﻿338 cole. 



with sprue; 3 with filariasis: 1 with rheumatism; 1 with liver abscess, 

 and 1 with epilepsy. 



Thirty-eight cases have been admitted to the hospital for other con- 

 ditions, and ova of Uncinaria have subsequently been found in their 

 stools. The diagnosis in nineteen of these has been changed to uncina- 

 riasis with no complication. In nearly all of the others gastro-intestinal 

 disturbance was marked ; anaemia being observed in five. Of the remain- 

 ing cases, dysentery, tuberculosis and malaria were common complica- 

 tions. Three of these were diagnosed as beriberi and in one the diagnosis 

 was changed to uncinariasis. 



I have not had an opportunity during my tour of duty in these Islands 

 to travel through the country districts where one would expect to find 

 conditions most favorable for the development of Uncinaria and to en- 

 counter the most serious cases of uncinariasis. The patients I have had 

 an opportunity to examine and the records of cases to which I have 

 been able to refer, have all been of soldiers who had not more than three 

 years previously passed a rigid physical examination. These men had 

 only been exposed to the infection during longer or shorter periods of 

 active service in the field, but some of the Scouts may have been suffer- 

 ing from mild infections of a number of years' duration. 



In the United States it has been found that women and children are 

 the greatest sufferers, except in the cases where the employment of the 

 men caused an exposure of the bare skin to the contaminated earth. 

 Soldiers are exposed to infection by this parasite while performing field 

 service and then only during the rainy season. It would hardly be pos- 

 sible that cases as severe would be found among these picked men as 

 among natives in a barrio. 



The health of the soldier in garrison is safeguarded by all the precau- 

 tions known to the sanitarian; it would be a grave condition indeed if 

 under these circumstances severe cases of uncinariasis could develop at 

 all and it could hardly be possible for a severe infection to occur in any 

 great number of soldiers during the short tours of field duty which are 

 customary in these Islands. 



In the provinces no precautions at all are taken properly to dispose of 

 the waste. Privies and vaults are among the rarities and the surface of 

 the ground around by far the greater majority of the houses has been 

 contaminated from the time that the houses were built. The abundant 

 growth of vegetation around dwellings furnishes the most favorable con- 

 ditions (shade and moisture) for preserving the vitality of rhabditiform 

 embryos, and the barefooted householder and his family are constantly 

 exposed to the infection. 



