Licence: In copyright
Credit: Ankylostomiasis : its cause, treatment, and prevention. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
6/36 (page 4)
![one time that both dogs and horses were capable of harbouring the parasite; but all the investigations made on this point by Tenholt gave merely negative results. On the other hand, ova—producing larvae similar to those of Anhylostominn—have been found by Dr. Bruns, of Gelsenkirchen, in the dejecta of two monkeys, on which he had intended to experiment in this connection; but the absolute identity of the two species has not yet been demonstrated. The life of the worm extends over several years, a fact which has recently received confirmation in the case of several reservists in the German army, who, after two years’ service with the colours, have been found suffering from ankylostomiasis on their return to pit work. Though the disease is very common in tropical and sub-tropical climates, it is confined in temperate zones to workers in mines, tunnels, and brickworks. So far as miners are concerned, it is restricted to those actually working -underground, the few cases observed in Germany of men working at the surface having been traced to their previous employment in the pit. Fear has been expressed that the malady might be communi- cated to the families of affected men ; but the instances in which such transference has been confirmed are relatively insignificant. One recorded case in Germany is that of a miner’s son, aged nine, who was in the habit of cleaning his father’s dirty boots on Saturdays, the latter taking his working clothes home at the end of the week to be washed; and two or three similar instances have occurred at Anzin, the infection having been no doubt communicated -in much the same way; so that, practically, as already mentioned, the complaint is restricted to actual workers underground. Two mining engineers in Belgium have contracted the disease, but this circumstance is attributed to their constant occu- pation in infected pits. The symptoms of ankylostomiasis are those of an anaemic condition of the blood, the lips, tongue, gums, and inner surface of the eyelids becoming pale, whilst the face and tips of the ears assume a greyish tinge. These symptoms are accompanied by the usual con- comitants of anaemia, viz., palpitation, dizziness, and shortness of breath on exertion, the appetite is affected, and other symptoms of gastro-intestinal disturbance are observed; and in the case of the men attacked at Dolcoath, irritating, pustular skin eruptions, locally known as “ bunches,” are reported. In advanced stages of the malady the slightest exertion produces intense lassitude and fainting. It is but seldom, however, that fatal results ensue, the cases observed up to the present 1 having been complicated by pneumonia or other mala- ] dies exercising a contributory influence. Nevertheless, | where the disease has gained a firm hold the conse- I quences are so serious, as regards the diminution of ] energy, that we may have, to quote the words of j Director Meyer, of Gelsenkirchen, with reference to the 1 epidemic at Brennberg, “ an entire working population 1 incapable of labour.” One curious feature of ankylostomiasis is that the 1 symptoms are not in proportion to the degree of infec- 1 tion, there being (in Germany especially) numerous ] instances of men who are found to be infested with the 1 worm (“worm carriers ”), and yet do not experience any I marked degree of inconvenience or exhibit the charac-1 teristic pallor and weakness. For this reason it was at 1 one time proposed to discriminate between such men and those who are actually rendered ill by the disease.® but it is now recognised that - the former constitute an equal danger as regards the transmission of the com- fl plaint to others, and they are therefore subjected to § the same regulations as the rest. The investigations of Dr. Haldane show that the pallor and other main symptoms are due to a deficient percentage of haemoglobin (red colouring matter) in the * blood, whilst the fainting, palpitation, &c., are caused by the defective aeration of the tissues, and in particular ^ of the heart, just as happens in cases of poisoning by carbon monoxide. Measurements of the total volume of the blood show that the anaemia is due to a great increase in that volume, with a corresponding dilution of the haemoglobin, and not, as hitherto supposed, to actual loss or destruction of blood. According to Dr. Tenholt, the poisonous metabolic products of the living worm may in some cases gain access to the blood of the infected person and set up decomposition therein, attended by alteration of the red blood corpuscles and the percentage of haemoglobin. Dr. Haldane has shown that the disease is accompanied by the presence of Fosinnphile leucocytes* in the blood. In view of the variable intensity of the external symptoms, the only reliable means of ascertaining the existence of infection is by microscopic examination of the faeces, to determine the presence of ova, the adult worm never being found except after the exhibition of some vermifuge. The method generally adopted is to make three cover-glass preparations of the undiluted faeces on a single slide, and examine them under a * White bodies distinguished by their capacity for absorbing eosine dye, which stains them a pale red. \ N](https://iiif.wellcomecollection.org/image/b22395052_0008.jp2/full/800%2C/0/default.jpg)
