Uncinariasis (Hookworm disease) in Porto Rico : a medical and economic problem . ins in belly, chest, and legs. 15. Debility, fever, pain in body and chest, and uneasiness in Does not know. 26. Dizziness, pain in chest, legs dead. 23. Debility, indigestion, constipation, palpitation, and headache. 51. Fever, chills, dizziness, and weariness. 52. Weariness in legs, arms, can not work. It is perfectly evident after reading this list of first symptoms that the patient has often reached a pretty advanced stage of hisdisease before he realized that he had something out of theordinary. N
Uncinariasis (Hookworm disease) in Porto Rico : a medical and economic problem . ins in belly, chest, and legs. 15. Debility, fever, pain in body and chest, and uneasiness in Does not know. 26. Dizziness, pain in chest, legs dead. 23. Debility, indigestion, constipation, palpitation, and headache. 51. Fever, chills, dizziness, and weariness. 52. Weariness in legs, arms, can not work. It is perfectly evident after reading this list of first symptoms that the patient has often reached a pretty advanced stage of hisdisease before he realized that he had something out of theordinary. Nevertheless, the salient points come out rather strongly as delin-eated at the outset of our remarks on first symptoms. CUTANEOUS The pallor is not usually a mere whitening of the skin. There isfilmost always an icteric hue which rarely becomes true icterus. The as been described as lemon-tinted, waxy white to a tan, tallowy, yellowish-green, etc. We prefer todirty-yellowish or muddy. This is considerably modi-rmar complexion and, in mulattoes, a grayish, pasty. ^LrupM UNCINARIASIS IN PORTO RICO. 51 pallor is noted; in negroes a darker, ashen gray. We have seen adead white skin in blondes. It is very rash to always judge ofanemia by pallor. Aside from the remarks made under pseudo-anemia (see diagnosis, report for 1904), Ave desire to call atten-tion to descriptions of the pallor possessed by some of our patients,and found upon their histories, together with the actual hemoglobino-metric readings taken later the same day: Not very noticeable Hb. 40 per cent. « Little Hb. 39, 42, 50, 54 per cent. Pronounced Hb. 02. 05 per cent. Marked Hb. 58, 80 per cent. Slightly marked Hb. 24, 44, 47 per cent. None Hb. 43, 57 per cent. Relatively severe Hb. 58 per cent. I decided Hb. 74 per cent. Very pallid Hb. 70 per cent. Moderate Hb. 22, 32, 33. 34 per cent. Dirty greenish-yellow Hb. 02 per cent. In general, however, the pallor is a fair superficial guide to theanemia prese
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