54 
ber and a greater proportion of extreme cases. (3) The children in 
pla 3 nng in the sand around the house, and owing to their more careless 
personal habits, are of course especial!}^ liable to infection. (4) The 
men being stronger, are, as a rule, better able to withstand the effects 
of infection. An interesting and important fact is that men of about 
20 to 24 seem in many cases to more or less outgrow the effects of the 
malad}". They give a histor}- of medium or severe infection from, 
sa}% 10 to 18 years of age, then at 18 or 20 they begin to improve, 
and final!}" appear much better, although their features and physique 
still show the effects of former disease. This time of improvement 
corresponds to the years following their first more active participa- 
tion in work which takes them more awav from the house, hence to 
years when they are subjected less constantly to infection. 
Sandwith states that nearly all of his 402 patients were in the prime 
of life, between 20 and 40 years of age. His youngest case was a boy 
of 6 years; 48 patients were between 10 and 20 years of age; ITO 
patients were between 20 and 30 years of age; 140 were between 30 
and 40 years of age; 21 were between 40 and 50; 15 were between 50 
and 60; and T were above 60. 
Giles reports a case of a girl 4 years of age. My youngest patient 
was 3 years old. 
Of Sandwith’s 402 cases only 3 were females. This statement is in 
striking contrast to my observations. Sandwith and I made our 
studies, however, under totally different conditions, for his patients | 
came to his hospital, while I went to the homes of the infected persons. 
Possibly this will explain, in part, our different results, for he states 
that " ‘ women have not yet learned to apply for hospital relief in the 
same proportion as the men.” ! 
SEVERAL CASES ARE LIKELY TO OCCUR IK THE SAME FAMILY. ; 
Uncinariasis commonly occurs in groups of cases. If one child in a ;j 
family is accused of being a ‘‘dirt-eater,” and is shown by physical |, 
and microscopic examination to represent an extreme case of unci- 
nariasis, an examination of the remaining members of the family w"ill i 
usually show that most or all of them are suffering from anemia in ,j 
different degrees, and the microscope will disclose infections with | 
Uncinaria. This condition of affairs is so general that it may be j 
looked upon as the rule among farming classes, while the occurrence | 
of isolated cases in a family, except possibly among miners, may be I 
looked upon as the exception. Numerous observations could be cited 
in support of this view; for instance, in the first family examined in | 
the sand district near Haile Goldmine only one member had the repu- f 
tation of being a “dirt-eater,” but all 11 were in different stages of | 
anemia. In a family of 10 members on a neighboring plantation only 
1 was noted as a resin-chewer, but all 10 were anemic. In orphan 
