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One late afternoon in February, 1922, I keeled back in my office chair and appreciated the soreness a middle-aged prize fighter must feel after he has taken the count in round one. With a sanitary squad of nine native and Indian assistants and the invaluable Chris Kendrick I had again made a round and seen the dank hopelessness of two races weakened by their own customs and by the unfriendly acts of nature. It was just as Paley had shown: rainfall flooded their shallow wells and mixed with the foulness of their latrines so that both wells and latrines had the same bacterial flora. In some districts hookworm infection ran as high as 98 per cent. This condition was not limited to primitive natives by any means; the Hindu and Moslem of ancient culture were quite as ignorant of sanitation, and more worm-laden than their dark brown brothers.
This filthy stable must be cleaned, but the baffling thing was to find the cure. Our International Health Board was sharing expenses with the Government for a three-year campaign. The question of throwing good money after bad had come up again. Officially, I should have been pro-chenopodium. Actually that drug was the first word in my Hymn of Hate. And the discouraging thing was this: despite the crucial need of hygienic improvements, an effective cure must take first place as an educational demonstration. If you destroy all the hookworms inside the human body, no more of their eggs will fall to the ground to hatch the larvae that make the worms that suck the blood.... The whole Jack-built song of consequences with a tropical setting. Sounds very simple, doesn’t it? So does astronomy.
I sat at my desk, 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 Association, a November 1921 issue, and an invisible finger seemed to point the page for me. And there was the title: “The 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 profession did. As Senior Zoologist of the 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 pharmacopoeia! Hitherto it had been useful only in dry-cleaning fluids and fire extinguishers. He had observed that patients under chloroform anesthesia 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 relation. Chloroform’s chemical initials are CHCl₃. Tetrachloride’s laboratory name is CCl₄.
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 pathological changes that could be traced to CCl₄. 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 morning with no pathological symptoms. The dangerous drops he had swigged the night before had had none of the nauseous effects of chenopodium. His animal experiments had shown him that it worked as fast, as safely and more thoroughly. And here was another point in its favor: tetrachloride tried on animals seemed to have no ill effects on pregnancy. Chenopodium had always been a dangerous thing to give a woman with child. It was, at times, among the unsafe abortifacients—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.