Stuff You Should Know - Selects: Southerners Aren't Lazy and Dumb, They Just Had Hookworm

Episode Date: September 11, 2021

There was a time when the lower classes of the American South were considered lazy and dimwitted, a stereotype that still somewhat survives today. But this stereotype was rooted in fact. Hookworms, it turns out, were sapping Southerners’ life force. Find out all about it in this classic episode. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

Hey, I'm Lance Bass, host of the new iHeart podcast Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology is way more widespread than any of us want to

believe. You can find in Major League Baseball, International Banks, K-pop groups, even the White House. But just when I thought I had a handle on this subject, something completely unbelievable happened to me and my whole view on astrology changed. Whether you're a skeptic or a believer, give me a few minutes because I think your ideas are about to change too. Listen to Skyline Drive on the iHeart radio app, Apple podcast, or wherever you get your podcasts. Hi, everyone. It's me, Josh, and for this week's S-Y-S-K Selects, I've chosen a rather peculiar episode that peaks in on a strange and fascinating quirk of nature and geography that changed the course of history. A lot of the sciences and humanities are covered here, and it is a gross

episode, but it's also engrossing. So please enjoy this one on Hookworms and the South. Welcome to Stuff You Should Know, a production of iHeart radio. Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant. There's Jerry Rowland. It's Stuff You Should Know. Here she goes. She just ran away after nine years. I knew that would happen eventually. Yep. She had her little spindle sack over her shoulder. And she's barefoot, which is dangerous, Jerry. That was a nice little setup. Yeah. You might get, what do you call it, the do itch. Yeah, or, well, that's the best one. The ground itch. Do itch is way better than ground itch. Sure. Give a little discomfort

in the webbing between your toes. A little scratchy. Maybe a few days later, you're like, is this athlete's foot? No, that doesn't make you cough. Yeah, plus you're no athlete. Don't flatter yourself. That's what they would say. And then you start coughing a little bit and a few weeks after that, you're just a big dope that can't lift an arm to go stand up and do anything. You have hookworm. Yeah. Well, there you have it. Were you told as a child, like you'll get worms? I knew you were going to ask me that because I grew up in the South. Well, no, I mean, I was told that too. I don't remember hearing this stuff. Really? I remember being scared about scoliosis. And I remember being scared about nuclear annihilation. And so was I.

And that's about it. That's good. Razors and apples at Halloween. Yeah, which is, as we've covered, not true. Any instance that happened of that happened because of the urban legend not giving rise to it. Yeah. No, I never really heard of this. And what made you think of this, by the way? I don't know. You like the parasites. I love parasites. They're interesting, especially this particular parasite, because it turns out the hookworm might be the most interesting of all of the parasitic worms here on planet earth, if you ask me. Well, agreed, because as you will see, the social context in the Southern United States of what the hookworm meant over centuries never knew about it. And it's pretty astounding.

And as someone who has long had to defend the South as not just a backward place with a bunch of dumb yokels, I'm just going to, from now on, I'm just going to say hookworm, look it up. Listen to our episode. And people right now are going, what in the world? So let's get into it. Let's remove the fog of curiosity and maybe irritation a little bit and start talking about hookworms. So we said it starts with your foot. Yeah, these are roundworms. Yes, they're a type of roundworm, a nematode, right? Yeah, a nematode phylum. They're pretty young, about 400 million years old. And they have been described in this article you sent most commonly, as far as the way they look,

as a tube within a tube, like a pair of socks. And then at one end, they have cutting plates, also called fangs or teeth. Yeah, mouth parts. Yeah, mouth parts. And as Tracy Wilson would put it, and they use those things for sucking blood. That's what they want, is your blood, because they get nutrients from your blood, and that makes them parasites. Yeah, and they, as we sourced a few really great articles on this, but as one of them points out too, that a good parasite or a good hookworm doesn't want to kill you, because as it says in this article, that means the ride is over. You're right, exactly. They want to keep you alive and lazy, so they can just keep reproducing and keep sucking on your blood forever and ever and ever.

