SUPPLEMENT 623 



such as optic atrophy, and when the onset of such occurred the drug was 

 usually discontinued. However, Daniels 1 (July, 1915) points out that 

 eye troubles, such as iridocyclitis, are symptoms of trypanosomiasis. ' 



Other arsenical preparations such as soamin and arsenophenylglycin 

 have been used, but less successfully than atoxyl. Fowler's solution, 

 well diluted, has been given by the mouth when treatment by injection 

 was not possible, the doses commencing with 5 minims and increasing 

 to 15 minims. 



Salvarsan and neo-salvarsan have also been tried for sleeping 

 sickness. Plimmer recommended powdered- antimony suspended 

 in sterile olive oil. Ranken used precipitated metallic antimony in 

 normal saline solution injected intravenously. 



Laveran and Thiroux have recommended a combined treatment 

 of atoxyl and an inorganic salt of arsenic such as orpiment. The 

 orpiment is given as pills, in doses of 2 gr. of orpiment two or three 

 times daily. Opium is added to the orpiment to prevent diarrhoea. 

 This treatment is said to have been used in man with good results. 



Trypanosoma rhodesiense seems less amenable to treatment than 

 T . gambiense. 



The main preventive measures seem to lie in segregation of the 

 sick in areas not infested with Glossinae, and in measures against these 

 flies, such as bush clearing and destruction, to some extent, of proved 

 reservoirs in big game. 



South American Trypanosomiasis. 



The chief clinical features of the trypanosomiasis occurring in 

 Brazil have already been indicated (see p. 87). With regard to 

 treatment, according to Castellani and Chalmers the indications are 

 the same as those for African trypanosomiasis, together with treat- 

 ment for hypothyroidism. Preventive measures are directed against 

 the Reduviid bug, Triatoma uiegista, that transmits the disease. The 

 bugs occur in numbers in the cracks of the houses of the poor of 

 Minas Geraes, and may be destroyed by sulphur fumigation, lime- 

 washing or whitewashing. 



III.-FLAGELLATE DIARRH(EA AND DYSENTERY. 



The chief causal agents are Trichonwnas hominis (T. intestinal is), 

 Chilomastix (Tetramitns) mesnili and allied organisms (see pp. 54 to 57), 

 and Laniblia intestinalis (see pp. 57 to 60 and Appendix pp. 734 to 736). 



These parasites and the associated diarrhoeas occur in temperate 

 as well as in warm climates. Probably some of the diarrhoeas in India 

 are thus caused. The same, or similar parasites occur in various 

 Muridae, especially rats and mice, which may act as reservoirs. 



. Trop. Med. and Hyg.^ xviii, p. 157. 



