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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    In the Ponce series of 1902,15 were edematous. Two had edema of the feet alone, 4 of the feet and legs, 4 of the face, feet, and legs, and 5 had general anasarca. In the Utuado series of 1904, 50 were edematous. Twenty-one had edema of the lower extremities, 8 of the face and lower extremities, 4 of the face, upper, and lower extremities, 3 of the face alone, 1 of the face and upper extremities, 1 of the face and trunk, and 12 had general anasarca. Eight of the 50, apart from the cases of anasarca, were noted as having been very extreme. Nine had no edema, and in 2 cases there was no remark made upon this symptom. In the Rio Piedras series of 1900 all had edema, 7 of the lower extremities and 5 of the face and lower extremities. Therefore, of 111 cases (it is true, marked or very marked in over 90 per cent) 76 per cent suffered from edema. As a matter of fact, however, in the out-patient clinic only severe cases were edematous, as a rule, with notable exceptions, as above stated. The edema which we saw in patients who were not very anemic was, as a rule, fleeting. GENERAL DEVELOPMENT. Uncinariasis of childhood is a potent cause of retarded develop- ment and of stunted mental and physical growth thereafter. We have often been deceived in the true age of an individual, persons of 20 years seeming to be of 12 or 15. Puberty is often delayed. In males the genital organs may be undeveloped and the hair of the body lack- ing. In females, menstruation, which occurs here much earlier than in the more temperate climates, may not make its appearance until the age of 18 to 20. We have known cases where children have been born of mothers who have said that they have never menstruated. More than all, many children born of anemic mothers are rachitic and are little resistant to disease and hardship. Among the 100 cases studied in Ponce, 19 of which form part of the basis for a special study of the symptomatology, there were 4 cases of special mention regarding development: Case 8, 11 years of age, was stunted mentally and physically. Case 18, 16 years of age, has matured but little and appears to be from 8 to 10 years old. Cases 81 and 83, each 18 years of age and each with the following- remark : Very much stunted mentally and physically. Looked to be about 10 years of age. Genitals infantile type. In the 1904 Utuado series six are noted as having defects in de- velopment. NUTRITION. The nutrition is generally good. In the Ponce series of 1899, 7 were well nourished, 1 fairly so, 3 were not very well nourished, and 8 were emaciated. In this series the average poor nutrition was in part due to lack of food and priva- tion incident to the hurricane. In the Ponce series of 1902, 13 male adults, averaging 66 inches in height, showed an average of 129.2 pounds weight. Two others were not weighed and the rest were children.