Report on anaemia, or beri-beri, of Ceylon / by W.R. Kynsey.

Ceylon. Civil Medical Officer.

Date:: 1887

Credit: Report on anaemia, or beri-beri, of Ceylon / by W.R. Kynsey. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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4. In a tea-per-ceot. solution of bromide of potash the larvae were still alive after thirty minutes. 5. In a five-per-cent. solution of chloral hydrate the larvae of various stages were still alive after three hours. 6. 7, 8. The sulphate, bisulphate, and phosphate of soda in strong solutions (seven to eight per cent.) inflicted no injury on the larvae. 9. In pure glycerine the larvae gave still signs of life after the lapse of forty minutes. (The young larvae died quickly, even in a weak solution.—Lutz.) 10. In aethyl-alcohol larvae of various stages died in five minutes ; in strong wine they died within an hour and twenty minutes. 11. Turpentine vapour was tolerated over six hours. 12. An infusion of kamala had no effect. 13. Santonate of soda did not kill the mature larva. 14. Concentrated sulphuric and muriatic acids, on the contrary, at once. In a forty-per- cent, solution of sulphuric acid they died within three minutes; in a twenty-per-cent, solution, within fifteen or sixteen minutes. 15. A one-per-cent. solution of thymol killed the larvce in one minute ; a half-per-cent. solution the immature in eight or ten minutes. Water which was allowed to stand over thymol for some time, and had a distinct taste and smell of the drug, showed itself effective. (Lutz.) 16. In a good sj)ecimen of Ext. Fil. Liq. they died quickly. Doubtful or bad perparations no effect. (Lutz.)* 17. In the scarcely diluted milky-juice of Ficus doliaria and Carica dodecaphylla the young larvae remained over an hour still living. (Lutz.) 18. 01. absinth, menth. caryoph. chenop. ambros. 19. Naphthalin showed itself, suspended in water, as without effect. (Lutz.) 20. A temperature of 50° C. killed the embryo in the various stages of development in less than five minutes. After having shown that the parasites could be expelled by the first-mentioned anthel- mintic, there still remained the question whether the parasites were really the cause of the disease, and whether with their removal the symptoms came to an end. This question must be looked on as already decided, as every observer is agreed that the most rapid and the most striking recoveries were made by those from whom complete expulsion had taken place.f Should no secondary cachexia exist, and it does not exist, in consequence of a disease existing only for a short time, or in children even after a disease of several years' duration, a high degree of anaemia may disappear in an astonishingly short time (three to five weeks), a quicker recovery than takes place in anaemia caused by haemmorrhage. Even when the conditions are not quite favourable the anaemia disappears in two, or at the least three months, as has been proved by examination of the blood. I have still to mention a few drugs, which are not anthelmintics, but which have a reputation in anchylostomiasis. Their use can naturally be only symptomatic or pal- liative, and I shall therefore mention them in connection with individual symptoms and complications. The most striking symptoms of our disease is anaemia, which can only be cured gradually within a certain time. It may be asked (1) whether this symptom can be removed without removing the cause ; and (2) whether on removal of the cause the anfemia can be cured in a much shorter time. The latter is attempted in various ways, and the following agents are employed : drugs, diatetic treatment, and tranfusion. Among the drugs, iron takes the first place, already used in all kinds of antemia, although it has shown specific effects only in chlorosis. The improvement noted after its use in other forms of anaemia, and especially in the anaemia resulting from haemorrhage, has not been so striking. Now, anchylostomiasis is very like chlorosis in its external appearance, and it was therefore resolved to give iron a trial in the former, especially at the time when the cause was unknown, or could not be removed, and when the treatment was merely symptomatic. As a matter of fact, this remedy was in use everywhere. Notwithstanding this it is difficult to estimate its advan- tages clearly, as other factors in the treatment have also to be taken into account. At all events, iron alone cannot prevent relapse and fatal terminations—rather these were observed in spite of a free use of iron. This, a priori, is not to be expected otherwise, as the anaemia depends principally upon losses of blood, which cannot be replaced by ever so rich a supply of blood constituents ; and we cannot expect it to influence the disordered digestion for the better. As far as its favourable effects on the blood corpuscles are concerned, we have no proof that these in one disease suffer individually, or that their normal function can be increased by drugs. On the other hand, improvement frequently takes place in chronic, almost stationary cases, by the use of iron, rest, and good diet, whilst on these being discontinued the patient relapses, so that it is not justifiable to refuse to the iron some share in the improvement. Probably also much depends on the form in which the iron is given. In the province of Sao Paulo the impure sulphate of iron is used by the people at large. In spite of its impurity, and of the large quanti- ties in which it is taken, it is well borne, and the results are good. Another favourite remedy with the people is iron filings boiled with lemon or citron juice. * I tried the effects of Ext. Fil. Liq. obtained from Messrs. N. S. Campbell & Co. of Colombo, on the larvte, and they died very quickly in it. The druji was very pure.—Trans. t Very rapid recoveries are made in the Colombo hospital after the expulsion of the parasites.— Ti-ans. 77—87 [ 579 ]

Report on anaemia, or beri-beri, of Ceylon / by W.R. Kynsey.

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