Miscellaneous* 



158 



[August, 1910. 



a bottle, composed largely of alcohol, 

 which while making the patient " feel 

 good " for a time, greatly aggravates his 

 condition. Not only the men but many 

 of the women and children smoke and 

 chew tobacco and " dip snuff." When 

 the weired abnormal appetite of dirt- 

 eating is found among these wretched 

 people it is a pretty sure indication of 

 the presence of intestinal parasites. 



Unprepossessing in appearance, with 

 yellow skin, wrinkled and waxy, dry 

 and lustrelsss hair, colourless eyes, dull 

 stupid and intensely melancholy expres- 

 sion, they will eat dirt and clay* right 

 off the ground, or they will pick lumps 

 of black soot out of the chimney and 

 suck it until they swallow it, as though 

 it were a toothsome candy. A curious 

 phase of the habit is that the victims 

 will hardly ever admit it, even when 

 caught with the dirt in their mouths. 

 They protest that they have not the least 

 idea how it got there, "deed an' honest 

 they don't." Resin and coffee chewing, 

 lemon sucking and salt lapping are mild 

 forms. One confirmed " dirt eater " may 

 consider mortar picked from between 

 bricks a positive tid-bit, while another 

 may have a liking for pebbles, sand, 

 mud, chalk, slate pencils, shells, rotten 

 wood, raw cotton, cloth and pipe stems. 

 The devouring of mice and even young 

 rats is by no means uncommon, Dr. 

 Stiles reports seeing one person eating 

 live mice, while another had eaten up 

 three coats, thread by thread, in a year. 

 An insane girl suffering from hookworm 

 disease swallowed so much hair that her 

 stomach became crammed and she died 

 of starvation. 



As we have seen, the hookworm usually 

 finds its way into the body through the 

 skin, entering the pores of hair folicles, 

 although it is frequently swallowed in 

 water or in unwashed vegetables eaten 

 raw. After entering the skin the 

 young worm makes its way to the blood 

 and passes with the blood through the 

 heart to the lungs, thence making its 

 way up the windpipe, down the gullet 

 and through the stomach to the small 

 intestine, where it gradually sheds its 

 skin two more times, becomes mature, 

 and then begins its work of injuring the 

 walls of the intestine by sucking the 

 blood and poisoning its victim. 



The worm has hard cutting plates or 

 jaws guarding the entrance of its mouth, 

 with the aid of which the parasite 

 fastens itself to the intestinal wall. 

 In the mouth cavity may be seen a large 

 hollow tooth, reminding one of the fang 



* Why do our coolies, some of them, secretly eat 

 clay? 



of a poisonous snake being two of the 

 four sharp lancets which guard the 

 entrance to the esophagus. It is this 

 tooth, connected with a tiny poison 

 gland, which starts the blood flowing. 

 The action of the worm's poison seems to 

 render the blood more fluid. When it 

 has been injected into the wound the 

 blood flows more freely and continues 

 to do so long after the worm has relin- 

 quished its grip and taken a fresh hold 

 in another spot, so that in the course of 

 time there are a number of tiny streams 

 of blood escaping into the intestine a 

 deadly drain on the supply of vital fluid 

 in the body, which will in the course of 

 time produce the serious consequences 

 observed in hookworm victims, such as 

 physical weakness, emaciation, a death- 

 like pallor, and such symptoms as 

 headache, dizziness, fluttering of the 

 heart, " misery " in the stomach and 

 dropsy. 



Southern School teachers say that 

 children afflicted with the complaint, If 

 they remain seated for any length of 

 time, "swell up." "Children affected 

 with hookworm are dwarfed," says one 

 writer on the subject. " Lads of eigh- 

 teen appear to be only ten or eleven 

 years old ; boys of ten or eleven look 

 like little children. The littte children 

 are like old men and women ; one never 

 sees them play or romp. They are as 

 backward mentally as they are physi- 

 cally, and studying and learning is 

 difficult. 



"One of the most striking marks of 

 the hookworm sufferer is a peculiar dull, 

 blank, fishlike stare." One constantly 

 sees this dreadful expressionless stare 

 among the " poor whites" of the South. 

 A person may harbour a few hookworms, 

 or several hundreds, or several thou- 

 sands, according to the amount of 

 infection to which he has been sub- 

 jected. But the parasites do not multi- 

 ply in the intestine, as their eggs 

 require oxygen in order to develop. 

 Every hookworm found in the patient 

 therefore represents a germ which has 

 found its way into the body from the 

 outside. But the female parasite, while 

 there, lays hundreds of eggs, and these 

 find their way into the soil from the 

 intestine. 



In a few hours a young worm hatches 

 in each of these eggs. For about a week 

 it feeds and sheds its skin twice, some- 

 what in the same way that the snake 

 sloughs its skin. It is now ready for 

 its human victim and eats no more food 

 until it enters some person, where in 

 turn it lays its hundreds of eggs. 

 Climate has an important influence on 

 the development of these parasites. The 



