new discovery clears up a matter of great importance from the standpoint of the practising physician, and it is not an exaggeration to state that it means a revolution in the treatment of fully half of the sick people found in the southern sand areas.
One of the most important symptoms of 'hookworm' disease is an extreme lassitude, both mental and physical; this condition is due to the emaciation and to the thin watery character of the blood, which does not properly nourish either the brain or the muscles. Now, curiously enough, it is especially in the sand areas of the south that the poorer whites, known as the 'poor white trash,' are found, and Dr. Stiles, who has been living among these people for a number of weeks, positively states that it is among these people that hookworm disease is especially common and especially severe. He found entire families and entire neighborhoods affected, and owing to the symptoms which the disease causes, he asserts that this malady is very largely responsible for the present condition of these people. He states in fact that if we were to place the strongest class of men and women in the country in the conditions of infection under which these poorer whites are living, they would within a generation or two deteriorate to the same poverty of mind, body and worldly goods, which is proverbial for the 'poor white trash.'
It is true that the poorer whites are found on clay soils as well as on sand, but Dr. Stiles maintains that on clay soil these people are healthier, stronger and more intelligent, hence that they are better fitted for the competition in life, from which the hookworm disease practically excludes the poorer whites of the sand farms. He has further traced families from sand to clay or to the cities and proved their improvement under the new conditions; and conversely he has traced families from clay to sand and proved their deterioration.
An important point claimed in these investigations is that hookworm disease is especially prevalent among children, and that it not only interferes with their school attendance, but that children who are afflicted with the malady and who have gone from sandy districts to a city have the reputation among their teachers of being more or less backward and even stupid in their studies. All this agrees with well established symptoms of the disease, for it is thoroughly established, not only by Dr. Stiles's investigations, but by observations in Europe and Africa, that hookworm diseases stunts both the physical and the mental development. Dr. Stiles states in fact that he has found patients of twenty to twenty-three years of age who both mentally and physically were not developed beyond the average boy or girl of eleven to sixteen years old.
There are other points in connection with this work, such as the perverted habit of dirt-eating, the presence of the disease among factory hands who formerly lived in the country, the financial loss involved, etc., into which we can not enter here at present. The happiest part of the entire work is that the disease can be easily prevented and that it can be cured. Under these circumstances, we may look for decided improvement among the poorer whites in the sand districts of the south, although this remark is not to be interpreted as meaning that we consider that 'hookworm disease' gives us a complete explanation of all ills in the southern states.
The full report of these investigations will be in the printers' hands this month and will be issued as a bulletin of the Hygienic Laboratory, U. S. Public Health and Marine Hospital Service.
CARNEGIE INSTITUTION OF WASHINGTON.
It is the purpose of the Carnegie Institution of Washington, among other plans, to encourage exceptional talent
