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May 16, 1914


JAMA. 1914;LXII(20):1561-1562. doi:10.1001/jama.1914.02560450043020

Although the presence of one or both of two species of parasitic worms — the New World hookworm, Necator americanus or the Old World Ankylostoma duodenale — is universally accepted as the primary etiologic factor in the hookworm disease of man, one of the most conspicuous symptoms, namely, the hookworm anemia, is by no means satisfactorily determined. Opinion is still to a large extent empirical on this feature of ankylostomiasis. It was early assumed that the habits of the worms in biting and attaching themselves to the alimentary wall would lead to hemorrhages, and that the resulting loss of blood would account for the characteristic anemia. Examination of the small intestines in suitable cases has often revealed a diffuse catarrh of variable severity; there may be large spots of hemorrhagic infiltration each with a worm hanging to its center; hemorrhages may or may not be present. It does not follow,

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