Right. And in a very large part, hookworms have co-evolved with humans, and they've done so in a way that they get the maximum benefit out of infecting a human without the pitfall of killing the human and ending the ride for themselves, right? Yeah. And they've had 400 million years to do it, and there's two kinds of hookworms mainly. There's tons of hookworms. From what I understand, just about every animal, every mammal has its own type of hookworm, but they don't infect cross animal typically. And there's two types of hookworms that infect humans specifically. There's the new world hookworm, Nercator Americanus. Very open-minded. And then there's the old world hookworm, Ancelostoma Duodinale. A little less open-minded. Right. And so both of them thrive

in warmer, tropical-ish climates, and the Anamericanus in particular loves sandy loamy soil. And it just so happens that in the American South, it has just the kind of climate to host an Americanus, and it's around. Yeah. So here's what happens. We were kind of kidding around about Jerry walking around barefoot, but Jerry's old like me, and she grew up in the South. We all come from sharecroppers and had outhouses. So here's what would happen all the way up until 1985, which is kind of distressing. Yeah, I thought so too. You could walk around barefoot as southern children were wanting to do. Yeah, apparently the chances of being a kid with shoes, especially in the rural South, was like next to nothing up until maybe the 50s or 60s.

Really? Yeah. So they would, like we talked about the do itch, you would walk around barefoot. These little guys would get between your toes, root into your body through the feet, make their way to the blood vessels, and start the voyage to the lungs. This is, it's a fantastic voyage. Well, for them it is. Yeah. It's like inner space. Yeah. Up through the lungs, finally, through the circulatory system to the lungs, where eventually, like you said, you cough it up with a dry cough, and then you swallow it into your gut and the intestine. And that's when it's like, this is where I wanted to be all along. Isn't that nuts? They go up through the foot, circulatory system to the lungs, make you cough,

then you swallow them, and then they finally get to the place where they're supposed to be, the small intestine. And they latch on, and they start sucking blood. Yeah, and hookworms are interesting. Tapeworms are hermaphroditic, but hookworms, like a lot of aroundworms, they need to do it. Yeah. I was about to say they like to. Who knows? Maybe a little bit both, depending on the mood. They have to in order to reproduce. So what you do is they get into that intestine, they find a lover, they take a lover, excuse me, Robert Lamb in here. They take a lover, and then they attach themselves to the intestinal wall, and say, I'm here forever. I've seen up to 30,000 eggs a day. Right. The female will lay 30,000 fertilized eggs a day, right?

And that's on the highest end, but let's say the low end is 10,000. Right. And say the low end is 1,000. It's still a lot of eggs. And that's just one female worm, right? You can have dozens, hundreds of these things. They found that a human can host up to about 500 worms and survive. You're not living a very fulfilling life, as we'll see, but you could have a number of these worms, all pumping out eggs. And a worm typically lives between one and five years in the comforts of your gut. And then you can also be reinfected. And here's how, right? So when the females are spurting out 1,000 to 30,000 eggs, take your pick on a daily basis, you're pooping those eggs out. Yeah. And if you're pooping in, say, like by the bushes,

or in some sort of like outhouse. Yeah, it's 1875 in West Virginia. You don't have indoor plumbing. Right. And let's say your outhouse isn't all that great, or you're just, again, pooping in the bushes. Yeah. You are probably not wearing shoes. Yeah. Those two things usually go hand in hand. And so you're stepping in your old fecal material that still had eggs in it before. Those eggs have since hatched into larva, gone through the first two larval stages, entered the third infective larval stage, and now it's crawling up into your foot again. And your, what's called worm burden is expanded even further from one or two to 10 to 20 to up to hundreds. Yeah. And that's if you just accidentally step in old poo, whether it's like spread around by animals,

walking around, or by the rain. Yeah. The chances of, or exponentially more, if you have a good old fashioned poop slinging fight. Sure. You know. You don't want to get hit in the mouth with that. Oh my God. The other problem that was part of the problem was that, that was the second version of that even, was that people were using poop as fertilizer. Yeah. Now it's one thing, again, you can't really catch, I'm sure you can catch some worms. I know trichnosis is a problem for humans, and that's a pork worm. Gross. But you, using say horse manure is relatively safe compared to using human manure as fertilizer in your field. Yeah. That's a relatively recent discovery. People were using human manure as fertilizer for very, a very, very long time. Yeah.

