79 
Sandwith (1894, p. 13) found inipotonco to bo a docidod symptom in 
bookworm disease. Of 38 men especially examined on this }M)int, 24 
bad completely and 5 bad almost entirely lost their virile power, 
while of the remaining 9 men. 5 aged from 19 to 25 bud their puberty 
considerably delayed. 
TENDENCY TO ABORTION. 
Among women affected with uncinariasis I found a marki'd tend- 
- ency to abortion. Given a woman about 28 years old who had been 
married nine }’ears — a not uncommon history is that she* has had 3 to 
5 children and 3 to 4 miscarriages, and she looks to be about 5o years 
old. Not being able to follow these cases through their (Mitire 
medical history and the history of their husbands, I must leayi‘ the 
question open as to how many of these abortions are to be attributed 
to uncinariasis and how many are due to other causes. In the country 
districts I was thrown in with the anemic not with the healthy 
families, hence 1 haye no good liasis for conq)arison of these two 
classes for the particular localities yisited. In some cases a history 
of yenereal disease was sus])ected or admitted: in others, the aliortion 
came on after yiitching fodder; in some cases the jiatients had taken 
more or less quinine during their life, under the supposition that they 
had malaria; and in still other cases, my suspicions were aroused in 
other directions. The determination of the exact relation of uncina- 
riasis to the miscarriages, which are certainly strikingly prevalent, 
must be left to those who can follow the cases for a longer yieriod of 
time. 
PREyALENCE OF I XC'INARIASIS IN THE I'NITEl) STATES. 
In seyeral earlier papers (1901, p. 524; 1902 a, p. 778; 11*92 b, pp. 183, 
212) T haye adyanced the yiew that uncinariasis must be more common 
in this country than is generally siqiposed. In my iireliminary r(qK)i*t 
on this trip (see aboye, p. 35), 1 said that: “'riiere is in fact not the 
slightest room for doubt that uncinariasis is one of the most impor- 
tant and most common diseases of this }>art [South C'arolina] of the 
South, especially on farms and plantations in sandy disti'icts."’ 
Harris (see aboye, y>. 3*5) went even farther than this and claimed 
that uncinariasis is ‘‘the most common of the seven* diseast's of the 
South." 
In considering the subject of the freiiuency and economic impor- 
tance of the disease under dis(*ussion, I do not wish to seem to under- 
estimate the prevalence of tuberculosis and of venen*al diseases among 
the negroes or of malaria among the wdiites. Further, I recognize 
the fact that at the pi'i*sent moment an exact mathematical estimate 
can not be made. Speaking in general t(*rm>, however, the fa<*ts at my 
disposal at present seem to indicate that taking the Southern Atlantic 
