DISCUSSION ON THE PAPER, "STATISTICAL STUDIES OF 

 UNCINARIASIS AMONG WHITE MEN IN THE PHIL- 

 IPPINES," BY DOCTOR CHAMBERLAIN. 



Dr. Aldo Castellani, professor of tropical medicine and lecturer on 

 dermatology,, Ceylon Medical College, delegate from the government of 

 Ceylon. — I would like to say just a few words in regard to Major 

 Chamberlain's paper, which is a most interesting one. The subject of 

 uncinariasis is one of great practical importance in the Tropics and in 

 subtropical countries. In some districts of Ceylon about 65 to 75 per 

 cent of the people are affected with uncinariasis. 



I think Doctor Chamberlain is quite right when he says that even a 

 small number of agchylostomes is of great importance, as secondary 

 bacterial infections may take place through the small lesions produced 

 b} r them in the intestinal mucosa. 



In connection with uncinariasis, I would call attention to a symptom 

 seldom mentioned in text-books : Fever. If a temperature chart be kept 

 of all uncinariasis patients, it will be found that in about 20 per cent 

 of the severe cases, fever is present. This fever is generally of a low 

 type, intermittent or remittent, rarely continuous. 



Dr. E. B. Stittj surgeon, United States Navy, associate professor of 

 medical zoology, Department of Tropical Medicine, Philippine Medical 

 School, Manila, P. I. — In connection with the question of the period of 

 time a man may remain infected with the hookworm in the absence of 

 the possibility of the removal of the infection, the experience at the 

 United States Naval Medical School with the infection of dogs with 

 Agchylostoma is interesting. 



In the school there are two classes, one of which, in the practical 

 study of medical zoology under Doctor Stiles, performs autopsies on dogs 

 killed at the municipal pound during the autumn months, and the 

 second class do their work in the late spring months. We have observed 

 that the dogs autopsied in the autumn show very heavy infections, 

 while in those autopsied in the spring the hookworms give very small 

 numbers. These observations extended over several years. From this 

 it would seem that the dog became free of his infection during the 

 winter and reinfected himself the following summer. When one con- 

 siders the formidable teeth of the dog hookworm imbedded in the 

 intestinal mucosa, it would seem that at any rate Necator americanus, 

 with only chitinous plates, should be more readily eliminated by man. 



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