268 HOOKWORMS 



made by such measures. If money sufficient to buy shoes and 

 other protective garments were invested in improving sanitary 

 conditions much more permanent good would result. This does 

 not mean, however, that such protection as is gained by the use 

 of shoes and spraying of ground is not well worth while for such 

 individuals as can afford it and who are forced by occupation or 

 other circumstances to come in contact with polluted soil. 



The isolation and treatment of infected persons is to be highly 

 recommended, especially in case of immigrants or new arrivals 

 from infected regions. In 1910 the Board of Health of San Fran- 

 cisco made an examination of a shipload of Hindus which had 

 just arrived and found 90 per cent to be infected, whereupon a 

 quarantine was established, and has since been maintained, for 

 hookworm patients. Every colony of Hindu coolies in California 

 is a center from which hookworm disease is spreading. Had a 

 hookworm quarantine been established years before, California 

 would have been to a great extent free from this parasite. Quar- 

 antine measures have been taken in Natal, where all infected 

 immigrants are treated before being assigned to plantations. 

 When the infection does appear in a mine or plantation the in- 

 fected persons should be treated, and not allowed to return to 

 work until their faeces are free from eggs. 



The treatment of hookworm disease is of such vital importance 

 to the public of any endemic region that it should be supervised 

 and aided by the government. Such aid should consist in the 

 establishment of free dispensaries for hookworm patients, the 

 supply of necessary drugs at cost for the treatment of hookworm 

 disease, the appointment of inspectors to enforce sanitary regu- 

 lations, and the distribution of information regarding the disease 

 by free pamphlets, public lectures and school instruction. In 

 the United States this work has been done largely by the American 

 Hookworm Commission, financed by a gift of $1,000,000 from 

 John D. Rockefeller. In 1914 the Rockefeller Foundation ex- 

 tended the work of hookworm eradication " to those countries and 

 peoples where conditions invite." Such work has been begun in 

 a number of West Indian islands, Central America and Egypt. 



It has been pointed out that demonstration as well as instruc- 

 tion is necessary to impress the natives of hookworm districts 

 with the advantages of sanitation and hygienic conditions. It 

 is absurd to rely upon the ability of the average native, dwelling 



