3i8 DISEASES DUE TO HELMINTHS 



The disease is often fatal during parturition and during operative 

 treatment. Sometimes a low fever is present, but this is the exception. 



The aucemic condition is probably caused by a toxin excreted by 

 the Axorms which passes into the circulation through the wound made 

 in the mucosa of the jejunum, together with the actual blood lost at 

 the site of the bites. The condition is aggravated undoubtedly by 

 septic absorption from the same foci. 



Post mortem, }'ellow pigments and iron granules are found deposited 

 in the liver and kidneA' cells in bad cases. 



COMPLICATIONS. 



Albuminuria, present in 80 per cent, of Sandwith's cases. 

 General oedema may be present. 



Any inlercurrenl disease, as d\senlery, which is common. 

 Pregnane}' or operatiA-e procedure are serious complications. The 

 former cases die of heart failure just before the child is born. 

 TJiere is a tendency to post-partum hccmorrhage. 

 Cardiac failure is common. 



PROPHYLAXIS. 



The ankylostome embryos, wlien passed under good conditions for 

 them, can survive and develop as free living larvae awaiting access 

 to man in order to complete their development, hence prophylaxis is 

 important and may be summarized thus : — 



(1) Educational. 



The instruction of rich and poor a\ ilh regard to methods of infection, 

 symptoms, treatment and prophylaxis. 



(2) Public. 



Search for and treat carriers, aucemic people and those with skin 

 eruptions. 



The provision of sanitar)- conveniences which should be kept in 

 good condition. 



(3) Private. 



Protection of the feet bv boots, &c. 



The proper cleaning of hands before meals. 



Immediate treatment of eruption on hands and feet. 



TREATMENT. 



1 he indications are to expel the worms and to aid blood formation. 

 There are four main lines of treatment as follows : — 



(1) Thymol Treatment. 



Put the patient in bed on starvation diet for two days. 

 Exclude all other possible ailments. 



