Last updated 10th July 2024: Online ordering is currently unavailable due to technical issues. We apologise for any delays responding to customers while we resolve this. For further updates please visit our website https://www.cambridge.org/news-and-insights/technical-incident
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 15 May 2009
The experience of the last few years in the Westphalian coal-field has shewn that the presence of Ankylostoma in a mine may become a matter of considerable industrial importance. Since it has been shewn that several of the metalliferous mines in Cornwall are throughly infected, the question of how far it may be present in, or spread to, other British mines has arisen in a practical form. When any large number of individuals have to undergo a medical examination for any such purpose it is of importance that such examination should be convenient at once for the examiner and for the examinee, that it should occupy as short a time as possible, and should, at the same time, be reliable. The diagnosis of the presence of Ankylostoma is commonly made by searching for the characteristic eggs in the faeces; and indeed a final diagnosis must rest in nearly every case on the results of this procedure. Which is therefore not easily replaced by any other method when separate individuals are in question. But as applied to a large body of active working men this process has many disadvantages, and at the request of the Home Secretary an inquiry has been made into the practicability of other methods of examination1.
page 438 note 1 A short account of the results obtained has already appeared as a Parliamentary Paper [Cd. 2066], 1904.
page 439 note 1 What proportion of the total number employed underground constitutes a “sufficient number” is difficult to say. In most cases, however, where the worm has gained a footing in a mine, a large proportion—often nearly the whole—of the men are infected. The proportion, no doubt, varies with the suitability of the conditions (temperature, moisture, etc.) for the abundant growth and spread of the larvae; it will be lower in cool and dry than in hot and wet mines. If these conditions are not unfavourable, an examination of 10 per cent. of the men, taken at random, will probably give a very good idea of the frequency of infection. Scattered cases, however, might easily be missed in this way.
page 440 note 1 Journal of Hygiene, III. 1903, p. 111.Google Scholar
page 441 note 1 This extension of the cases, and especially the periodical examinations of the blood in men under treatment, has been rendered possible only by a copious supply of films and estimations of haemoglobin for which I am indebted to Mr. R. A. Thomas.
page 442 note 1 The counts in these tables are all based on the classification of 500 leucocytes; in a few cases 1000 were enumerated.
page 443 note 1 At Dolcoath the total number of underground hands (“complement”) is 717, of whom 148 have been examined=20 per cent.
page 444 note 1 Mast cells present, but not seen in the 500 cells enumerated.
page 445 note 1 Eosinophiles present, though not seen in the 500 cells enumerated.
page 445 note 2 Mast cells present.
page 448 note 1 Considerable leucocytosis present from cystitis due to an enlarged prostate.
page 448 note 1 All these neighbouring mines (Botallack, etc.) have shut down some years since.
page 448 note 2 Complement 478: examined 8½ per cent.
page 449 note 1 Repeated searches failed to find any Ascaris eggs in this first sample; in the second they were very abundant.
page 450 note 1 Atlantic sea-water contains 3·4 p.c. NaCl.
page 451 note 1 Mast cells present.
page 452 note 1 Worked at Dolocoath 7 years since, when he was pale and dyspnoeic: soon recovered in this mine.
page 452 note 2 Mast cells present.
page 452 note 3 Eosinophiles found.
page 455 note 1 Even in medullary leukaemia the blood may at intervals be quite normal. The author has seen such a case.
page 455 note 2 We are I believe indebted to Dr Otto Grünbaum for this happy expression of a truth which is often forgotten.
page 457 note 1 This Journal, III. 1903, p. 115.Google Scholar
page 458 note 1 This Journal, III. 1903, p. 121.Google Scholar
page 459 note 1 American Medicine, VI. 1903, p. 391: some doubt is here thrown upon the accuracy of our observations relative to the existence of high eosinophile leucocytosis due to Ankylostoma because the authors have not been fortunate enough to meet with such cases. Ashford has however himself recorded a good example (7,200 eosinophiles in 18,000 total leucocytes), though he prefers to consider that it was due to a pneumonia of a somewhat hypothetical nature.
page 459 note 2 The very low figures for the haemoglobin (7—12 p.c.) given here must be regarded with suspicion in the absence of any evidence as to the accuracy of the standardisation of the instrument used. I have recently found that in this part of the scale the MiescherFleischl apparatus gives results about 25 to 30 p.c. too low.
page 460 note 1 Our own figures do not shew this clearly, but the number of cases of severe anaemia seen in Cornwall has been comparatively very small.
page 460 note 2 American Medicine, vi. 1903, p. 391.
