cases of ankylostomiasis in which more drastic treatment is contraindicated by a condition of extreme debility.
Convalescence.— The dieting of convalescents from serious ankylostomum disease must, for a time, be very carefully conducted. In such, a rich, full dietary is to be avoided until the powers of digestion have become re-established; otherwise, enteritis and diarrhœa may prove very troublesome and retard recovery —perhaps prevent it altogether. Iron and arsenic are indicated as blood restorers.
Prophylaxis.— In devising a system of prophylaxis for ankylostomiasis, the fact that it is by means of the fæces of the already infected that the parasite is spread must be kept prominently in view. Fæcal contamination of the soil and water must therefore be prevented. The promiscuous deposition of fæces about huts, villages, and fields must be interdicted. Abundant and easily accessible privy accommodation must be provided in coolie lines, in miners' camps, in native villages, and along the highways of traffic. In the absence of a more elaborate system of conservancy, pits or trenches will suffice. They may be filled up with earth and fresh ones opened from time to time. I believe the Chinese plan of storing night-soil for months in large, cemented, watertight pits is a good one. It is known that if the ova of the ankylostomum are kept in pure fæces the embryo is developed and escapes from the egg in due course.; but it is also known that, unless the embryo be supplied with a certain amount of air and earth, it soon dies. The thing to be avoided, therefore, is the mixing of fresh fæces with earth. By the Chinese system the embryos of the ankylostomum are killed, and, at the same time, a valuable fertilizer is secured for the agriculturist.
It is manifest that in devising privies and sanitary regulations the habits of the people they are intended to benefit must be taken into account; if this be not attended to, if native habits and prejudices are ignored, any system, no matter how perfect it may be in theory, will fail in practice.
