616 MAN AS A CONQUEROR 



The hookworm was first recognized as an insidious cause of dis- 

 ease in this country by Dr. C. W. Stiles in 1902. He considered 

 it a major factor responsible for the condition of indigent and shift- 

 less people known as "poor whites" throughout the southeastern 

 part of the United States. Infection by hookworm has recently 

 been found to be almost universal in some tropical countries and is 

 widespread in all tropical countries at the present time. The Negro 

 is apparently much more resistant to the debilitating effects of this 

 parasite than his white brother. The survey work of the Rockefeller 

 Sanitary Commission has made it possible to follow the progress of 

 educational campaigns throughout the world to combat hookworm 

 disease as well as to study the effects of the treatments administered 

 for its suppression. Between 1910 and 1915, a survey was conducted 

 in the United States under the auspices of this commission and it 

 was found that children between six and eighteen years of age carry 

 the heaviest infection. Of approximately 90,000 children examined, 

 55.1 per cent were infected. Between 1920 and 1923, an inspection of 

 more than 44,000 children from some of the same areas showed that 

 the infection had dropped to 27.8 per cent. In this same connection 

 it should be noted that the infection was also much lighter, some 

 school children harboring but few worms. 



The question arises as to the way in which the infection becomes 

 established, and how it happens that children are more heavily 

 infected than their parents. The fact that youngsters are usually 

 barefoot while a much greater proportion of the adults wear shoes 

 has a direct relation to the spread of the infection. The control of 

 the hookworm is due largely to education in community sanitation 

 in addition to therapeutic measures. In the poorer districts of the 

 South, sanitary privies were rarely found, hence the soil in many 

 localities was literally alive with hookworm larvae. With the build- 

 ing of privies and educating people, both young and old, to wear shoes 

 as a means of prevention, the danger of infection in these regions 

 was greatly decreased. Several substances have been used as ver- 

 mifuges, carbon tetrachloride in a chemically pure form having been 

 found most efficient. 



In foreign tropical countries aid given to over seventy different 

 countries or states through the International Board of the Rocke- 

 feller Foundation has reduced hookworm infection on an average of 

 50 per cent in Ceylon, India, the Philippines, and Siam, as well as in 

 some South American countries. 