And it was called night soil, because at night, the guys would come out and clean your, your privy out and walk the muck, your poop, your fecal material down the street and collect more and collect more and then they would turn it into fertilizer. They would say release the night soil right before they dumped it. Exactly. And it would be fertilizer and that'd be great to make your crops grow, but it also just contaminate your entire field with hookworms. And then little kids would go out and work the field, shoeless. Yep. And they would become infected from that too. So there were all these really great opportunities for people to become infected by hookworms. By great, you mean awful. Right. Yeah. But there, the hookworm habitat followed a certain,

a certain line from about West Virginia down to I think East Texas. Yeah. And beneath that line, that was the hookworm belt. Yeah, they called it that. And above it, they used human manure for fertilizer too, but they didn't have hookworm. It was in the south that the hookworm was a problem and it was a big problem it turned out. Yeah. It just occurred to me. We walked right past maybe the best band name of all time in here. What? Wormburden. Oh yeah, Wormburden. It's pretty good. All right. Well, that's the setup before we hit you with the social context. So let's take a little break here and we'll talk a little bit more about my old Kenfolk right after this. advice would Lance Bass and my favorite boy bands give me in this situation. If you do,

you've come to the right place because I'm here to help. This I promise you. Oh god. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh man. And so my husband, Michael. Um, hey, that's me. Yeah, we know that Michael and a different hot, sexy teen crush boy band are each week to guide you through life step by step. Not another one. Uh-huh. Kids, relationships, life in general can get messy. You may be thinking this is the story of my life. Just stop now. If so, tell everybody, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple podcast, or wherever you listen to podcasts.

I'm Mangesha Tickler and to be honest, I don't believe in astrology, but from the moment I was born, it's been a part of my life. In India, it's like smoking. You might not smoke, but you're going to get secondhand astrology. And lately, I've been wondering if the universe has been trying to tell me to stop running and pay attention because maybe there is magic in the stars if you're willing to look for it. So I rounded up some friends and we dove in and let me tell you, it got weird fast. Tantric curses, Major League Baseball teams, canceled marriages, K-pop. But just when I thought I had to handle on this sweet and curious show about astrology, my whole world can crash down. Situation doesn't

look good. There is risk to father. And my whole view on astrology, it changed. Whether you're a skeptic or a believer, I think your ideas are going to change too. Listen to Skyline Drive and the iHeart Radio App, Apple Podcast, or wherever you get your podcasts. All right. So before we broke, we talked about what the hookworm is and all the different myriad ways which it could spread from accidentally walking in poop to poop slaying in fights. Night soil, release the night soil, rolling in it to ultimately increase your worm burden. So you found this great article called How a Worm Gave the South a Bad Name by a woman named Rachel Newer. It's on Nova. Yeah, it was really good. And she is from the South and kind of wrote

it from that point of view. And I get the feeling like me, she kind of has long had to defend the American South as, hey, we're not a bunch of dumb lazy yokels. Because that was, you know, for a long time and still continuing today to a certain degree. Yeah, astoundingly. Yeah, that notion kind of exists that if you're from the South, you're kind of slow. You may be a little dimwitted. You may be lazy. Sure. And this was, you know, for white folks, black folks, Native Americans. Yeah. Just something about the South made you lazy and dumb. Especially among the lower socioeconomic classes. And this wasn't just like off the cuff stereotyping. It was rooted in fact, in reality, there was something different about people of the lower socioeconomic classes in the South

specifically. If you put them side by side among the same socioeconomic classes of the North, the ones of the North would be like, let's shovel some coal, baby. And the ones in the South would be like, I'm just going to lay here down next to my wheelbarrow because I can't get up. And so Southerners came to be seen as lazy, shiftless, couldn't be trusted to do an honest day's work. And they just thought it was part of the Southern character. Yeah. And this wasn't just a perception. Like they literally lagged behind the North in terms of productivity, economic development. And we'll, you know, we'll talk about some of these statistics as we go. Well, plus the Civil War didn't help anything either. Well, no, that was obviously a big setback.

Right. So it would have been in the South. And it would have been for any region, right? At level of devastation and death, but coupled with their already predisposition to what came to be called the lazy germ, it just set it back even further. Yeah. And at one point in the American South, up to 40%, amazingly, 40% of the population, like you said, from Southeastern Texas to West Virginia and all the way down, was infected with hookworm. Yes. That's a lot of people. I mean, it's obviously not a majority, almost a majority. That would have been a dumb Southerner. You got the hookworm. But 40%, I mean, that's a lot of folks.

