STATISTICAL STUDY OF UNCINARIASIS. 257 



encountered present little clinical evidence of the disease, I do not think 

 that the importance of the condition should be underestimated. From 

 observations on soldiers in New Orleans I concluded that while the light 

 infections did not materially affect the efficiency of the man doing garrison 

 duty at home, nevertheless, he was somewhat more energetic and felt 

 better after the expulsion, of the worms. It is probable that even a few 

 parasites, by injuring the intestinal mucosa, by disturbing digestion, by 

 secreting toxins, by producing a slight ansemia and by altering the normal 

 proportions of the different varieties of leucocytes, usually at the expense 

 of the polynuclears, must to some extent lower the vitality, thereby pre- 

 disposing to various infections, especially in active military service. Even 

 a slight lowering of vitality is of importance in the Tropics where the 

 white man is confronted by so many serious diseases awaiting an oppor- 

 tunity to overcome his natural resistance. Therefore, in view of the ease 

 of microscopic diagnosis and the success of vermifuge treatment, it seems 

 desirable that all white residents of the Tropics should be examined at 

 intervals to determine if they serve as the hosts for uncinaria. The 

 importance of this is emphasized by the frequency with which uncinaria 

 were found associated with gastro-intestinal diseases, especially sprue, 

 diarrhoea, and dysentery, which are the arch enemies of the white man in 

 the Tropics. < 



CONCLUSIONS. 



1. Uncinariasis is found among the Filipinos in probably not over 15 

 per cent of the general population and is mild in type and of small 

 economic importance. 



2. The percentage of infections is higher in adult males, reaching 

 50 or 60 per cent among the Filipino Scouts and Bilibid prisoners. 



3. The average percentage of infection of the white population of the 

 southern part of the United States is probably much higher than the rate 

 among the Filipinos. 



4. From 65 to 85 per cent of the southern-bred white recruits for the 

 United States Army are infected with uncinaria, usually mildly, and 

 these infected soldiers, have been coming in considerable numbers to the 

 Philippines, thus importing Uncinaria americana. 



5. The majority of these soldiers, if not reinfected, become free from 

 the worms by natural processes in about five years. 



6. Uncinariasis, sufficiently marked to be evident clinically, is very 

 rare among American men in the Philippine Islands. 



7. Even a routine stool examination among Americans shows few cases, 

 71 out of 8,000 examinations at the Division Hospital and 19 out of 800 

 examinations at the Fort "William McKinley Hospital. 



8. An exhaustive stool examination among Americans in the Philippine 

 Islands would probably show a somewhat greater frequency. 



9. Of the 90 cases of uncinariasis found at the above hospitals, only 

 11 were admitted for uncinariasis. Forty-five were admitted for gastro- 



