23.6 Leach et al: Hookworm Infestation 477 



with a certain amount of risk, especially in the case of the con- 

 stant and heavy drinker. Our study of these cases, however, 

 has led us to the belief that the drug may be administered with 

 perfect safety to persons who indulge moderately in alcoholic 

 drinks, provided they are willing to forego them for three or 

 four days prior to taking the drug. We are of the opinion, 

 however, that carbon tetrachloride should be given with the 

 utmost caution to those who drink habitually to the point of 

 intoxication, and it also should be withheld from those who are 

 not willing to abstain from alcohol for a few days before and 

 after treatment. 



Lambert (6) says that alcoholism is a contraindication and 

 that liquor should not be taken for "several hours" before and 

 after treatment. We prefer to err on the side of prudence, 

 however, and withhold alcohol from our patients for three or 

 four days prior to treatment. 



Notwithstanding we have treated many persons who have 

 admitted the use of alcohol in a moderate degree, and several 

 who were not so abstemious, we have been able, by withdraw- 

 ing alcohol for the time stated, to avoid the untoward effects 

 that show themselves in alcoholics. However, we have noted 

 the effects of disregard of this precaution in men treated by 

 practicing physicians. 



One case was afforded by an American business man whose 

 daily regimen included several glasses of "Scotch and soda," 

 but who could not be classed as a drunkard. Following the 

 finding of hookworm ova in his stools, he was referred to his 

 physician, who had treated several patients with carbon tetra- 

 chloride and was quite familiar with the contraindications to 

 its use. Unfortunately he failed to caution his patient. 



So the man attended a business luncheon, indulging in two 

 cocktails and a heavy course meal. Later in the afternoon he 

 partook of four Scotch and sodas and shortly afterwards 

 drank 8.5 cubic centimeters of carbon tetrachloride. He was 

 violently nauseated at intervals during the night and his bowels 

 moved freely. The following day he became markedly jaundiced 

 and very weak, and the jaundice persisted for two days, after 

 which he recovered and showed no further ill effects except 

 a marked distaste for carbon tetrachloride. 



The second case was presented by a Spaniard engaged in busi- 

 ness in the provinces who contracted a hookworm infestation 

 that gave rise to a marked anaemia. He had an eosinophilia 

 of 11 per cent. He was treated by his family physician and 



