256 CHAMBERLAIN. 



I and II with this point in mind, it is seen that 14 of the southern-born men 

 (cases Nos. 7, 15, 19, 21, 23, 26, 29, 33, 34, 39, 44, 74, 77, 87) had served in the 

 Army five years or over at the date of current admission on sick report, and 

 therefore had probably freed themselves of any original infection and had gained 

 their present infection in the Philippines during this or a previous tour of duty. 

 Deducting these 14 long-service men from the 44 southern-born men, leaves 

 30 cases out of the 90 (33 per cent) in which it appears probable that the 

 hookworm infection may ha.ve originated in the United States and have been 

 imported into the Philippines. Of course it is impossible to prove that these 

 men may not have received additional infections while in the Islands. 5 



There is, with one or two exceptions, nothing in the histories and 

 residences of the 41 cases not born in the South, to indicate that the 

 infection occurred elsewhere than in the Philippine Islands. Just how 

 the worms gained entry into the intestines in these cases is an interesting 

 subject for speculation. 



It is rare for a civilian or a soldier in the peaceful times of the last 

 few years to run much risk of contracting ground itch, since good shoes 

 are universally worn, and the persons considered are not engaged in agri- 

 cultural pursuits, or severe, field service. Great efforts are made to provide 

 .safe drinking water and well-prepared food for all Americans, but that 

 sufficient care in this respect is not always taken seems evident from the 

 numerous cases of dysentery that continue to occur. In view of these 

 facts, it seems probable to the writer that infection with hookworms 

 among Americans in the Philippines occurs more commonly by mouth 

 than through the integument. 



IMPORTANCE OF TREATING MILD UNCINARIASIS. 



Although this investigation shows that hookworm infections among 

 Americans in the Philippines are rarely found and that such as are 



5 Since writing this article I have received some additional statistics from 

 Camp Jossman. Out of 06 cases of uncinariasis (found between December 18, 

 1907, and March 19, 1908) in the Eighth Infantry, 16 were from southern States, 

 a percentage of 24. Deducting 12 men with over five years' service, leaves only 

 4 cases, or 6 per cent of the total, in which it appears likely that the men 

 brought their present infections from the United States, unless they were re- 

 infected at their homes while on furlough. Out of 20 cases of uncinariasis in the 

 Fourth Infantry, which relieved the Eighth at Camp Jossman (period from 

 April 11, 1908, to December 14, 1909), 16 were from southern States, a per- 

 centage of 75. Deducting 5 long-service men, leaves 11 cases, or 55 per cent, 

 in which there is a likelihood that their present infection originated in the 

 United States. As the Fourth Infantry had newly arrived in the Islands (April 

 1, 1908), the high proportion of southern-born men found infected correctly 

 indicates the influence of southern birth on uncinaria infection. The Eighth 

 Infantry had been in the Islands about a year and a half when the first examina- 

 tions were made and it shows no predominance of infection among southern- 

 born men, which goes to indicate that a large proportion of these men were 

 infected in the Islands during their two years of service. 



I am indebted for these statistics to First Lieut. Alexander D. Parce, Medical 

 Corps, United States Army. 



