﻿NECATOR AMERICANUS IN THE PHILIPPINES. 339 



I wish to quote a few lines from Ashford 12 in regard to the severity of 

 this disease in Porto Rico : 



There seems to be no doubt that for many years from 5,000 to 7,000 people 

 have been dying annually from this easily curable and preventable disease; nor 

 is it an exaggeration to say that the great majority of those affected with 

 Necator americanus are physically incapable of rendering anything like their 

 full quota of labor. * * * Fully 70 per cent of the worm carriers suffer more 

 or less severely from their infection, and an incredibly large number of men that 

 should form the bone and sinew of this healthful and beautiful island are ghost- 

 like invalids, compelled to work, though sick, that their families may not starve. 



If such a condition exists in Porto Rico why should not a similar one 

 be found in the Philippine Islands where we have the same parasite, all 

 the favoring conditions for its growth which a tropical climate affords 

 and a popidation whose habits are such that the greatest care could not 

 facilitate the dissemination of the infection more perfectly ? 



There are two conditions existing in Porto Rico which have been found 

 favorable for the spread of uncinariasis that are dissimilar in these 

 Islands. They are : 



First. An occupation in which a large number of barefooted people 

 are gathered together during the rainy season, and each by his careless 

 habits increases the danger to the others. 



Second. The Porto Ricans are a lighter skinned race than the Fili- 

 pinos. 



In the Philippine Islands the cultivation of coffee is not a very exten- 

 sive industry and the number of people engaged in it is comparatively 

 small. There is no single industry in which great numbers of the Fili- 

 pinos are engaged that presents equally favorable opportunities for uni- 

 versal dissemination of the infection. Nearly every writer upon uncina- 

 riasis states that the Negro living in localities where uncinariasis is 

 prevalent does not suffer from the anaemia which lighter skinned people 

 are subject to. The Filipino being quite dark skinned may be less sus- 

 ceptible than the Porto Rican. 



For many years authorities have considered the Porto Rican anaemia 

 to be due to an innutritious diet. The Porto Rican Anaemia Commission 

 proved the fallacy of this supposition by restoring thousands to health 

 by removing the Uncinaria with which the poorer people were infected. 

 One would not expect the poor negro of our Southern States or of Porto 

 Rico to subsist upon a more nutritious diet than the poor white of the 

 same locality; yet many investigators have observed the relative infre- 

 qnency of .severe cases of anaemia in the negroes of these districts. 



n - Military Sure/. (1007), 20, 41. 