It is a lot of folks. And that was the culprit behind this lazy shiftlessness among the poverty-stricken Southern poor. And the rural, the poverty-stricken rural Southern poor was apparently the majority of the South from the end of the Civil War up until the, I believe the mid 19th or mid 20th century. If you were a Southerner, it was likely that you were poor and did not live in the city. Well, yeah. Up until about the 40s. And there's a pretty clear demarcation line if you did. If you were wealthy in the South or you were lived in the city in the South in the 19th and early 20th century, you wore shoes, you had bedpans, and you could probably avoid this. But if you didn't, those are the 40%, it says in this

article that it was almost impossible to avoid if you were poor and lived in the South. Right. Because you also didn't have very good sanitation? No. You were just, it was just perfectly set up for you to keep getting reinfected. You know, every couple of years you'd shed a dead hookworm, but in that time you probably would have taken on several more. All right. So what does this mean? If you get hookworm, like we said, it's likely not going to directly kill you. You might die from a common cold. You might die from malaria or

typhoid fever or something else may ultimately take you out because your body is so weakened. But what it does in large part is it causes an iron deficiency. If you're a pregnant woman or a kid, iron deficiency is really bad. If you're a child, you need that iron for your brain development. So not only would you get like physical symptoms like stomach bloat, what was the eye thing like this? The dull fishy stare, fishy eyed stare. Yeah. Just sort of like, they basically describe these kids as just sort of vacant. Right. Just staring off into space.

You know, some of those are physical symptoms, but others were literally like a lower IQ. Right. And so they believe that enamericanus came over as a result of the Atlantic slave trade that it was imported from Africa. So for centuries, generations of kids were being born in the South who had their, they were physically and developmentally stunted by hookworm infections. Yeah. Sometimes girls wouldn't begin menstruation. Boys a lot of times would not even hit their growth spurts and not only where they had lower IQs and learning, you know, development disabilities, but they were smaller and weaker. Yeah. And then you combine this loss of blood. So apparently about a hundred worms in a normal

adult will drink about a teaspoon a day, which doesn't sound like that much. But if you couple it, that level of iron deficiency with a preexisting malnourishment due to poverty or the lack of availability of like good food, then it really becomes a huge problem. It goes from like, this is a problem too. This is, this is a catastrophic problem that can keep an entire region of a country down productive, productively. Yeah. And it, like a lot of disease we've talked about, whether it's like famine or lack of clean water, it's cyclical in nature. So it would occur where there was poverty and then it would keep people from working to work their way out of poverty. Right. And it just kind of compounded on each other. Right. And then think about slavery

as well. Right. So not only have you been brought over to the U.S. as a slave, you're being forced to work against your will in these horrific conditions. You're also being forced to work and live in these same conditions that promotes hookworm. So you're feeling lazy and shiftless. T.S. for you, you're a slave. Add that to your toil and misery. Right. You know? Like it just, it just keeps getting worse. All right. So I think we've made it clear. Big problem in the south. But again, no one had any idea why. Yeah. It was just, you know, the lazy south. And it's, you know, people have said that it literally set the south back like decades and decades from the rest of the country. Right. No one knows what's going on until 1902. This dude came along

and they should be kind of a weird movie to market. Yeah. But this would be a good movie, I think. Oh, I think so too. The story of Charles Stiles and hookworm. It's a big roller coaster, right? All right. So 1902, this guy named Charles Stiles comes along. He's a zoologist from New York City. Educated in Europe, no less. So he played real well in the south. Yeah. Which as you'll see, it was a bit of part of the problem. And the Department of Agriculture said, hey, we need you to help these farmers down there, keep their animals healthy. So go down there and check things out. And he was like, he started to notice he's like, something's going on. These people are physically stunted. They're a little off. Yeah, they're mentally stunted. And I don't think they're

just dumb and lazy. So he started, apparently, he sounds like one of these guys that was just had to get to the bottom of something, you know, like he wouldn't just say, you know, oh, well, everyone's right about how it is down here. Right. So he really stuck to his instinct and realized that it was hookworm. Yeah. He literally was the guy who discovered that that was the problem. Exactly. I think he did that by analyzing stool samples. So he basically just hung around men's rooms and said, like, you're going to use that? And they'd say, no, have at it. I was educated in Europe, by the way. Right, exactly. And the people would just walk away. All right. Is that how it went down? I don't know how it went down.

