and Chenopodium, 

 which produci- thymol and wormseed oil, respectively, 

 grow in the West Indies ; hence the question as to 

 which is the best specific against ankylostomiasis 

 (hookworm disease), dealt with in the following 

 article from the Perfumery and Essential Oil Record 

 for May, will be studied with interest : — 



A note in our last issue drew attention to steps in 

 India to cultivate wormseed, and provide a local source of 

 the oil lor the treatment of miners' hookworm disease. The 

 growing importance for this purpose of the oil, and, inciden- 

 tally, its competition with thymol, is brought out in medical 

 reports received from Fiji, Trinidad and Seychelles. These 

 and other reports are evidence of a world movement to 

 tackle the disease, and as we write, a cable comes to hand 

 from Sydney stating the trouble is being seriously 

 investigated there. Seeing that two products of great 

 importance in the essential oil world are involved it ia 

 desirable that the experiments, observations, and deductions 

 of the various medical Commissions engaged in the work 

 should be recorded. In a campaign conducted by the 

 Trinidad Commission, the drug most used was thymoL 

 mixed with an equal weight of sodium bicarbonate, and 

 finely powdered. It wis given in two equal doses at 

 6 a.m. and 8 a.m., being preceded the night before and 

 followed at 10 a.m by a purge. The normal dose for an 

 adult was 40 grms., with a maximum of 60 grms. 

 Owing to children resenting the treatment, a preliminary 

 aperient was abolished, and at 6 am. one minim of oil of 

 chenopodium for each year of apparent age was given, and 

 at the same time A-oz. of castor oil. The number of cases 

 trpated with chenopodium oil was very small against those 

 vnth thymol, and this should be carefully borne in mind in 

 interpreting the statistics of the work. Anyway, the report 

 states that the oil of chenopodium proved only half as 

 eflBcient as thymol in rendering the pitient's stool free from 

 ova of hookworms, but the chenopodium had the distinct 

 advantage of removing Ascaris lumhricoidcs from a large 

 number of the children treated with it. The reason for this 

 very low efficiency of the oil of chenopodium in the treatment 

 of ankylostomiasis is probably due to the unusally small dose 

 administered, the medical Commission apparently being led 

 to its adoption by some untoward experiences in earlier trials 

 with this drug. 



However, a very different account of the value of 

 chenopodium oil comes from Fiji, where the authorities speak 

 in the most un(iualified praise of its efficiency. During 1917 

 oil of chenopodium was exclusively used in the treatment of 

 ankylostome at the Tamanua hospital, where 1,818 cases 

 were dealt with. 'There is no doubt whatever of the superi- 

 ority of chenopodium oil compared with thymol, or any 

 other drug hitherto tried. < Chenopodium oil also possesses 

 the additional value, in that it is a most potent destroyer of 



