36 
are concerned a radical change in the general therapeutics practiced in the localities 
in question is urgently indicated. 
As for the economic side of the problem, it should be recalled that the disease in 
question is resulting in loss of wages, loss in productiveness of the farms, loss in 
the school attendance of the children, extra expenses for drugs and for physicians’ 
services, etc. 
The heavy and frequent infections found are amply explained by the almost total 
absence of privies and closets on the farms visited. Defecation occurs at almost any 
place within a radius of 50 meters from the house or hut, and as a result the prem- 
ises become heavily infested with the embryos. 
The disease as thus far traced is primarily a “poor man’s” malady, and in fre- 
quency it far exceeds even the most extreme limit which theoretical deductions 
seemed to justify before commencing the field work. There is, in fact, not the 
slightest room for doubt that uncinariasis is one of the most important and most 
common diseases of this part of the South, especially on farms and plantations in 
sandy districts, and indications are not entirely lacking that much of the trouble 
popularly attributed to “dirt-eating,” “resin-chewing,” and even some of the pro- 
verbial laziness of the poorer classes of the white population are in reality various 
manifestations of uncinariasis. 
The infection among the miners, so far as discovered, is less severe and less com- 
mon than the infection on the farms and plantations of the sandy districts. 
Respectfully, 
Ch. Waedell Stiles, Ph. D., 
Chief of Division of Zoology. 
On November 15, Dr. H. F. Harris, of Atlanta, Ga., published an 
important notice regarding uncinariasis in the South. After refer- 
ring to his first case (see above, p. 35), he says: 
“The discovery of a distinct American species of the hookworm is very important, 
as it leads to the inference that the aborigines of this country were infested with this 
parasite, and that the worm is probably present in all parts of the United States 
where the conditions are suitable for its development. 
“My observations during the last six months bear out this assumption in a most 
striking manner. A few weeks after my first case of the disease was seen, a second 
one was encountered that originated in middle Georgia, but though I was constantly 
on the search for it no other case was found among the numerous patients that come 
to the clinics of the Atlanta College of Physicians. In June of the present year I 
made a trip to north Georgia, a region that has long been noted as one in which the 
inhabitants are very pale and anaemic, this condition being commonly reputed to be 
the result of dirt eating. Here I saw many instances of what was in all probability 
ankylostomiasis; but as a result of the ignorance of the people and their suspicion of 
all strangers a proper examination could be obtained in only four cases, in all of 
which the parasite was demonstrated. Subsequently a case of the disease was seen 
that originated in middle Alabama. During September and October I have been 
studying malaria in south Georgia and Florida, a region in which the people show 
profound anaemia even more often than in north Georgia. This condition is com- 
monly ascribed to malaria, but my observations show that in almost all instances the 
sufferers have no malarial parasites in their blood, but eggs of the ankylostoma are 
constantly found in the feces. During my entire stay in this region I only saw one 
case of profound anaemia from malaria, and in this instance the patient did not exhibit 
the extraordinary anaemia so commonly found in those infected with the ankylostoma. 
I feel no hesitation in saying that time will show that by far the greater number of 
cases of anaemia in Georgia, Alabama, and Florida are due not to malaria but to 
the ankylostoma, and that this is Ihe most common of all the serious diseases in this 
