A Medical

Miracle

How a Doctor's Clever Application

of an American Vet's Discovery

Conquered one of Mankind's

Worst Diseases.

years ago, most of the South Pacific communities, in common with tropical and sub-tropical peoples all over the world, were “rotten with hookworm”.

To-day, hookworm is conquered, and is becoming a thing of the past.

The dramatic story of how a medical miracle was accomplished is told in Dr.

S. M. Lambert’s new book (see review on page 21).

In 1920-1922, Dr. Lambert travelled in Queensland, Papua, New Guinea, the Solomons and Fiji, trying to reduce hookworm incidence (which was appal ling) with the then known specific, oil of chenopodium. But chenopodium, while efficacious enough, was not sufficient.

Infection was so widespread, and the infected were in such masses, that people who were treated, and partly cured, were infected again before the disease could be cleared out of the district.

“Chenopodium, on which we relied for a cure for one of the world’s most preva lent blights, was not coming up to expectations.”

Now, let Dr. Lambert himself tell the story. This is copied directly from his book: — I SAT at my desk, in Suva, facing facts, and not liking a single one of them.

Evening was coming on, and I should have been home for dinner. I was too sick of myself and my work to move a muscle. Three more years of this, and where would it get us? Nowhere.

Maybe it was my guardian angel who stole up and laid a still hand over mine.

Without knowing what I did or why I did it, I moved my hand across the desk and woke, blinking. I had picked up the “Journal of the American Medical Asso

elation”, a November, 1921, issue, and an invisible finger seemed to point the page for me. Ana there was the title: Tne Use of Carbon Tetrachloride in the Removal of Hookworm ... by Maurice C Hall”.

Hall was the man who approved my experiment, down in Rabaul, when I gave those injections to six cannibal prisoners.

I respected him, as most of the pro fession did. As Senior Zoologist of ihe United States Bureau of Animal Industry, his researches had gone far in his own field. He didn’t talk unless he knew what he was talking about.

Here was Hall s report in the modest gray of scientific language, revealing years of most careful observation. His tests had led him to a novel drug— carbon tetrachloride. Queer, humble thing to have fished out of the phar macopoeia! Hitherto, it had been useful only in dry-cleaning fluids and fire extinguishers. He had observed that patients under chloroform anaesthesia frequently emit a number of intestinal parasites. Chloroform, then, would be a successful vermifuge were it not for its poisonous qualities. Hall made hundreds of tests down the list of hydrocarbons, until he came to chloroform s close rela tion. Chloroform’s chemical initials are CHCL;. Tetrachloride’s laboratory name is CCh.

Tetrachloride touched the spot Hall had been looking for. He tried it first on dogs, then on swine, horses, monkeys.

He carefully gauged the dosage to 3 cc. for every 10 pounds of animal weight; later he found that O'. 3 cc. to every kilogram of body-weight expelled the worms in surprising quantities. After treatment, he had performed postmortems on many animals and had examined internal organs which showed no patho logical changes that could be traced to CClt. In animal experimentation it had been an unqualified success.

In animals, yes. But what of man?

THE answer came like a clap of thunder out of Hall’s quietest paragraph.

He had tried the stuff on himself.

Audaciously, he had taken a 3 cc. dose, gone to bed, and wakened in the morn ing with no pathological symptoms. The dangerous drops he had swigged the night

before had had none of the nauseous effects of chenopodium. His animal ex periments had shown him that it worked as fast, as safely and more thoroughly.

And here was another point in its favour: tetrachloride, tried on animals, seemed to have no ill effects on pregnancy.

Chenopodium had always been a dan gerous thing to give a woman with child.

It was, at times, among the unsafe abor tifacients —often effective if used up to the poison point.

The message of tetrachloride came to me like an answer to prayer. But would the dog-cure turn out to be a man-killer?

Probably not. Hall had tried it on himself. . . .

WITH a hop, skip and jump I went to the laboratory used by the Medical Officer of Health. Naturally, old Garment, who presided over the collection, wouldn’t have the drug. Why should he?

