SECTION IV
HELMINTHIC INFECTIONS

CHAPTER XXI
ANCYLOSTOMIASIS

History and Geographical Distribution

History.—It is very probable that hookworm disease existed in Egypt in the remote past and it has been claimed that a disease mentioned in the Ebers Papyrus was of that nature.

Goeze found a hookworm in a badger in 1782. He named the parasite Ascaris criniformis. Froelich, in 1789, found hookworms in the fox and named them hookworms from the hook-like ribs of the copulatory bursa. He proposed the generic name Uncinaria. Therefore Uncinaria belongs to the hookworms of the fox and is not valid for any human species.

In 1838, Dubini noted that these worms were generally found in very anaemic cases and that the mucosa of the duodenum or jejunum frequently showed punctate haemorrhages. On account of the four ventral teeth projecting from the mouth he gave it the name Agchylostoma or correctly Ancylostoma.

In 1854 Griesinger, as a result of frequently noting the lesions produced by the worms, stated that they were the cause of Egyptian chlorosis. In 1866, Wucherer connected hookworms with a disease of Brazil called opilacao. In 1878 Grassi noted that the disease could be diagnosed by the finding of the characteristic eggs in the stools of patients.

It was the prevalence of a severe anaemia among the workmen employed in the construction of the St. Gothard tunnel, which Perroncito proved to be due to hookworm infection, that established the great importance of this parasitic disease as the cause of a severe and fatal anaemia (1879). About the same time it became generally considered that the anaemias which affected workmen in mines were of a similar nature.

That the disease was very prevalent in the Southern States of the U. S., as long ago as 1849, is shown by the writings of Duncan, who noted the frequency of anaemia, often associated with dirt eating, among the slaves. He described the oedematous legs, the protuberant belly and cardiac palpitation. There were several cases reported in the U. S. from 1893-1897 but they were mainly in foreigners.