23,1 Leach et al.: Hookworm Disease 107 



be published in the near future, we shall present figures in 

 support of this statement. We shall, at the same time, endeavor 

 to explain how some of the misconceptions we have mentioned 

 have arisen. It is our intent in this paper to limit our discus- 

 sion to hookworm disease in Cebu. 



During the survey on Cebu we were early impressed by the 

 number of persons presenting themselves for examination and 

 treatment who plainly were suffering from marked anaemia and, 

 in many instances, pronounced oedema. Many of them were 

 forced to rest in chairs after mounting the stairs that led to the 

 improvised laboratory, until they could recover from the very 

 obvious dyspnoea and exhaustion produced by even this slight 

 exertion. 



Although the general picture presented by these people in- 

 dicated that they were suffering from hookworm disease, it 

 seemed to us desirable, in view of the prevailing skepticism, to 

 inquire more thoroughly into their actual physical condition 



This we were able to do through the courtesy of Dr. Augusto 

 Villalon, director of the Southern Islands Hospital, in the city 

 of Cebu, who admitted our patients to his institution and placed 

 all his facilities at our disposal. We desire at this time to record 

 our appreciation of the assistance rendered to us by Doctor 

 Villalon and his staff. 



Our time at Cebu was limited, so it was not possible to make 

 an intensive study of the cases. We feel however that, in- 

 complete as our observations are, they establish the existence 

 of hookworm disease on Cebu Island beyond a reasonable doubt. 



A few of the more-striking cases that we found at Carcar 

 were sent to the Southern Islands Hospital ; others were found 

 in the hospital 4 so that, without any trouble, we found eleven 

 cases of seemingly typical hookworm disease. These were all 

 we could handle in the time at our disposal. 



Each subject was given a thorough physical examination, the 

 blood and urine 5 were studied, and the faeces were checked to 



4 Of one hundred twenty-five patients admitted to the Southern Islands 

 Hospital during the month of November, 1922, forty-four, or 35 per cent, 

 were hookworm positive. These figures are based on ordinary study of 

 cover-glass preparations, no concentration having been used. Moreover, 

 the greater number of these positives are represented by patients with 

 obvious anaamia, which led to special examination of their faeces for hook- 



' No pathological elements were found in any of the specimens of urine 

 obtained from these patients, so no further allusion will be made to the 

 urine. 



