ANKYLOSTOMIASIS 



1771 



of which 6 drachms (gr. xxx, of beta-naphthol) is given to an adult male, 

 5 drachms to an adult female, and i to 2 drachms to children, for a dose. 

 Three doses are given at intervals of two hours. Two hours after the last 

 dose a saline aperient is given. Beta-naphthol does not keep well, and should 

 be stored in ^-pound bottles, and kept in a cool place. 



Male fern, followed by castor oil, or calomel, or infusion of senna, has also 

 been strongly recommended, and was generally used before Bozzolo introduced 

 thymol in 1880. The Porto Rico Commission found it useless even in doses 

 which produced toxic symptoms. 



Nattan-Larrier recommends the following method of administering Filix 

 mas : — • 



First day: Milk diet and saline purge. Second day: Milk diet; a capsule 

 containing 0*30 centigramme of oil of Filix mas every ten minutes until twenty 

 have been taken, followed in one- quarter of an hour by a capsule of ether 

 every three minutes until eight have been taken. After the last capsule, 

 15 grams of castor oil are administered, and, after half an hour, 25 grammes 

 of castor oil. Third day: A saline purge. Fourth day: Examination of the 

 faeces and repetition of the treatment. Brimont recommends the essence of 

 Melaleuca viridi flora. 



Worms in the Fences. — Whatever treatment be adopted its effect 

 must be judged by the worms found on examining all the faeces 

 passed during the first twelve to twenty-four hours after dosage. 

 These faeces are stirred up with water, allowed to settle, and the 

 water decanted, and this process repeated several times, after which 

 the deposit is placed on a flat dish with a black background, and 

 the whitish or greyish little worms looked for. 



Treatment of the Skin Eruption. — The area showing the eruption 

 should be painted with a solution of salicylic acid in collodion (i in 6) 

 in the early stages, or later it should be soaked in a weak solution of 

 carbolic lotion (i in 100), and the vesicles, pustules, etc., should be 

 opened and cleaned with i in 40 carbolic lotion, and the whole area 

 dressed with a carbolic lotion or carbolic ointment dressing. The 

 itching may be relieved by an ointment of salicylic acid gr. v. 

 in 3ii. of zinc oxide ointment and vaseline. The dressing should 

 be performed twice daily, and the internal treatment, as de- 

 scribed above, begun at once, and repeated every week for some time. 



Treatment of the Mouth. — For about two weeks after infection 

 the patient should use a mild antiseptic gargle several times a day, 

 and should be instructed to spit out his saliva, sputum, etc., and 

 not to swallow it. The gargling should be performed before drinking 

 or eating anything. The sputum should be collected and examined 

 for larvae. 



Prophylaxis. — Prophylaxis must be based upon an attempt to kill 

 the parasites in the human being, and to prevent the infection of 

 the human being by the parasite, but in order to be successful in 

 these methods it is absolutely necessary to educate both the rich 

 and the poor of a district in the essentials of the disease. This must 

 be done by illustrated lectures and pamphlets in the vernacular. 

 An appeal must also be made to the people to come at once for 

 treatment when suffering from skin eruptions or anaemia. 



The first method is the most feasible, and has been tried on a large 

 scale at Porto Rico, and on many estates and in mmes. The 



