43 
medication is generally followed by marked improvement m the 
condition of the patient, in which the outward and visible signs can 
be noticed by the patient and his friends. In the case of undersized, 
imbecile children, the improvement can be so marked that it must be 
seen to be believed. We have seen a veritable idiot transformed 
into a bright, active child: a change which impresses the patients, 
and is a valuable aid in persuading other patients to take treatment. 
We have used thymol, beta-naphthol and Mons’ mixture of 
chloroform-eucalyptus. For children we prefer to give thymol or 
beta-naphthol in small doses, as the drowsy condition induced by the 
chloroform-eucalyptus mixture is apt to alarm the parents. When 
there is much weakness, oedema, or cardiac dilatation present, the 
treatment must be carried out with caution. Beta-naphthol has not 
acted well in our hands and is not to be compared with thymol, which 
is an excellent and reliable drug. The simple precautions which are 
advised for thymol medication should be observed; we have never 
seen ill effects, and the patients are rapidly cleared of ankylostomes. 
Only severe cases require to be treated in the hospitals. We have 
found it advisable to superintend the treatment of a person in a 
particular district, and when he is on the way to recovery to appoint 
him to supervise the treatment of the other local patients. 
This is a disease which should be actively combated by the State. 
Treatment on a large scale should be carried out on the lines of the 
Porto Rican campaign. Malaria and ankylostomiasis should be 
fought together, as one disease influences the other. We have the 
advantage that both are suited for treatment in clinics, where the 
patients cannot have much medical supervision. Severe types of the 
disease should on no account be treated in the district clinics: they 
are the suitable cases for admittance into the hospitals. 
BERI-BERI 
In the hospitals a great number of cases of this disease are 
admitted from the river steamers arriving from the interior of the 
State. The Acre, Purus and Javary districts furnish many cases. 
Manaos proper, as well as the suburbs, supplies many examples of 
this malady. 
The oedematous type is the most common, a mixed oedematous 
and paralytic form, and a pure atrophic type, are both frequently 
