ANKYLOSTOMIASIS 313 



duced upon fruits and vegetables. The Qgg capsule is dissolved in the 

 stomach, the embryo passes to the small intestine, grows and becomes 

 mature in fourteen days and then copulation takes place. 



The adult worm is a fine, minute, thread-like, round worm with a 

 long bulbous oesophagus and transversely striated cuticle. The male 

 is coiled up at the posterior end and carries one spicule. 



The female is straight and the posterior end tapers to a point. 



SYMPTOMATOLOGY. 



Irritation about the anus is common. 

 One often meets with nocturnal enuresis and insomnia. 

 Entero-colitis and slight fever are rare. 

 Nasal irritation is uncommon. 



The worms may cause vaginitis in girls and masturbation in both 

 sexes. 



TREATMENT. 



To kill the young forms use santonin and calomel as for Ascaris. 



To kill the gravid females give rectal injections of quassia, alum, 

 one drachm to one pint, or of salt, two drachms to one pint. 



For rectal irritation or vaginitis give diluted mercurial ointment, 

 one in four. Iodoform or napthalin suppositories may be used. 



ANKYLOSTOMIASIS. 

 DEFINITION. 



This is a toxaemia passing to a progressive anemia caused by the 

 Ankylostome duodenale and the Necator americanus associated with 

 fatty degeneration of the heart, liver, kidneys, and of the intestinal 

 mucosa. 



DISTRIBUTION. 



The disease is found wherever there is moisture and a suitable 

 temperature for the growth of the parasite. 



It is present in America, Africa, Asia, Australia, New Guinea, Fiji, 

 and in the mines of Cornwall and Belgium. 



It was taken to the United States by African slaves. 



In Porto Rico 70 per cent, of the people are infected and 30 per 

 cent, of the death rate is due to this cause. 



In the Army of the Southern States 6 per cent, were carriers. 



In the mills of the Southern States 12 '6 per cent, were carriers. 



In Java 97 per cent, of the population is infected. ' 



THE PARASITE. 



This is the Ankylostome duodenale. (Also the Necator americanus 

 as it gives rise to similar svmptoms.) 