I looked. Actually, this guy is not the most celebrated person to ever save an entire region from an infection. So there's not, I didn't find a lot of background information on him in particular. So I have no idea how it happened. I saw somewhere that said that he became accidentally infected and that's how he understood, didn't see it backed up anywhere else. I have no idea how this man came to say the aha moment. Right. Yeah. Because again, you got to, you have to be trading in fecal material here. So this guy had his hands on human poop at some point or thought to look there. I'm not sure. Maybe he was in a good old fashioned poop sling and fight. It makes the most sense that he was, he's like, something's wrong. Oh, it's a worm.

The point is though, he was not well received. The local doctors didn't want to hear it. They wouldn't listen. They dismissed him as, you know, this, this carpet bag and Yankee from Europe who, you know, educated in Europe who's down here telling us, you know, he's, he's an animal expert and he's telling us about our poop making us lazy. Yeah, go back to Europe, your animal expert. Yeah, they really didn't listen to him much. So he was like, fine, I'll just go to John D. Rockefeller and tell him, I'm going to tell on you. That's basically what happened. Yeah. Rockefeller was, this is at the time when income inequality was about at the levels it was now and the wealthy industrialists of the age

were really, really worried that they were going to have the social order overthrown by angry people. So they invented philanthropy, right? Yeah, this is back when they worried about that kind of thing. Right. And Rockefeller said, well, we can't just, we can't do anything to actually support the problems that capitalism creates because then we'll just be drawing attention to the fact that there are major problems with capitalist system. Yeah. What else can I support? And he heard about styles and styles took a meeting with Rockefeller and some of his, his higher up friends. And apparently at that meeting, they closed the deal like we're funding this thing with the million bucks right out of the gate, which is about 26 million today. And they set up the

Rockefeller Sanitary Commission for the eradication of hookworm disease. That's right. But despite the fact that they were trying to help Southerners, not only with a medical issue, but to advance themselves as a people. Right. Again, the Southerners, A, they didn't want a light being shown on this problem. Right. Because it's gross and it has a stigma, but they didn't want, again, they didn't want these Yankees coming down there and saying they can fix you. Right. You know. And Rockefeller said TS. He said, I've got an oyster dish named after me. Maybe the best oyster dish besides raw. I'm glad you said that. Should we take a break? Yeah. All right. We're going to come back and talk a little bit about the road to eradication right after this. Hey, I'm Lance Bass,

host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough, or you're at the end of the road. Ah, okay. I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh God. Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh man. And so my husband, Michael. Um, hey, that's me. Yeah, we know that Michael and a different hot sexy teen crush boy band are each week to guide you through life step by step. Oh, not another one. Kids, relationships, life in

general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen. So we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast or wherever you listen to podcasts. I'm Mangesh Atikulur and to be honest, I don't believe in astrology, but from the moment I was born, it's been a part of my life. In India, it's like smoking. You might not smoke, but you're going to get secondhand astrology. And lately, I've been wondering if the universe has been trying to tell me to stop running and pay attention because maybe there is magic in the stars, if you're willing to look for it. So I rounded up

some friends and we dove in and let me tell you, it got weird fast. Tantric curses, major league baseball teams, canceled marriages, K-pop. But just when I thought I had to handle on this sweet and curious show about astrology, my whole world came crashing down. Situation doesn't look good. There is risk to father. And my whole view on astrology, it changed. Whether you're a skeptic or a believer, I think your ideas are going to change too. Listen to Skyline Drive and the iHeart Radio app, Apple Podcast, or wherever you get your podcasts. And we're back in Chuck. We had not just a jingle, that was a real blues song. Yeah, people were like, man, somebody really made an authentic old blue-sounding jingle.

Just for this episode. No, that was the legendary Blind Blake with his song, Hookworm Blues, which is a real song about the hookworm blues. Right. And I think Blind Blake came up with that song in 1926, I believe. And the fact that he is singing about hookworms, starting in the 1920s, represents or just goes to show how much progress was made between the time the Rockefeller Sanitary Commission was set up. And Blind Blake had his number one hit. And in between that time for promoting this idea that there was such a thing as hookworm and that it was a real problem. Because when the Rockefeller Sanitary Commission was set up in 1909, the south was still in basically the grips of reconstruction.

