Page:Tropical Diseases.djvu/887

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XLV]
TREATMENT
831

was the anthelmintic usually employed in ankylostomiasis.

Thymol.— Before the administration of thymol the patient should be put on liquid diet for a day or two, and have the bowels well cleared out by an aperient. In the morning, and following the action of the aperient, three or four 10- to 30-gr. doses of welltriturated thymol, in cachets, in capsules, or in emulsion, are given on an empty stomach at intervals of an hour. If the bowels do not open spontaneously within four or five hours of the last dose an aperient should be given. Usually, by this treatment many ankylostomes are expelled and may be found in the motions. One such course of thymol may suffice; but it is well, after a week has elapsed, again to examine the stools microscopically, and, if it be found that ova are still being passed, to repeat the course of thymol once or oftener.

Certain precautions have to be observed in employing this drug. At times it gives rise to a very unpleasant form of intoxication vertigo, excitement etc., and the urine may become dark, as in carbolicacid poisoning. It is advisable therefore for the patient, while taking the drug, to keep his bed and to lie down for several hours after the last dose. Thymol is very insoluble in water, and is consequently, in ordinary circumstances, not readily absorbed in poisonous quantities; should, however, the patient, while thymol is present in the stomach, partake of any alcoholic drink, there is considerable risk of poisoning ensuing. Alcohol, ether, glycerin, turpentine, chloroform, and oils are all solvents of thymol, and must therefore be avoided when this drug is being exhibited. Thornhill related an instance in which a fatal result was brought about, apparently, by neglect of the obvious precautions suggested by these facts. A man had received 30 gr. of thymol in water at 7 a.m. " He experienced no special symptoms after it, and at 9 a.m. the nurse gave him a second dose of 30 gr. As this man was supplied with arrack as an extra, and as in such cases a portion of the arrack was usually given at 9 a.m., the nurse gave it to him