264 MESSRS. D. HOOPER AND H. H. MANN ON 



impossible to conceal it. When these have been questioned they say they are so strongly 

 tempted to eat that they cannot do without it, although they fully realise the danger it 

 entails. Some women, however, evasively reply that they experience no ill effects what- 

 ever. The uncontrollable craving for this is like the opium or alcohol habit, and the 

 ravenous symptoms and anxiety in the faces and actions of the eaters are similar to those 

 found in the devotees of one or other of these vices. 



Among married women the habit is almost confined to the period of pregnancy, but 

 a few women indulge it at other times also. In Baluchistan clays are eaten during the 

 first four months. In the coal-mining districts of Bengal between the sixth and eighth 

 month. In Delhi it is reported to be used in the later months. 



The amount eaten per day varies with different individuals. "It is eaten by women 

 in small quantities of an ounce or so at a time, but men eat it in larger quantities ; half 

 or three quarters of a pound seems to be enjoyed by some healthy men." (Delhi). "It 

 appears not unusual for a woman to eat as much as a quarter to half a pound a day. 

 (Hughes-Buller, Baluchistan). " One female will swallow as much three chittacks (6 oz.) 

 of clay per day from the mines." (J. Grundy, Inspector of Mines, Bengal.) "Coolie 

 women on the Cochin Hills eat it in large quantities of i or i-| pounds. " (T. H. 

 Welchman. 1 ) 



Reports are almost unanimous in stating that the habit when indulged in causes 

 anaemia. Cases of intense anaemia are recorded with the history that the patients were 

 perfectly well until they took to mud-eating. It is, however, almost certain that anaemia 

 gives rise to the habit, and most probable that the habit is both the cause and the conse- 

 quence of anaemia. Clay is eaten by people who are already anaemic, and the more 

 they eat it the more anaemic they become. 



Earth-eaters are frequently troubled by worms, but whether they are caused by 

 earth-eating, or their presence is a cont.ributary cause of the habit, is not quite decided. 

 The most general idea, among medical men who have had to deal with large numbers of 

 cases is that to anaemia, accompanied by morbid gastric sensations, is most often due to the 

 commencement of the habit. The anaemia due to the anchylostoma 2 worm is particularly 

 accompanied by gastric cravings. One might compare the depraved appetites of 

 pregnant women suffering from gastric ulcer. 



Dr. Brooks (Sylhet) says it may or may not cause anchylostomiasis, of which 

 anaemia is, in his districts, nearly always a symptom. The habit is frequently a symptom 

 not a cause in amenorrhcea and dysmenorrhea. The presence of anchylostoma duode- 

 nale in the intestine seems invariably connected with the earth-eating habit in Bengal. 



Coolie children of both sexes suffer almost universally from ascaris, but this is pro- 

 bably due to their eating soil near houses, which is contaminated by the ova of ascarides, 

 whereas the clay eaten by pregnant women and anaemics is usually dug well below the 

 surface and is probably free from all organic contamination of an infectious character 

 such as faeces and intestinal parasites. 



1 Bulletin of the Madras Government Museum, Vol. IV., No. 2, 120. 



2 Anchylostoma duodenale, a Nematode worm found in the upper part of the small intestine of man. 



