65 
sions 1 ^vas informed that this symptom intorfei’cd seriously with the 
school attendance, for if the children sat still a loin^ time \u school 
‘‘the}" began to swell/’ Quite generally, as was to be ex})(‘cted, 
testimony was to the effect that the edema was less freipieut \w the 
winter than in the summer. 
Eijelida; conjunctivse . — An examination of the eyelids exhibits the 
visibility of the blood vessels in light cases, but an absolute marble 
whiteness in very severe cases, with all possible intermediate stages 
corresponding to the general degree of anemia. 
Eyes . — While looking at the eyelids for anemia, the observer fre- 
quently notices that the pupils are dilated or that they dilate readily 
and that the eyes are dull, dry, and usually of a chalky white. If the 
patient is directed to stare intently into the observer’s t*yes, there will 
be noticed a symptom which it is difficult to describe, but which I have 
found more constant than almost any other noticed, namely: After a 
moment, the length of time apparently varying slightly according to the 
degree of the disease, the pupils dilate and the patient’s eyes assume a 
dull, blank, almost stupid, ffsh-like or cadaveric stare, very similar to 
that noticed in cases of extreme alcoholic intoxication. 1 am not familiar 
enough with the stare of anemic patients in general to state how 
common this peculiar look is among them, nor have 1 found any of my 
medical friends who could give me much information on this subject; 
but I can state that among the several scores of anemic people whom I 
examined on this trip, in the severe cases with two exceptions, 1 found 
the egors of Uncinaria americana in everv one (whose feces were ex- 
amined) in whom I observed that indescribable stare; the two excep- 
tions in (piestion were city boys, both of them sons of a contirmed 
inebriate; further I failed to find the eggs present in certain (‘xtreiiudy 
anemic patients in whom the stare was not noticed. It certaiidy was 
absolutely absent from a number’of typical cases of malaria, d'oward 
the end of the trip, I found myself unconsciously relying more upon 
the presence or absence of the blank stare than upon any other single 
symptom, except of course the presence of the eggs in the stools. 
I will not go to the extent of stating that this stare is diagnostic for 
uncinariasis (and I will even warn that in dark eyes it is less evident 
than in eyes of light color), for 1 do not feel that I have had expm’i- 
ence enough with the peculiarities of eyes in various diseases to speak 
authoritatively upon the subject. I sini})ly mention this pt'cul- 
iarity in connection with the discussion of the eye as a sym])tom 
which, as my investigations progressed, mad(‘ moi'i* and mon* of an 
impression upon me. Kpon calling the attention ot sevm al local physi- 
cians to this peculiar stare, they informed mi* that it was a totally now 
symptom to them, but that after (‘xamining several cases they found 
it a very prominent symptom. As a general rule tlu' eyes in advanced 
stages are drv. In this connection it may be noticed that sevenil 
19558 — No. lU — ()8- 
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