The Southern Disease.

Hookworm is an aggressive intestinal parasite that causes physical and mental underdevelopment and other symptoms such as dry hair, ulcered shins and feet, protruding shoulder blades and stomachs, and a general lack of energy. The hookworm contaminates soil through unsanitary privies or outhouses; primarily, victims become infected by walking through larvae-rich soil in bare feet. The disease was common in the rural American South after the Civil War. This "germ of laziness" or "ground itch" created a southern stereotype: poor, barefoot, lazy, deformed, and mentally deficient.

First Known American Cases.

The parasite was first identified in Europe in the mid 1800s. A few American physicians suspected its presence in the United States as well, but the first confirmed case was not reported until Philadelphia physician Abe Blickhalm published an account in 1893. Other cases from Richmond and New Orleans soon...