9 
rience in this kind of work. It was realized at the outset that in order 
to have a broad basis for our study it would be necessary to turn 
to large institutions where people were gathered under such control 
as would make it possible to obtain specimens in sufhciently large 
numbers and under properly governed conditions. 
The Government Hospital for the Insane, in the District of Colum- 
bia, offered a convenient and favorable field for the investigation, and 
in September. 1902, it was arranged with Dr. A. B. Richardson, late 
superintendent, that we should examine the patients of that institu- 
tion. These cotutesies were continued after Doctor Richardson’s 
death by Acting Superintendent Dr. M. J. Stack, and later by Dr. 
TC. A. White, Doctor Richardson's successor. 
Invitations were subsequently received to take up the work in a 
number of institutions in various parts of the country. It was decided 
to accept that of the Connecticut Hospital for the Insane at Middle- 
town. Conn., and during the summer of 1903 specimens from over 1 .000 
of the patients were examined. Desiring to obtain data for children, 
arrangements were made with an orphanage in the District of Colum- 
bia by which we examined 123 inmates of the institution. 
It was fullv realized that in selecting these fields for our investiga- 
tion we were departing from the normal conditions of life found in 
the general population and that this departiue might introduce cer- 
tain elements which would modify our results. It undoubtedly has 
done so. Nevertheless, from facts brought out in the investigation 
itself, we consider that the results obtained are of value not only as 
indicating the frequency and distribution of intestinal worms among 
the classes of patients actually studied, but that these results, though 
very complicated, will, properly interpreted, serve as a fair indication 
of the presence of helminthiasis in the population at large in the New 
England and the Middle Atlantic States. 
Scope of the work. — Our aim primarily was to determine the fre- 
quency of the different species of intestinal worms in man in the locali- 
ties in question. At the same time we have endeavored to ascertain 
any conditions among our cases which might have any relation to the 
presence of worms in the intestine. For this purpose as full data as 
possible were taken from the records of the patients examined, includ- 
ing race, sex, age, nativity, occupation, residence, and length of 
institutional life. YCe have considered also the distribution of the 
infections upon the wards of the hospitals. Finally there is appended 
a summary of the results of other statistical researches into the preva- 
lence of worms in the human intestine and a brief consideration of the 
relative prevalence of whipworms among the whites and negroes in 
the District of Columbia with regard to the occurrence of typhoid fever 
in the two races. 
