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Ninety per cent, of the common people in Porto Rico, accord- 

 ing to a recent P. R. Govt. Report on "Anemia in Porto Rico," 

 are infested with intestinal parasites. The further startling state- 

 ment is made that 30% of all deaths in that island are due to 

 "Anemia," a disease caused by these parasites. Up to 1899 

 Anemia was considered to be due to insufficient or faulty diet, and 

 was in turn attributed to malaria, climate, lack of hygiene, etc. 

 Later it was one of the things laid at the door of "American Occu- 

 pation" and the Hurricane. 



The parasites now known to be the sole cause of Anemia are 

 minute blcod-sucking worms, one-fourth to one-third inch long. 

 Contrary to previous supposition it has been proved that infec- 

 tion takes place solely through contact of the skin of the human 

 body with wet earth or mud containing the microscopic eggs of 

 the worm. The motile ova pierce the skin causing a characteris- 

 tic eruption at point of entrance and migrate thence through the 

 tissues until they reach the body cavity. They then pierce the 

 intestines and attach themselves to the inner mucous membranes 

 and suck the blood directly from the capillaries. 



Anemia owes its prevalence to soil infection from human ex- 

 crement. It is a disease of the "bare-footed peoples." The eggs 

 of the worms are killed by drying or exposure to sunshine. For 

 this reason sugar plantations are comparatively free from Anemia, 

 while the Porto Rican coffee estates are said to fairly reek with 

 it, the shade and moisture furnishing ideal conditions for the long 

 life of the eggs of this worm in the soil. 



The Anemia of Porto Rico has been found to be identical with 

 "mine sickness" or "tunnel sickness" of England and Germany. 

 It is common among laborers in brick yards. It also occurs in 

 certain districts of the Southern States, in Egypt, South America 

 and probably, at least sporadically, in all the countries of the globe. 

 Prevention consists in rigid enforcement of the use of latrines 

 by laborers working in infected districts, and medical treatment 

 of the sufferers. Specifics for this parasitic worm are thymol and 

 Beta-naphthol, both of which are powerful drugs which should 

 be administered only by physicians. 



The very thorough investigation of this wide-spread tropical 

 disease reflects great credit upon Capt. B. K. Ashford, Asst. Sur- 

 geon, U. S. A., the chairman of the commission named by Gov- 

 ernor Winthrop of Porto Rico to study and report upon it. 