page 460 note 3 Cabot, R. C., Clinical Examination of the Blood, ed. 4, 1903, p. 433.Google Scholar
page 463 note 1 The opportunity has been taken of shewing in this case that the fluid in blisters from burns and in the various stages of superficial skin infections contains no excess of eosinophiles though in the blood this variety was more numerous than the neutrophiles.
page 464 note 1 loc. cit. p. 394.
page 464 note 2 A doubt was previously (this Journal, III. p. 127) expressed as to the validity of the evidence adduced by Ehrlich in support of his statement that an eosinophilia persists for a long time after explusion of the worms. His statement is, it appears, correct, though the case cited by him does not shew it.
page 465 note 1 This is actually seen in some anaemias.
page 465 note 2 Ehrlich, P. and Lazarus, A., Die Anaemie, Part I. p. 113.Google Scholar
page 465 note 3 The most probable cause seems to be a latent carcinoma; the patient (aet. 51) has symptoms of gastric trouble.
page 465 note 4 It is well to remember that trivial boils may give rise to a very considerable inflammatory leucocytosis.
page 466 note 1 References to a few typical records are alone given. Many other references will be found in the text-books of Cabot, da Costa, Ewing, and Bezancon and Labbé, and in the memoirs referred to.
page 466 note 2 Billings, J. S., New York Med. Journ. vol. LXV. 1897, p. 692:Google Scholar
French, H. S. Practitioner, LXX. 1903, p. 307.Google Scholar
page 467 note 1 Zappert, J., Zeitschr. f. klin. Med, XXIII. 1893, pp. 272–273.Google Scholar
page 467 note 2 Laredde, , Annal. de Dermatol. [3] IX. 1898, p. 1016.Google Scholar
page 467 note 3 Canon, P., Deutsche med. Wochenschr. XVIII. 1892, p. 206.CrossRefGoogle Scholar
page 467 note 4 Ehrlich, and Lazarus, , Die Anaemie, Part I. Transl. by Myers, , p. 150.Google Scholar
page 467 note 5 Guy's Hospital Reports, 1903. It is very desirable that similar statistical records should be prepared for the other conditions in which eosinophilia occurs. Our information rests too much on the records of individual cases.
page 467 note 6 Brit. Med. Journ. 1902, I. p. 1137.Google Scholar
page 467 note 7 Lancet, 1902, II. p. 1540.Google Scholar
page 467 note 8 Brit. Med. Journ. 1903, II. p. 1268.Google Scholar
page 467 note 9 J., Ewing, Clinical Pathology of the Blood, ed. 2, 1904, p. 473.Google Scholar
page 467 note 10 Münch. med. Wochenschr. 1894, p. 22.Google Scholar
page 467 note 11 Thése de Paris, 1901, p. 78: the whole subject of the occurrence of eosinophilia in worm infections is here reviewed.
page 468 note 1 Brit. Med. Journ. 1903, II. p. 1268.Google Scholar
page 468 note 2 Journ. Experimental Med, 1898, p. 315.Google Scholar
page 468 note 3 Clinical Examination of the Blood, ed. 4, 1903, pp. 434 ff.Google Scholar
page 468 note 4 Clinical Haematology, 1902, p. 435: a local eosinophilia was found in the affected muscles.Google Scholar
page 468 note 5 Phil. Med. Journ. IV. 1899, p. 1085.Google Scholar
page 468 note 6 Amer. Journ. Med. Sci. CXXVII. 1904, p. 477.Google Scholar
page 468 note 7 E., Bloch, Deutsche med. Wochenschr. XXIX. 1903, p. 511.Google Scholar
page 468 note 8 Coles, A. C., Brit. Med. Journ. 1902, I. p. 1137;CrossRefGoogle Scholar
G. L Gulland, ibid. p. 831;
Vaquez, C. R. de la Soc. de Biol. LIV. 1902, p. 1425;Google Scholar
J. A Sicard, ibid. p. 1427;
Calvert, , Johns Hopkins Hosp. Bull. XIII. 1902, p. 133.Google Scholar
page 468 note 9 Rembinger, C. R.. de la Soc. de Biol. LIV, 1902, p. 1145.Google Scholar
page 468 note 10 Brit. Med. Journ. 1904, I. p. 73.Google Scholar
page 468 note 11 Boston Med. and Surg. Journ. CXLVIII, 1903, p. 585.Google Scholar
page 469 note 1 Deutsche med. Wochenschr. 1902, p. 468.Google Scholar
page 469 note 2 Münch. med. Wochenschr. 1894, p. 22.Google Scholar
page 469 note 3 Boston Med. and Surg. Journ. CXLVIII. 1903, p. 583.Google Scholar
page 469 note 4 Centralbl. für Bakteriol. XXVI. 1899, p. 608.Google Scholar
page 469 note 5 Johns Hopkins Hosp. Reports, X. 1902, p. 94.Google Scholar
page 469 note 6 Ehrlich, and Lazarus, , Die Anaemie, Part I. Eng. Transl. 1900, p. 151.Google Scholar
page 469 note 7 Thése de Paris, 1901, p. 66 ff.Google Scholar
page 469 note 8 Most of the cases are hydatids of liver.