It wasn't the reconstruction era anymore as the Jim Crow south, but it was still really far behind as a result of the war. And there were not a lot of public services available. So one thing the Rockefeller Sanitary Commission had going for it was money, and that it was going to be money invested in public health. All right. So this is how they went about it. It's 1909. And like you said, the Rockefeller donated a million bucks. Which is how much today? 26 million. 26 million. That's pretty good. And they realize, well, I don't, I assume this was kind of a purposeful move that they got a southerner on board to kind of help lead the charge. Definitely. This person named Wycliffe Rose, great name. If there's a hero of this story, it's him if you ask me.

You think so? Uh-huh. Not what's his face? No. Styles? Yeah. No. All right. I mean, he did some great work. It was good, but Wycliffe Rose was the one who... Wycliffe? That's how I pronounce it. He was the one who made it happen. Because Styles could have discovered Hookworm all day long, but if he didn't have the personality to cure people, then it doesn't really help. So this would be Matthew McConaughey then. Right. In the movie. Yeah. So... And what in the... Styles would be Paul Giamatti. And this is McConaughey coming in now. So they get this southerner. He's from Nashville on board to run the organization. And they had this approach where they would go to a town that

they would go to a town in the south with these doctors. But before they did that, they would start this campaign, like an awareness campaign, in schools to get. And as I think we've talked about in other things, you get the kids on board in schools and they kind of help get the parents on board. And they started this campaign to tell children about what's going on. And the kids would in turn, hopefully, go home and tell their parents, like, you know, my pa ain't dumb, I got the hookworm. Right. Look, my poop is wiggling away. Exactly. And it was... You know, they had a challenge in front of them because, you know, you got to poop in a bag or something and give it to your teacher. Your teacher. And entire schools, these one-room schoolhouses,

were infected. And this one kid they talked to later on said... Well, he was a kid at the time. Well, yeah. He was scared. Like he said, he had constipation for a week. He didn't want to... Like, he didn't want to have hookworm. I don't want my teacher to know me in this way. Yeah, pretty much. I don't want to get my teacher's stool sample. Boy, yeah. Oh, never mind. But that was the whole setup, right? Yeah. I mean, like, there was a public information campaign. That was part of it. There was community involvement. That was a really big thing that Wycliffe Rose started. He said, we can't do this without the support of the local community. So they built networks with doctors and local health boards. They got the schools

involved. And it became a community thing, right? Yeah. So once you had the public on board, they would set up these clinics. Not permanent, these kind of temporary clinics. And they would... It was kind of a big deal in the town. It said that they would treat it like an event. And people would bring picnics. I don't know if that's a wise thing to do at a hookworm clinic. But they would bring picnics. And it says in here that some people even wanted to get married in the hookworm tent. And I was like, that seems weird and kind of like kitschy. But then I also was like, I'll bet a lot of these people have never seen a tent before. So they were like, this is our one chance to just stand under a tent. Yeah, yeah. Can we get married in the hookworm

tent? And so there'd be this public information campaign leading up to the day of the hookworm day. You can just call it. Yeah. And a young doctor... They would elect to miss hookworm. Right. To lead the hookworm braid. A young doctor would ride into town on a horseback. And he had a microscope and everything. There was a couple of parts to it. There was the sanitation lecture. Yeah. Which was, here's how you guys are getting hookworm. Here's how you build what's called a sanitary privy. Yeah. Like they couldn't give them indoor plumbing, but they could at least teach them how to have a nice enough outhouse. Right. And there's some very, very simple principles. One is like, don't dig your latrine down until you hit groundwater. Yeah. Don't let it go out

into the stream. Make sure animals can't get into it and like spread it around. Have a good door. Make sure your feet aren't standing in the same pit that you're pooping in. It's really basic stuff, but like that was a big part of it, right? Yeah. And then also explaining how the infection process worked, right? So because they understood very early on that yes, you can get rid of hookworms fairly easily, but you can also get reinfected fairly easily. So they had to get that part across as well. Yeah. And like, again, you can't buy everyone shoes, but you can say, maybe don't play near the outhouse. You got to stop the poop slinging fights all together. Yeah. They just have to be gone. Thing of the past. That's the number one thing.

