1904 - 5 .] Ankylostomiasis , or the Miners' Worm Disease. 825 
intestine he found large quantities of blood and mucus, marked 
evidence of catarrh of the mucous membranes. He also found 
that the worms attached to the intestinal wall contained blood. 
It is possible, therefore, that in acute cases the cause of the 
anaemia is rapid abstraction of blood and concurrent subacute 
enteritis, and that in the chronic cases toxaemia is more important. 
The question has sometimes been raised as to why the worms 
in the intestine are not digested by the trypsin of the pancreatic 
juice. It may be that their protoplasm offers some natural 
resistance to the action of proteolytic ferments, or that the worms, 
in defence, produce some antiferment or other substance that 
inhibits the action of the trypsin. 
The treatment of ankylostomiasis is preventive and curative. 
The curative or medicinal part of the treatment may well be 
left to the medical man in charge of the patient. It consists 
mainly in the administration of purgatives and of anthelmintics. 
In this country the administration of large doses of thymol has 
been followed by good results. On the Continent filix mas is 
frequently given, large doses of which have caused blindness. 
Preventive . — It is known that the ova require for their develop- 
ment into larvae, moisture, oxygen, and a fairly warm temperature. 
On the whole, the mines on the Continent have a higher tempera- 
ture than those in this country. Ankylostomiasis, however, has 
already gained a foothold in Cornwall. Here the mines which are 
metalliferous have a greater depth and higher temperature 
than the coal mines generally throughout the country. There 
are many coal mines in the county of Durham and other 
parts of England (I cannot speak for Scotland) where the tem- 
perature at the working place is over 60° F. British mine-owners 
and mining officials are inclined to attribute their freedom 
from ankylostomiasis to the lower temperature and better ven- 
tilation of their coal mines compared with those abroad. May 
it not be that they are closing their eyes to possibilities, and are 
allowing themselves to be lulled into a sense of false security? 
Ankylostomiasis takes a long time to travel from one country to 
another — even from one mine to another. Experience shows that 
it goes on silently developing in a mine for months, or it may be 
years, before there is an outbreak. This was certainly what 
