62 
Ayikylostomiasis in Grenada 
No nucleated red cells were seen in any of the films which I ex¬ 
amined and megalocytes in only three of the cases. Poikilocytosis and 
polychromasia were each observed in two specimens. The blood ob¬ 
tained for examination was always pale in colour and abnormally fluid. 
The red cells displayed no variation in colour and were uniformly pale. 
I am unable to agree with those observers who state that the blood 
of natives suffering from this disease more closely resembles that of 
patients suffering from pernicious anaemia, whilst that examined from 
cases of the disease in white subjects approximates moi’e closely to that 
seen in cases of chlorosis. The above results were all obtained from 
specimens taken from either negroes, coolies or patients of African 
descent, and vary little, if at all, from those obtained by Haldane and 
Boycott as the result of their observations on Cornish miners. 
A history of ground-itch was given in 93 “/o of the cases and this 
percentage would, in all probability, have been larger had one been 
sufficiently well acquainted with all the languages spoken in the island. 
With regard to the intermittent fever mentioned at the commence¬ 
ment of this paper I am unable, at present, to say more than that its 
presence is inconstant and that it is not dependent upon the severity of 
the infection. I found that all the febrifuges employed were useless in 
reducing the temperature and that the only method which succeeded 
in accomplishing this end was treatment with one of the drugs that 
brought about the expulsion of the parasites. 
One of the commouest of the complaints made by patients suffering 
from this disease is that of constipation, but it occasionally happens 
that the complaint made is that of diarrhoea, associated with the 
passage of blood and mucus. In consequence, many of these patients 
are sent up to the Hospitals for treatment for dysentery. One such case, 
who complained of having had this distressing trouble for several years, 
was found to harbour many of these parasites and the expulsion of 
these was followed by complete cessation of the trouble for which he 
was admitted. In this case I was unable to find any amoebae upon the 
examination of the stool, and my attempts to isolate B. dysenteriae 
were also negative. This patient reported himself as “well” a year 
after his discharge from the institution, and I can come to no other 
conclusion than that the dysenteric symptoms were caused by the 
presence of Ayikylostoma duodenale alone. 
The treatment of ankylostomiasis resolves itself into : 
(1) That directed to the removal of the parasites. 
(2) That needed for the effects produced by their presence. 
