Practical sanitation by Fletcher Gardner

Author:Fletcher Gardner
Language: eng
Format: epub, pdf
Publisher: C.V. Mosby Co.
Published: 1914-03-25T05:00:00+00:00

must be frequently facfed that many rural people who have no objection to a microscopic examination of their sputum and urine do object very decidedly to furnishing samples of their stools. This may appear incomprehensible, but it is a factor which must be squarely faced. Again, in remote rural regions it is often impracticable to make several trips to the house to obtain a stool, and it is often impossible to induce the patient's family to take the trouble of sending a stool to the phj'sician. In such cases almost the only plan to follow is to institute an experimental treatment and see if hookworms are passed.

Treatment.—^The fundamental principle underlying the treatment of hookworm disease is the same as that which underlies the treatment of all other zoJTparasitic diseases, namely, first treat the parasite, not the patient. After the parasite is treated, attention may be directed to treating the patient.

Although hookworm dise^lse may b^cur in persons in any walk of life, it is particularly among the poorer classes that it is found, and the average hookworm patient (children excepted, to a certain extent) can not afford to lose several days* wages to undergo treatment. It is therefore frequently expedient to conduct the treatment Saturday evening and Sunday morning. It will often be found difficult to arouse the interest of a community in regard to the presence of hookworm disease and the need of treatment. This can frequently be done, however, if it is borne in riiind that the resulting anemia is, in common with other anemias, a frequent cause of amenorrhea.

Warning. —Recalling that primarily we are to treat the parasite, not the pitient, it should be remembered that if too great a quantity of thymol is absorbed by the patient, alarming symptoms and even death may occur. Accordingly, the patient and the patient's family should be carefully warned not to permit the patient under any circumstances to have on the Sunday during which the treatment is given ajiy food or drink containing alcohol^ fats, or oil. Patent medicines should be mentioned in particular, because of the alcohol many of them contain, and even milk and butter should be forbidden. I know of one case of serious thymol poisoning which followed promptly after the patient took a copiou^ drink of milk the day thymol was taken.

Preliminary treatment. —On Saturday evening give a dose of Epsom salts. The reajw)n is this: The hookworms are surrounded by more or less mucus and partially digested food. Unless this is removed, the thymol may not reach the parasites, but may reach the patient, and this is contrary to what is desired, as the thymol is intended for the parasite, not the patient.

Thymol treatment on Sunday. — (1) Position of patient: Instruct the patient to lie on his right side immediately before taking the drug and to remain in that position for at least half an hour after. The reason for this is that many of these patients have enlarged stomachs, and if they lie on

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