They're part of the salad days. And then the sample analysis would begin. And the poor doctor would just look with his microscope at each poop sample and say, pass, fail, pass, fail. And if the bag was vibrating, they didn't even have to look. Yeah. Like that cheese in Sardinia, I think. Oh, yeah. With the maggots, the maggot cheese. Didn't we talk about it in a maggot episode? Surely we did. Or both. So if you were found to be infected with worms, you would get very simple pharmaceutical treatment. Really simple. Yeah. There's this extraordinarily toxic stuff called thymol. Yeah, T-H-I-M-O-L. Yeah. And it would kill your worms. Yeah. And it could also kill you if you took it with the wrong combination of foods

and or alcoholic beverages. Yeah. You wanted to avoid alcohol and fats and oils on the day you took it. And then you would follow your dose of thymol with epsom salt, which would remove the thymol from your body. Yeah. And they said at some point, you know what? That stuff is super toxic. So why don't we replace that with something called carbon tetrachloride? That must be much better. No, it was also very lethal. I guess they just, you know, at the time didn't have anything that wasn't also dangerous to take. Right. And that did the trick. And the fact that the epsom salt would get rid of it, I think, helped quite a bit. Yeah. So the great end to this story would be if the Rockefeller's money was well spent and five to 10 years later, they eradicated hookworm in the south.

But that didn't happen. It was successful in a lot of ways. Awareness kind of being the chief way. But as we've said a few times, reinfection is kind of the biggest problem. They might have gotten rid of a lot of hookworm only, you know, to have these kids who couldn't help but have their poop slinging fights and then get hookworm all over again. Exactly. And so, but if you go and read the Rockefeller's, the Rockefeller Foundation's rundown of that program, they basically say it was this one guy who lobbied hard to like just move on, whatever. It was somebody from the Rockefeller Foundation that said, we're done with this, we've done our work, right? Gotcha. And they had, like you said, in a certain way, they had set up some of the earliest public health

networks in the south. Yeah. They had convinced the south that there was such a thing as hookworm and that it was a big problem and that if they were able to get rid of it, they could catch up to the rest of the country. And they said, now the local doctors, now the local health clinics can take over from here. But again, yeah, it wasn't until the 40s that that hookworm really started to be eradicated. And it had very little to do with the pharmaceutical treatments. It was the fact that indoor plumbing became prevalent. Yeah. I mean, it was literally like better food, better plumbing, more shoes. The end of sharecropping, which was a type of agricultural system that kept people poor and kept people in the fields. So it was, it kept the same unsanitary conditions

for hookworm infection right there. Yeah. What did you call it when they would dump the poop? Night soil. Yeah. No more night soil dumping. Mechanization started. And it was kind of a combination of all these just the modernization of the American south is really what ended it. And the proof is kind of in the pudding in that today, in conditions similar to the American south a hundred years ago plus and other parts of the world, it's still a really big problem. It is a really big problem. Apparently something like I saw up to in this article, The War on Hookworms by Andy Borowitz, he says that up to something like 740 million people around the world are thought to have hookworm infections. Right? Yeah. About 40 to 50 million

of which are pregnant women, which is obviously one of the worst, like we said, kids and pregnant women is one of the worst kind of people to get it and the saddest. Right. And mainly because it increases your chances of dying during childbirth because of anemia. Right? So it is a huge problem around the world. There's this kind of moniker for hookworm infection along with certain other infections. They're lumped together under the umbrella of neglected tropical diseases. Yeah. And the reason they're called that is because this is stuff that you can easily get rid of if you alleviate poverty in the developing world, but we're not doing that and it's out of neglect basically. Yeah. It's not the kind of thing where you can just invent the vaccine and it's gone,

again, because of the reinfection because these people are still poor and still in those conditions. We're talking at some of the highest rates are Sierra Leone, Democratic Republic of Congo, Nigeria, Ethiopia, India, Venezuela, Indonesia. Also interestingly, China and Brazil, which kind of surprised me. Yeah. Well, it's the same thing as like the South back in the day where you have very, very, or well off urban areas and very, very, very poor rural areas. Same thing in parts of China and Brazil today. Yeah. And I think another reason, at least this article you sent kind of makes the argument that it's still a problem. In fact, since 1990, it's declined globally by just 5%. Yes. This is really sad. Despite the fact that something like 450 million people

have been treated for hookworm. Yeah. But that declines. It's only gone down 5%. And what that's saying is, as long as there's the unsanitary conditions, there's going to be hookworm, right? So we have to alleviate the unsanitary conditions and you do that by alleviating poverty. And there's a group of foundations like the Bill and Melinda Gates Foundation, World Health Organization, they've gotten together to create this N7 program. And they're trying to end seven of the neglected tropical diseases by 2020. And hookworm is one of them. And there's treatments that's really easy to get rid of hookworm. There's actually a couple of ironic treatments for hookworm. One medication for getting rid of hookworm prevents the hookworms from creating ATP, which is like an energy source.

