254 



CHAMBERLAIN. 



CAUSES OF ADMISSION AND ASSOCIATED DISEASES. 



A study of Tables I and II, pages 251-262, and 263, shows that the 

 cause for admission in the 90 men harboring hookworms was uncinariasis 

 in 11 cases, and for the remaining 79 as follows : 



Table III. 



Cause of admission. 



Dysentery 



Diarrhoea 



Enteritis 



Sprue 



Gastritis , 



Total gastro-intestinal 



Number 

 of cases. 



Cause of admission. 



Dengue 



Malaria 



Surgical 



Cardiac, organic 



Tuberculosis 



Venereal 



Miscellaneous 



Unknown 



Total other than gastro-intestinal 



Number 

 of cases. 



34 



It is notable that among 90 men found to have uncinariasis, gastro- 

 intestinal troubles were the cause of 50 per cent of the admissions, the 

 coexistence of dysenteiy and uncinariasis being especially common. This 

 coincidence is possibly explained in part by the fact that the stools of 

 diarrhoea and dysentery patients were thoroughly examined for the 

 possible presence of amoeba? and the hookworm ova discovered accidently, 

 while the faeces of the patients having no enteric symptoms were not 

 always examined and consequently mild cases of uncinariasis, without 

 clinical signs, may frequently have escaped notice. 



However, there are two other possibilities : First, that the presence of 

 uncinaria lowered the vitality, thereby favoring the development of 

 gastroenteric diseases, and, second, that the infection with hookworms 

 occurred by mouth at the same time that the causes of dysentery gained 

 entry. Study of the case histories throws no light on these points. 



SYMPTOMATOLOGY. 



It is unnecessary to describe the classical symptoms of hookworm 

 disease as given in the . textbooks. A review of the histories of the 71 

 cases at the Division Hospital proves that such a train of symptoms is 

 rare in the class of patients this paper deals with. Anaemia was not at all 

 a prominent symptom. In a few instances in which the haemoglobin 

 was estimated it was indeed low, ranging from 40 to 85 per cent, but in 

 all these patients there were ample causes for anaemia other than the 

 hookworm. Cole found that in his series anaemia, dyspnoea and oedema 

 were not marked (10). Wolf was struck with the fact that the majority 

 of patients in the Philippine Islands harboring uncinaria appeared to be 

 in excellent health (6). Table III shows how commonly gastro-intestinal 

 symptoms were associated with uncinariasis, and also that usually the 