Yes, but there it was! A big, brown bottle with the label CCh. It had never been opened, of course, and how it got there nobody knows. Strange, useless things drift onto laboratory shelves.

When I went up to Dr. Montague’s office I had the brown bottle under one arm and the Medical Journal under the other.

“Read that, and look at this”, I said.

He read the article painstakingly, then turned the bottle in his hand.

“Lambert, try anything”, he sighed.

That was about the way we all felt those days.

We had been trained in the empirical school. Try anything, if evidence ‘is in its favour. . . .

The old empiricals had moved along that line. But men of the new thought, like Pasteur, like Ehrlich, had set out deliberately to fit a drug to a condition.

And that was how Hall had worked.

So we were trying to cure hookworm disease with a cleaning fluid. A veterinary had recommended it. True, he was about the greatest vet. in the world.

I have to laugh, now, remembering how we, as green voung undergraduates at Syracuse Medical, used to snoot veterinaries and dentists as “hoss doctors” and “tooth yankers”. We didn’t take the trouble to remember that modern anaes thesia originated in a dentist’s brain.

And, since we lacked the gift of prophecy, how were we to know what a horse doctor would someday do with something out of a fire extinguisher.

MY mind was made up, but my heart wasn’t doing any too well when I went to the native ward and picked out four hookwormy East Indians. I wasn’t sure how these fellows would be have. for Mr. Gandhi’s Civil Disobedience had become their evening prayer. How ever, they felt pretty sick and were ready, like Montague, to say. “Try anything”.

I started them off with a stiff dose of salts.

At seven, next morning, mv faltering hand administered to each of them 3 cc. out of the brown bottle. The minute they swallowed it I felt like a Borgia.

It was too late to do anything about it. unless I gave them a quick emetic. If tetrachloride went back on me I’d be responsible for the death of a man, maybe four.

Doctors have to become hardened to death, otherwise they couldn’t remain in practice. But experimental killing is a different thing. If any of these Hindus died I’d have the weight on mv soul.

Not only that, I’d lose mv job. Already I saw my resignation from the Inter national Health Board being requested by cable. . . .

I HAD dosed my four Indians at seven, and time was wearing on. Tetrach loride. which is a purgative, should have acted quicker. The men w p ro dumb and drowsy. Would this be coma 1 ? I felt their lean wrists, listened to their lean

chests; pulse and respiration normal.

How soon would they take a turn for the worse?

Dr. Hall had taken a dose of it.

Yes, but Hall had been in the prime of health, able to throw off toxic poison ing-. These poor fellows were like dry leaves. The very thing that made treat ment necessary had weakened them to exhaustion point. Then I thought: Even if I had drugged myself with the stuff it wouldn’t have proved much; what I was trying to find out was its actual effect on hookworm.

I had wandered back to mv office, honing that solitude and a cigarette might tell me what to do next. . . . The door burst open and Chris Kendrick tumbled in on me. His look was grave as he said, “That tetrachloride—.”

“Are they dead” I asked, stiffly.

“Dead!” Chris waved his hands.

“They’re all jumping out of bed, and simply spouting hookworms!”

That was how the news came to me. I had been watching them for hours, while

local medical officers passed their beds and made long faces, which said to my fevered imagination, “See what Lambert’s done now!” Then the minute I turned my back CCh began to work.

For three days, while my Indians were, as Chris exaggerated it, “fairly spouting worms”, the result was a constant wonder.

Cordiality glowed in an atmosphere which had been none too warm. Doctors

gathered around our hookworm count like baseball fans around the box score.

The native orderlies were as excited as the rest. First day, second day, third . . .

I had gambled with four lives, and won.

AND so the cure was found. To-day, medical men all over the world are using tetrachloride — or, for preference, tetrachlor ethylene, for the gifted Dr.

Hall made an improvement on his dis covery—and hookworm can he controlled and conquered, at will.

This was one of the epoch-making dis coveries of medical science; and it was proved and developed in Fiji, hy Dr.

Lambert.

Miss Dorothy Read, of the South Sea Evangelical Mission, Malaita, Solomon Islands, is still undergoing medical treat ment in Victoria, and it is uncertain when she will return to her work.