594 The Andes and the Amazons. 



iiig whether the nematoid worm, ankylostome duodenal, 

 is the fons et origo of this complaint, though its presence 

 in the intestinal canal has been so repeatedly determined 

 by observers that I feel assnred of its presence. Locally, 

 among the people, one hears poor diet and a craving for 

 a change nrged by victims, as well as observers, as an ex- 

 citing cause of this practice, and the presence of the worm 

 would very naturally follow on a practice so dirty as this. 

 The sequelae of this geophagy — anaemia and dropsy — 

 are now, I believe, generally supposed to be consequent on 

 the abstraction of blood from the intestinal walls. I do 

 not know that the administration of vermifuges has ever 

 been practiced with a view of getting rid of these animal- 

 cules ; and, so far as my own experience and observations 

 go, the only thing done for this cachexia is the adminis- 

 tration of astringent tonics, and the giving of advice about 

 diet, which, however, amounts to little or nothing; the 

 patients disappear, after a greater or less time, disgusted 

 with the stranger's physic and admonition. The unnatu- 

 ral cravings of a diseased appetite are often not limited to 

 dirt merely, but the most outre articles that can be thought 

 of — coal, cigar -ashes, plaster — enter into their fanciful 

 minds ; and I was assured here by an officer that in the 

 case of an Indian girl nearly grown, who was punished for 

 the habit by being confined in a room where her meals 

 were regularly placed, the paper about the walls, the straw 

 of the mattress, linen hanging about, all seemed more at- 

 tractive to her palate. The most fanciful suggestions of 

 pregnancy — which was not her condition — could not have 

 equaled this poor girl's deranged appetite. It is almost 

 needless to add that treatment in this co'lnplaint is nearly 

 useless unless the habit is corrected, and even then the sys- 

 tem has been too much undermined often to make reme- 

 dies of much avail in restorine: either healthful looks or 



