HOOKWORM DISEASE, synonymy: anIcylostoniasis, anchylostomiasis, uncinanasis, dochmiosis, brickmakers' anemia, miners' anamia, geophagia or dirteating, Egyptian or tropical chlorosis, tunnel-workers' anamia, tun nel disease (and very improperly), malaria! cac.hexia or anaemia. The disease has also re ceived other names in many other tongue. That this disease existed in Africa and perhaa other countries from time immemorial there can be no feasonable doubt, but it was only within recent times that its cause was dis covered. Clinically the malady seems to have been first accurately described by Piso, in 1648. he having observed about that period persons evidently afflicted with the disease in Brazil, though he was ignorant of its causation. Al though the affection was unquestionably very common in most tropical countries, and must have been encountered by all practitioners in these regions, nothing further appears to have been written concerning it until just a hundred years later, when it was observed in Guadeloupe, and a short time thereafter in Jamaica. Follow ing this, under the name of °miners' anatnia,° it was described in Hungary, and later in Bohemia and France. Subsequently the worm which causes the malady was .discovered by Dubini, of Milan, in 1838, who proposed that the parasite be called ancylostoma which he first misspelled from two Greek words meaning °bent mouth." Notwithstand ing that others had preceded him in finding quite similar and closely related worms in the Intestines of various animals, and regardless of the fact that this investigator failed to recog nize the vital connection that exists between the presence of these parasites in the alimentary tract of the human being and the profound anaemia that follows, his work was of ele mentary importance in paving the way for a proper comprehension of this insidious, com mon and fatal affection.
The connection between these worms aral the symptoms that they produce when living in the intestinal tract of the human being was first dearly established by Bilhart, in 1853, and Griesinger, in 1854. In the succeeding years
this parasite was discovered in many countries of southern and middle Europe,— being mostly found in laborers in tunnels, mines and brick making establishments; Previous to this, as early as 1808, Mist-eating* was described in America by Pitt, and, about a half century later, still more fully by Duncan. Although several cases of the disease of foreign origin had been previously rcpu,tc I the first recorded cases of the endemic hookw rm disease of the United States are those of A. J. Smith, who, in 1901, recognized the eggs of the parasite in a sailor who had lived. for some time in America. It is of interest to note that the writer of this article observed and sketched the eggs of what was in all probability this parasite from a patient with amoebic dysentery about 1892, but, misled by the absence of all records of the disease in the new world, failed at the time to identify them. In the meantime the extreme prevalence of hookworm disease in the southern portions of the United States was slowly gain ing recognition, and after some years was gen erally accepted as one of our most common and most serious diseases. Such importance did the .subject later assume that the principal efforts of the boards of health of the Southern States have in recent years been directed toward combating this old but newly discovered affec tion. Some years ago a commission was formed for the eradication of the hookworm, and still more recently, owing to the fact that the malady was found extremely common in the West Indies, in Central and South America, and in other tropical countries, the activities of this commission have been greatly enlarged and its beneficent influences extended to these countries, preventing much suffering, saving many lives, and at the same time preparing the countries affected for the advance of civiliza tion.