99 
PEXNSy LVANIA. 
It is by no means impossible that nncinariasis will }>e found amont^ 
the miners of Pennsylvania. As so many of these men are immit»rants 
from Europe, the Old World species. Agcliylostnum ihimJcimU may be 
expected. 
Philadelphia, 190 ()- 1!)01 3 cases. O death. 
Boston’s cases reported by Allyn and Behrend ( 1901 ). See Stiles ( B»02b, j>. 21 1 ). 
Probably due to Vncinari(t (imericanfi. 
Philadelphia, liiOl 1 case, o death. 
Allyn andBEHRENo’s (1902) case, imported from Italy, hence due to Agchiilnxtomn 
duodenale. 
MARVLAXD. 
Baltimore, 190o 2 cases, n death. 
IIemmeter’s (1902) cases; probably infected in Porto Kico and due to I'licinaria 
americana. See Stiles (1902b, p. 210). 
Baltimore, 1901 1 case, 1 death. 
Hall’s (1901) case; imported, possibly from Vera Cruz. Due to Agchyloxtomn 
duodenale. See Stiles (1902b, pp. 213-215). 
Baltimore, 190:2 1 case. 0 death. 
Osler’s case [unpublished]. In Johns Hojikins Ho.spital. Patient came from 
North Carolina. Parasites determined by Boggs as Uncinarm americana, contirnie<l 
liy Stiles. 
DISTRICT OF COLUMBIA. 
Washington, 1901 [1 case. 1 death.] 
Claytor’s (1901a, 1902a) case, from Westmoreland County, Va., <lue to rnrinarin 
americana. See Stiles (1902b, pp. 211-212). 
Washington, 1902-_ __’ 1 case, 0 death. 
Herrick (1902, p. 101): !Male, 37 years old, lived in (Termany until 1S97, Sent to 
Philippine Islands September, 1899. “Present illne.«s began in July, UHX), with an 
attack of diarrhea. He had from 10 to 15 movements daily for three month.s with a 
moderate amount of tenesmus. Mucus and bloo<I appeared in the stools after the 
first month, giving them a dark tarry appearance. He lost weight and strength 
rapidly during this time and gradually became short of breath on slightt‘st ext*rtion. 
This was followed by a period of imiirovement, the stools becoming less fre<|ueiit; but 
in January, 1901, he lu'came worse and was sent to the hospital at Iloilo. Since then 
he has been confined to hospitals, on account of weakness and dyspnea. In Sejitem- 
ber, 1901, the diarrhea cea.^^ed, and although he has gained a little weiglit he has Ihhui 
steadily growing weaker. At no time had he heeii subjwt to heiimrrhages other 
than .stated. 
“Physical examination shows an apparently well-nourished man with a ]H‘culiar 
lemon-yellow pallor; conjunctivas and mucous membranes are pale; sliglit o‘dema of 
the ankles is present. He has marked «lyspn«ea on the sliglitest exertion. The lungs 
are negative; the heart is enlarged; the point of ma.ximum impul.<«* is in the filth 
intercostal space in the nipple line. A .‘^oft blowing systolic murmur is audible at 
the apex and in the pulmonic area. Liver dullness extends from the sixth intercfvstal 
s]>ace in the nipple line to 1 cm. lielow the costal margin. The i*dge is pal}»abh‘. The 
spleen is enlarged an<l the edge is palj»able at the costal margin. The urine is iu*gative. 
