ANKYLOSTOMIASIS  , or ANenYLosTOMIAS1s (also called helminthiasis, "miners'

anaemia," and in Germany Wurmkrank- heit), a disease to which in recent years much attention has been paid, from its prevalence in the mining industry in England, France, Germany, Belgium, North Queensland and elsewhere . This disease (apparently known in Egypt even in very ancient times) caused a great mortality among the negroes in the West Indies towards the end of the 18th century; and through descriptions sent from Brazil and various other tropical and sub-tropical regions, it was subsequently identified, chiefly through the labours of Bilharz and Griesinger in Egypt (18J4), as being due to the presence in the intestine of nematoid worms (Ankylostoma duodenalis) from one-third to half an inch long . The symptoms, as first observed among the negroes, were pain in the stomach, capricious appetite, pica (or dirt-eating), obstinate constipation followed by diarrhoea, palpitations, small and unsteady pulse, coldness of the skin, pallor of the skin and mucous membranes, diminution of the secretions, loss of strength and, in cases running a fatal course, dysentery, haemorrhages and dropsies . The parasites, which cling to the intestinal mucous membrane, draw their nourishment from the blood-vessels of their host, and as they are found in hundreds in the body after death, the disorders of digestion, the increasing anaemia and the consequent dropsies and other cachectic symptoms are easily explained . The disease was first known in Europe among the Italian workmen employed on the St Gotthard tunnel . In 1896, though prev iously unreported in Germany, 107 cases were registered there, and the number rose to 295 in 1900, and 1030 in 1901 . In England an outbreak at the Dolcoath mine, Cornwall, in 1902, led to an investigation for the home office by Dr Haldane F.R.S . (see especially the Parliamentary Paper, numbered Cd . 1843), and since then discussions and inquiries have been frequent . A committee of the British Association in 1904 issued a valuable report on the subject . After the Spanish-American War American physicians had also given it their attention, with valuable results; see Stiles (Hygienic Laboratory Bulletin, No. to, Washington, 1903) . The American parasite described by Stiles, and called Uncinaria americana (whence the name Uncinariasis for this disease) differs slightly from the Ankylostoma .

The parasites thrive in an environment of dirt, and the

main lines of precaution are those dictated by sanitary science . Malefern, santonine, thymol and other anthelmintic remedies are prescribed .