Page:Tropical Diseases.djvu/888

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832
ANKYLOSTOMIASIS
[CHAP.

just after administering the second dose of thymol. The result was that intense collapse set in almost at once, and, notwithstanding all efforts, the man died within twenty-four hours, the collapse manifestly being due to the arrack dissolving the thymol, which was thus absorbed." Thornhill mentions two additional fatal cases of thymol poisoning occurring in his experience; other writers have recorded similar fatalities. For this reason, and because it is an extremely unpleasant drug to take— sometimes giving rise to severe burning sensations in the stomach, throat and gullet, and, not infrequently, to excitement, giddiness, fainting, and vomiting— an equally efficient but safer drug is a desideratum.

Without careful preparation by rest and judicious feeding, thymol must on no account be used in advanced cases of ankylostomiasis or where prostration is extreme. It is contraindicated in gastritis, dysentery, nephritis, and in active heart disease.

Oleum chenopodium in three or four successive doses of 15 drops each is reported to be as efficacious as thymol, less unpleasant to take, and more free of risk to the patient.

Beta-naphthol given in the same way, in doses of 15 gr. repeated at intervals of two hours for two or three times, is nearly as efficacious, is cheaper, and much less unpleasant, and is therefore to be preferred to thymol.

Oil of eucalyptus 30 minims, chloroform 45 minims, castor oil 10 drachms, one half first thing in the morning, the other half thirty minutes later, is a very efficient vermifuge in ankylostomiasis, much less unpleasant and much less dangerous than any of the foregoing. It can be repeated for several days in succession. I have used this combination several times in Europeans who had on previous occasions taken thymol; they preferred the eucalyptus mixture. The dose of chloroform is a large one, but, in my experience, it has never had any ill effects. A daily dose of 5 gr. of thymol, kept up for several weeks, has been advocated by some practitioners of experience and might be tried in those