TREATMENT 263 



is not less terrible. There are many families in our South where 

 for at least four generations illiteracy and ignorance have re- 

 sulted from disablement by hookworm disease. In many com- 

 munities large proportions of the children are kept out of school 

 on account of physical or mental disablement from this cause. 

 Unlike many diseases, this one has no tendency to weed out the 

 weak and unfit; it works subtly, progressively, undermining 

 the physical and intellectual life of the community, each gener- 

 ation handing down an increased handicap to the next. 



Treatment. Treatment of hookworm disease consists, pri- 

 marily, of the administration of a drug which will kill and expel 

 the worms from the intestine. In severe- cases this is followed 

 by treatment with a tonic to bring back some of the lost health 

 and vitality. Recently it has been shown possible to hasten 

 recovery after expulsion of the worms by vaccinations prepared 

 from bacteria which are found in abundance in the faeces. This 

 indicates that some of the evil effects of hookworm disease are 

 due to absorption of bacterial toxins through the injured intestine. 



Until recently the classical remedy for use against hookworm 

 has been thymol. This is a drug which is poisonous to the 

 human system but under ordinary circumstances is not absorbed 

 by the digestive tract. It is, however, very soluble in alcohol, 

 ether and various oils, so that certain precautions have to be 

 taken in its use, and it should not be taken except under medical 

 supervision. Thymol is not highly efficient except in repeated 

 doses, taken some days apart, and this is a severe handicap in 

 its use. During the five-year period from 1909 to 1914, however, 

 the American Hookworm Commission, largely by the cooperation 

 of local physicians, treated nearly 700,000 hookworm patients 

 in southern United States with thymol. 



A few years ago oil of chenopodium came into favor in some 

 parts of the United States as a remedy for hookworm, and is now 

 rapidly supplanting all other remedies in all parts of the world. 

 It is made from a common weed, usually called Jerusalem oak 

 or goose-foot, and is therefore very cheap and the supply inex- 

 haustible. It is "more effective than thymol and is if anything 

 less dangerous to the patient. According to Hall and Foster, 

 oil of chenopodium is not entirely harmless, and among other 

 effects is distinctly constipating. To hasten the elimination of 

 the chenopodium as well as to counteract the constipating effect 



