97 
Again, it is almost a common experience to l)e told hv the father 
of a faniih’ that he spends for medicine all he earns, in the hojx‘ of 
ridding his children of this malady. Add to this the physicians' hills, 
the loss by death and funeral expenses, etc., and it is seen that this 
infection is keeping more than one family in absolute poverty. 
Nor should we forget that uncinariasis has its important bearing 
upon the mental as well as upon the physical and tinancial development 
of the poorer white people. As already stated, children infected with 
this maladv are often underdeveloped mentally; frequently they have 
a reputation in the schools, in the neighborhood, and in their own 
family, of being ‘‘stupid,'’ or “dull," or “backward" in their studies, 
etc. Tt has alreadv been mentioned that children sutieriiu^ with this 
disease are frequently kept home from school because of their tendencv 
to become edematous when they sit still for any length of time. 
When we now recall that these conditions coincide especially with the 
educational period, it should not seem strange that uncinariasis has a 
marked intiuence upon the general intellectual condition of the dis- 
tricts in which it occurs. 
Considering the subject in the light of all I saw on the trip, and 
taking what I believe to be a conservative view of the subject, 1 tind 
it exceedingly difficult to escape the conclusion that in uncinariasis, 
caused bv Unc'inaria amerlcana^ we have a pathologic basis as one of 
the most important factors in the inferior mental, physical, and tinancial 
condition of the poorer classes of the white population of the rural 
sand and piney wood districts which 1 visited. This sounds like an 
I extreme statement, but it is based upon extreme facts. 
By this position r do not intend to assert that uncinariasis is the 
only factor which comes into consideration. The warm climate and 
the monotonous diet, and probabh^ also the excessive use of tobacco 
in some cases, are not without influence. Still, with uncinariasis as it 
exi.sts to-day, these })eople are suflering from a handica]) in life which 
practically removes them from a fair chance in competition. If the 
uncinariasis is removed the\^ will be ])laced in a more favonihle con- 
dition both subjectively and objectively. With the present jirevalence 
of uncinariasis their lack of ambition is perfectly natural: riMiiove the 
disease and the}" can develop ambition. 
On the other hand, if we were to select the strongest pt'ople in the 
country and place them in the conditions under which these j)atients 
are now living it would be onlv a generation or two beton' even a 
race of athletes would lie in the same condition as the jn'rsons under 
discussion. 
The conditions described are familiar to ]iersons wlio have visited 
the rural sand districts. But they have existed for .so many years tliat 
many of us to-day look upon them as natural, hence they do not 
attract the consideration to which they are entitled. 
19558— No. 10 -03 — -7 • 
