be taken seriously or in jest, and the editorial remarks upon the subject have, therefore, varied from the serious to the sarcastic. The following are the facts of the case, as learned by the Popular Science Monthly from a reliable source.
The Eber's Papyrus, an Egyptian manuscript, about 3,500 years old, described a tropical malady as the 'AAA' or the 'U H A' disease, which is characterized by an extreme anemia, pains in the abdomen, palpitation of the heart, and certain other symptoms. This same disease is described by various authors in the eighteenth century, but its cause was not discovered until 1843, when Dubini, of Milan, found a parasitic, roundworm which inhabits the intestine and which he named Anchylostoma duodenale. This worm belongs to the strongyles and is closely related to the 'hookworm,' Uncinaria vulpis, described by Frölich in 1789.
It has been thoroughly established that Dubini's hookworm sucks the blood and produces a poison; also that it causes the conditions known under the various names of St. Gothard anemia, miner's anemia, brickmaker's anemia, Egyptian chlorosis, uncinariasis, ankylostomiasis, etc. This disease is known to be very prevalent in tropical countries, but curiously enough no positive case in the United States was recognized as such until 1893, when Dr. Blickman, of St. Louis, found a German who had brought the infection with him from Europe. Dr. Stiles, zoologist of the Public Health and Marine Hospital Service, has maintained for eight or ten years that this disease must be more or less common in the southern portion of this country, and that physicians have undoubtedly confused it with malaria. This view, which he has repeatedly defended before medical and scientific audiences, has been looked upon as extreme and has not been adopted by the American practitioners. Isolated cases of the disease were reported occasionally, but between 1892 and 1902 only about 35 cases were found in the United States, and most of these were imported. Dr. Ashford had, however, shown that the disease is common in Porto Rico. In May, 1902, Dr. Stiles obtained the parasites from three cases which occurred respectively in Virginia, Galveston and Porto Rico, and he showed that they were not identical with the parasite which causes miner's anemia in the Old World. He described this new worm as Uncinaria americana, and using Virginia, Galveston and Porto Rico as the three angles of a triangle, he maintained that this area must harbor a more or less common disease caused by the new parasite. In September, 1902, he started out to demonstrate the correctness of this view and in eight weeks time he proved his point.
The extreme and in some cases nonsensical statements made by the daily press have been startling, but not more so than the more serious and conservative statements Dr. Stiles made before the medical society to which he presented his results. The press has, however, misquoted his statements in more than one particular. His results briefly stated are these:
If we go south from Virginia to the gulf we meet two totally different kinds of anemia, which can be distinguished by the soils on which they occur, the parasites which cause them, the symptoms which result, and the treatment which is necessary. One of these anemias follows the more impervious soils such as clay and is due to malaria, which, as is well known, 13 caused by a minute parasite which lives in the blood and which may be cured by a proper use of quinine. The other anemia, preeminently a disease of the sandy regions, is caused by a parsitic 'hookworm' (Uncinaria americana) which lives in the intestine and which is not affected by quinine but can be killed by the use of thymol. These two anemias have heretofore been confused by most physicians, hence this
