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ANKYLOSTOMIASIS, OR HOOKWORM DISEASE *

Ankylostomiasis is due to a species of intestinal parasite belonging to.the sub-family Uncinariinæ.

The disease, prevalent in all parts of the tropical and subtropical belt, is less frequently met with in temperate climates ; but is encountered locally in mining districts in Great Britain, Holland, Germany, etc. It is more common among those who come in contact with damp earth, e.g. farmers, miners, or tunnel diggers.

The eggs, which are deposited in the intestine of the patient, do not develop until after they have been expelled with the

fæces, when development is rapid, varying with Infection the conditions of heat, moisture and amount of

oxygen. Infection may occur in two ways :— (a) The parasite may pass through the skin, and, having gained access to the circulatory system, pass from the luggs to the air passages, and thence up the larynx to reach the intestine by way of the œsophagus and stomach. (8) By the mouth, either with contaminated food or water, or from earth bearing the larvæ adhering to the hand.

The spread of ankylostomiasis is inconsistent with an efficient sewage system, cold weather or dry climate. Even in the tropics its frequency may be diminished by the proper disposal of excreta, as fortunately the parasite does not seem to affect domestic animals.

The parasites withdraw blood by suction, and the symptoms result from this slow depletion. In the early stage there are

gastro-intestinal disturbances. The appetite is has #4 variable and capricious, and in the late stages,

complete anorexia may arise. Perversion of the appetite occurs, patients evincing a desire for such indigestible materials as mud, charcoal, resin, etc. Flatulence and heartburn are common, nausea is frequently noted, and vomiting may occur. Epigastric pain and tenderness are mentioned by nearly all observers, and held by some to be the most constant, most suggestive, and most clearly marked symptoms. Constipation is common; but diarrhœa may occur. Anæmia, the most pronounced symptom, rapidly becomes acute in severe cases, causing shortness of breath and œdema. It gives rise to some of the vernacular names, such as miners’ anæmia, brick-makers’ anæmia, etc.

For à positive diagnosis the fæces should be microscopically

examined for the eggs; or, after administering an anthelmintic, for the adult worm.

Distribution

F ee ra: uncinariasis ; brick- makers’ anæmia ; dochmiosis ; Egyptian chlorosis; geophagia ; malarial anæmia ; miners’ anæmia ; miners’ cachexia; negro consumption ; St. (rothard tunnel disease: tropical chlorosis : tunnel disease : ; tunnel anæmia.

TREATMENT — As the parasites are more or less protected by the intestinal mucus, this should be removed by the administration over night of a sharp saline purge, such as two to four Re ‘’Tabloid’” Magnesium Sulphate Effervescent, gr. 60, followed in the morning by ‘Tabloid”? Thymol, the full adult dose of which, for this treatment, is 30 grains (2 grammes), Two hours later this dose should be repeated, and after a further lapse of two hours another saline purge administered. The dose of thymol should be modified according to the age and condition of the patient. ‘Tabloid’ Thymol, on account of its exceptional purity and: reliability, is particularly suitable for the treatment of ankylostomiasis, while the undernoted preparations will be found most useful in the subsequent constitutional treatment. NOTE.—IN THE INTERESTS OF SAFETY, no alcohol, oil or other solvent

of thymol should be given on the day of treatment. Hypodermic treatment should be employed if stimulants are necessary.

Preparations

a TABLOID’ 8sranp THY MOL, gr. I (0:065 gm.); Supplied in bottles of 25 and gr. 2 (0:13 gm.) “e ‘TABLOID’ sean THYMOL, gr. 5 (0:324 gm.) Supplied in bottles of 100

The following products will be found useful for the treatment of the anæmia and debility produced by ankylostomiasis : —

ft ‘ TABLOID'’ 8ranp BLAUD PILL COMPOUND R Pil. Ferrugin. (Blaud), gr. 10 (0-648 gm.); Pulv. Capsici, gr. 1/4 (0-016 gm.): Aloïini, gr. 1/30 (o-0022 gm.); Strychninæ, gr. 1/30 (o-0022 gm.): Acidi Arseniosi, gr. 1/30 (0-0022 gm.).

One, swallowed with a little water, twice or thrice daily, with or after food. S'upplied in bottles of 100

vire VAPOROLE’ gra IRON AND ARSENIC (Sterilised)

BR Ferri Citratis Viridis, 0-05 gm. (gr. 3/4); Sodii Arsenatis, o-002 gm. \ (gr. 1/32); Aquam ad z c.c.

The contents of one of these phials, injected hypodermically or intramuscularly, in severe anæmia and malnutrition.

Supplied in boxes of 10

‘KEPLER’ MALT EXTRACT WITH HÆMOGLOBIN (Trade Mark)

The ideal hæmatinic food. One teaspoonful to two dessertspoonfuls twice or thrice daily, with or immediately after food.

Supplied in bottles by all Pharmacists For prices, see B. W. & Co.'s List