Uncinariasis (Hookworm disease) in Porto Rico : a medical and economic problem / by Bailey K. Ashford and Pedro Gutiérrez Igaravidez ... members of the former Porto Rico Anemia Commission, San Juan, Porto Rico, August 5, 1910.

  • Ashford, Bailey K. (Bailey Kelly), 1873-1934.
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Credit: Uncinariasis (Hookworm disease) in Porto Rico : a medical and economic problem / by Bailey K. Ashford and Pedro Gutiérrez Igaravidez ... members of the former Porto Rico Anemia Commission, San Juan, Porto Rico, August 5, 1910. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    CONTENTS. Page. Introduction 1 Conditions affecting uncinariasis in Porto Rico 3 Comments on the early history of the island—uncinariasis introduced into the island by African slaves—social condition of victims of the disease misjudged by foreign visitors. Brief description of the island, its industries, and its working classes in the country districts: physical characters of Porto Rico—population and race—raising of coffee, sugar, and tobacco the chief industry—the impoverishment of the island at the time of the last cyclone due to damage to coffee plantations—social, labor, and economic conditions in the country and how these conditions are affected by and affect the endemic—the jibaro or peasant—the planter—how both are affected economically by the disease—the present organization of the health service—the small value of statistics relating to health in Porto Rico. History of a ten years' campaign against uncinariasis in Porto Rico 23 Anemia in the island previous to November 24, 1899—circumstances attending the identification of the cause of Porto Rican anemia—efforts to secure general recognition of the parasitic nature of the disease—a commission formed to study and report to the insular government upon anemia—resume of this and subsequent work on the island. A clinical study of uncinariasis 36 The clinical types of uncinariasis—reference to notable works on disease— definition of each of types encountered clinically—methods of history taking—cases forming basis of this chapter grouped according to age, color, sex, etc. Prodromes: uncinarial dermatitis—the onset of the disease. The cutaneous system: pallor—cyanosis—petechise—pruritus—urticaria— lack of perspiration—dryness and harshness of skin—burning of palms of hands and soles of feet—atrophy of skin—edema. General development—muscular system—temperature. Digestive system: digestive disturbances not so prominent in advanced cases—the dyspeptic form of uncinariasis—the appetite and geophagy— peculiar markings on tongue—catarrhal stomatitis—symptoms of gastric origin—abdominal tenderness—the feces; presence of blood not easily demonstrable—number of ova in a sample of feces—calculation of number of parasites from number of ova found uncertain. Circulatory system: varied signs found on physical examination of heart— vessels—precordial pain—palpitation—dyspnea—pericardial effusion— pulse—dizziness—tinnitus—syncope—cerebral edema a cause of sudden death. Respiratory system: lack of characteristic symptoms. Urine: albuminuria common. The blood: average hemoglobin percentage in different types of disease— hemoglobin percentage a key to real condition of patient—rise in hemo- globin under treatment—frequent inconsistency between number para- sites harbored and percentage of hemoglobin—reasons for a belief in a poisonous product of parasites causing a toxemia—low hemoglobin not a barrier to manual labor—average red cells per cubic millimeter in different clinical types—rapid rise under treatment—tendency toward microcytosis in return to normal—changes in red cells—the leucocytes—absence of leucocytosis—eosinophilia common—its prognostic value—other leuco- cytes. Nervous system: the mental condition—patients frequently appear as though drugged—hysteria major—uncinarial psycopathies—somno- lence—headache—neuralgia—tendon reflexes—tactile sensibility—impo- tence—amenorrhea—susceptibility to cold—paresthesias. The eye: retinal hemorrhages—night blindness—retinitis—premature cataract—interpretation of eye changes. in