55 
asylums it was noticed that if two or more children of oiu‘ family 
were present and one child was affected, the other childrt*n were* also 
affected. In fact, in eyery instance where 1 was able to examine the 
famih^ to which an alleged ‘‘ dirt-eater'’ or resin chewer " belonged, 
all or nearly all the members of the family showed an anemia with the 
general history of uncinariasis, and in eyery case examiniul micro- 
scopically the eggs were found. 
Two families may, howeyer, liye yery close together, and one family 
may .show seyeral seyere cases while the other may not show a single case 
seyere enough to be suspected symptomatically. Thus, on one planta- 
tion all the hands examined showed uncinariasis, while the [)lant(‘r's 
family, of much more cleanly personal habits, did not exhibit any 
signs of infection. It is, howeyer, more common to find that where 
one family is affected other families of the .same neiirhborhood will 
show infection, proyided of cour.se that the infected family in (pies- 
tion has not moyed into a city or a clay district. 
The occurrence of cases of uncinariasis of different detrrees of 
intensity in family or neighborhood groups is easily explained l>y 
the fact that in a giyen famih" or neighborhood all persons ai’e subject 
to the .same general conditions of infection, but owing to differences 
in age, daily occupation, personal habits, etc., .some will be more 
subject to infection than others. 
OIUECTIVE AM) SUBJECTIVE SYMPT03IS; ANALYSIS OF SVMF»TOM.S. 
It is difficult to draw a distinct line l)etween the subjectiye and tin* 
objectiye .s};mptoms. If a patient is left to tell his own story, prac- 
ticalh’ all that the obseryer will learn is that the patient ‘M’eels weak, 
has a headache, gets dizz}^, has ffuttering of the heart, tinds it hard to 
breathe, feels wor.se in summer than in winter, and has ‘misery' in tin* 
‘stomach.''’ In medium ca.ses a few judicious (jiie-stions, directed 
more to the parents than to the patient, will as a rule bring to light a 
hi.story upon which, taken in connection with wliat oik' can himself 
ob.sery(‘, a ])robable diagnosis may be made. As a rub‘. little weight 
can be jilaced ujion the statements mach* by a ])atient su tiering' from 
an .seyere infection of uncinariasis. lie will answei* ‘‘yes" or “no" 
in a most contradictory manner, so that by putting- (juestion.s in ditler- 
ent ways it is practically po.ssible to maki* him admit or (h*ny, as 
desirc'd, any jiarticular .symjitom. It is chi(*lly from the patient s 
family that one must judgi^ of what the p('rson has complained. 
ONSET AND I NC'L’ UATION. 
As it takes the ])arasit('s four to six wei'ks to reach maturity alter 
entering the .s}"stem, the earli(*r .sym})t<nns will lx* more j)articularly 
gastro-intestinjd (.see, howc'yer, ]>. <)D), and eyen it tlic.^e are pre'^ent in 
a marked degree we caji not look for a diagnosis by microscopic 
