3
There are two methods of examination—one for the worms and the other for
the ova. There are a few inmates in whose stools ankylostome ova are still
found, showing that the treatment adopted cannot be relied upon to completely
eradicate the worms, or that re-infection is frequent. The number of ova is,
however, small, and after regular treatments no ankylostome worms have been
found for the past six months. The treatment followed has been that which was
introduced by Captain Reaney after he had found an ankylostome worm in a case
which died on 23rd January 1911. A mixture containing castor-oil 10 drachms,
oil of eucalyptus 30 minims, and chloroform 45 minims, is given in two divided
doses at intervals of half an hour. This is said to be most effective in bringing
away not only the ankylostomes but thread worms and tape worms. It is
advisable also to give a dose of castor-oil on the evening preceding the day
on which the treatment is carried out.
All those who have been infected with worms have been formed into gangs
and if after three examinations no ova are found they are removed from the gangs.
The numbers remaining in these gangs on the 31st December were :—
Name.
Ankylo gang ... ...
Tricho gang ... ...
Ascaris gang ... ...
Males.
3
1
18
Females.
2
8
15
Total.
5
9
33
As there were reasons for thinking that ankylostoma infection was common
among the natives of these provinces, it was advisable to ascertain to what
extent this was so, before forming any definite conclusions as to how far the anky-
lostoma infection among the lunatics in the asylum was responsible for the heavy
mortality. Lieutenant-Colonel Banatvala, with my entire approval, examined the
stools of 251 prisoners in the Nagpur Central Jail. The result was, he found that
a percentage of 25.5 of these prisoners were infected with ankylostoma, while
among the inmates of the asylum the percentage of infection was 30.97. More
recently Captain Reaney, Civil Surgeon in the nighbouring district of Wardha, has
carried out a series of very careful examinations of the fæces of a large number
of healthy natives of that place in all classes of life and found that no less than
66 per cent of them were harbouring the ankylostoma worm in their intestines.
It is unnecessary to enter into details regarding Lieutenant-Colonel Banatvala's
very careful investigations and the extremely interesting report he submitted. It is
sufficient to say that in his opinion there was no proof whatever that anything
in the nature of true ankylostomiasis prevailed among the lunatics at the
asylum and that the existence of the worms among a fairly large proportion
of them could only be considered as a contributory cause of the very high
mortality that prevailed during the year 1910. There can be no question that
the asylum staff was insufficient and that it was impossible for the Superintendent
and his Deputy to efficiently supervise the work and to attend to the numberless
details that are necessary in an institution of this kind.
The various defects that were brought to light by Lieutenant-Colonel Banat-
vala were most carefully enquired into and many important charges have since
been made. Since August 1910 a whole-time Sub-Assistant Surgeon has been
attached to the asylum and in July 1911. I provided the Superintendent with a se-
cond Sub-Assistant Surgeon. The warder and sweeper staff has been considerably
strengthened and the Visiting Committee of the asylum has proposed a number
of structural improvements, amounting in all to a total expenditure of Rs 54,945.
Of this sum Rs. 17,408 have received administrative sanction during the present
financial year and the works are to be taken in hand immediately
During the
year 1912-13 a further sum of Rs. 16,936 will be expended on the asylum
buildings and the remaining works suggested will, it is hoped, be carried out
the following year.