page 469 note 9 Bezançon, F. and Labbé, M., Traité d' Hématologie, 1904, p. 623.Google Scholar
page 469 note 10 Lancet, 06 21, 1902.Google Scholar
page 469 note 11 Deutsche med. Wochenschr. XXIX. 1903, p. 511.Google Scholar
page 469 note 12 C. R. de la Soc. de Biol. 1901, p. 969.Google Scholar
page 470 note 1 Bull. de la Soc. Méd. des Hôpitaux (3), XVII. 1900, p. 867.Google Scholar
page 470 note 2 Ibid. (3), XVIII. 1901, p. 1126.
page 470 note 3 Zeitschr. f. klin. Med. XLIX. 1903, p. 193.Google Scholar
page 470 note 4 Journ. de Physiol. et Path. Gén. V. 1903, p. 353.Google Scholar
page 470 note 5 Lyon Médical, 05 4, 1902.Google Scholar
page 470 note 6 Clinical Journal, XXIII. 1903, p. 63.Google Scholar
page 470 note 7 Zeitschr. f. klin. Med. XLIX. 1903, p. 321.Google Scholar
page 471 note 1 Journ. Trop. Med. 1901, p. 285.Google Scholar
page 471 note 2 J., Ewing, op. cit. p. 471.Google Scholar
page 471 note 3 Zeitschr. f. klin. Med. XXIII. 1893, p. 244.Google Scholar
page 471 note 4 Fehrsen, A. O. M, Journ. of Physiology, XXX. 1903, p. 326.Google Scholar
page 471 note 5 Brit. Med. Journ. 1903, II. p. 1267:Google Scholar
Morse, J. L., Boston Med. and Surg. Journ. CXLVIII. 1903, p. 573:CrossRefGoogle Scholar
Raybaud, A., C. R. de la Soc. de Biol. LVI. (1904), p. 540.Google Scholar
page 472 note 1 E.g. ehorea: Zappert (loc. cit.) records four cases with 8·7 to 19·5 p.c., and T. R, Brown twelve with 5 to 9 p.c. (Medical News, LXXXII. 1903, p. 1117). J. A. Capps (Amer. Journ. Med. Sci. vol. CXI. 1896, p. 650) records two instances of definite eosinophilia among 19 cases of general paralysis, but the question of worms is not considered.
page 474 note 1 The series which are marked A were examined with cover-glasses, B with the cigarette-paper method, C with slide-smears, and the rest by a mixture of all three methods.
page 475 note 1 E.g. Lazarus-Barlow, W. S, Manual of General Pathology, ed. 2, 1904, p. 151.Google Scholar
page 475 note 2 Following Canon, P. (Deutsche med. Wochenschr. XVIII. 1892, p. 206) who failed to find any in 9 of 22 healthy persons.CrossRefGoogle Scholar
page 475 note 3 Cabot, R. C, Clinical Examination of the Blood, ed. 4, 1903, p. 66.Google Scholar
Ehrlich, P. and Lazarus, A., op. cit. p. 76.Google Scholar
page 475 note 4 This Journal, III. 1903, p. 125.Google Scholar
page 475 note 5 Ewing, J., Clinical Pathology of the Blood, ed. 2, 1904, p. 168.Google Scholar
page 476 note 1 See Bezancon and Labbé, Traité d' Hématologie, p. 487.Google Scholar
page 476 note 2 Medico-Chirurgical Trans. LXXXII. 1899, p. 331.Google Scholar
page 476 note 3 Many of them shew the scattered, irregular granules, staining a metachromatic red with Jenner's stain, which have been recently figured by Ewing, op. cit. 1904, Plate III. and p. 123.
page 477 note 1 Bull. No. 13, Hyg. Lab. U. S. Pub. Health and Mar.-Hosp. Serv., Washington, 1903.Google Scholar
page 478 note 1 Brit. Med. Journ. 1900, II. p. 541.Google Scholar
page 479 note 1 Pork is the chief meat eaten by the Cornish miners.
You have
Access
