HOOKWORM DISEASE: A CLINICAL ENTITY IN THE 

 PHILIPPINE ISLANDS 



By Charles N. Leach, 1 Benjamin Schwartz, 2 and Florence Dixon Leach 

 with the cooperation of 

 Frank G. Haughwout 3 



The observations recorded in this paper were made incidentally 

 to a brief inquiry into the incidence of hookworm infestation 

 in the country adjacent to the city of Cebu, Cebu Island, Phil- 

 ippine Islands (fig. 1). They are designed formally to record 

 the existence of hookworm disease in the Philippines because, 

 strangely enough, this appears not to have been done in the past. 

 To a considerable degree, the failure to record its existence 

 probably has been the result of preconceived ideas regarding the 

 behavior of Filipinos under the influence of hookworm infesta- 

 tion that have been gained from data of an unconvincing nature. 

 In justice to the medical men working in and about Cebu, it 

 must be said that they have recognized the condition for many 

 years. Moreover, it should be recalled that organized survey 

 work in tropical diseases practically ceased in 1915, at which 

 time more-accurate methods of determining hookworm incidence 

 were displacing the old hit-or-miss methods. As a result, 

 the impression has been gained that the incidence of hookworm 

 infestation in the Islands is less than 20 per cent, and that the 

 Filipinos suffer little, if any, inconvenience from the worms they 

 harbor ; in other words, that hookworm disease is nonexistent in 

 the Philippine Islands. 



Within the past few years, however, smaller studies have 

 been conducted in and about Manila, extending to small groups 

 of men from certain provinces in various parts of the Archi- 

 pelago. These studies have shown rather convincingly that the 

 incidence of hookworm infestation can be expected to vary from 

 40 to 90 per cent in certain of the rural districts. In papers to 



1 Of the International Health Board. 



2 Of the University of the Philippines; assigned to duty with the Phil- 

 ippine Health Service. 



8 Of the Bureau of Science, Manila. 