So they become lethargic and die just like they make you lethargic. The other medication attaches to the hookworm's intestines and prevents the hookworm from absorbing nutrients. So they die of malnourishment, just like they make people malnourished. I don't know if it's ironic or if they're like, we're going to get these things back. Right. So like I was saying a minute ago, part of the big problem with eradicating this is that it's not a big news item. Like Ebola comes along, it grabs all the news and all of a sudden you have a lot of funding. Hookworm isn't, you know, I don't want to say a sexy disease because it's gross, but it's not, it's kind of just oft forgotten. And so they don't have a lot of funding. I'm glad the Gates's are involved

because that, you know, that makes it much more high profile. But, you know, it's still a big, big issue. And hopefully, you know, this will help raise a little bit of awareness. Sure. Well, if hookworm is eradicated by 2020, we'll have played a rather large role in that. But now we have a final twist, correct? Yeah, there is this really great quote from the 60s from a Rockefeller parasitic worm specialist who said that we needed the eventual helminthic defawnation of man saying, getting rid of worms from the human race entirely, right? Right. And he said that for only in a society made up of parasite-free individuals, well, we know of what the human being is capable. Basically saying like, we have no idea how much we're being held back as

an entire race by worms. So we need to get rid of them. But there's this growing body of research, Chuck, that's showing that we actually need to be infected by hookworms it looks like. Well, it can potentially treat a few types of disease. I wouldn't say that humans need it. But right now there's some experimental research going on. And specific to hookworms, it seems that it might help asthma. Okay. There are other worms that they're using that could help with everything from ulcerative colitis to Crohn's disease to multiple sclerosis. But when it comes to the little hookworm, they think it might help asthma. They're not experimenting on humans yet in the United States, I don't think.

I think only in the United Kingdom right now are they using this in humans. But because it's hookworm, the side effects are basically all the things we've been talking about. Right. Everything bad about the hookworm is going to happen to you. Right. The thinking behind it though, because that makes zero sense, like why would that help, is that for some reason, parasitic worms prevent the human immune system from going overboard somehow, right? And that the reason why we have autoimmune diseases like multiple sclerosis or Crohn's disease are because of a lack of parasitic worms in our bodies, because we've eradicated them. So now these other diseases that are autoimmune diseases have been able to rise.

So it kind of is a, like you said, a weird little twist. Yeah, we'll see. I mean, right now they're mainly working in mice and rats. But like anytime you're working with mice and rats, it's, it can't exactly extrapolate that onto humans. So we shall see. There's only one way to find out. For you and I to volunteer. Well, they, you know, I did see some experiments, not for this, but when they were doing hookworm experiments, period, they would infect people with hookworm and volunteers. Yeah. And again, I mean, like it's not like a hookworm is going to kill you.

And if you are not going to get reinfected because you wear shoes and use like a toilet with running water, it's sure. Why not? You do it for science and money. Yes. You got anything else? I do not. Well, we want to recommend the articles how a worm gave the South bad name by Rachel Neewer and war on hookworms from Andy Borowitz. They're both well worth reading. And since I said they're well worth reading, it's time for a listener mail. All right. I'm going to call this a follow up from a very sweet couple I met at the airport.

I think I talked about them after our, I think the Midwestern tour, or no, no, no. It was Louisiana, New Orleans show. Okay. I met this very nice couple who had been to the show. They were, I think, one of our more veteran and wise listeners in show attendees. Okay. They were wonderful. And they stopped me in the airport. We talked for a little bit, and this is from them. Hey, Chuck, I wanted to follow up after the show in New Orleans. We talked to you at the airport while we were waiting for our flight back to Minneapolis. You were very gracious talking to us when we clearly interrupted you on your way to do or

get something. Probably had to poop. We told you our new hobby was going and following you guys around the country and making vacations out of your shows on tour. Remember that? But we haven't made it to a live show since. We haven't done a lot of shows since that. That's true. Well, we've done a handful. We've both been slacking, both parties. Yes, but we're going to hit the road for some shows later this year, by the way. Sure. Stay tuned for that. You and Josh did, however, inspire us and our new venture. We started a podcast just before we left to drive to Alaska in May. Joyce, who is the lady in the couple, downloaded a bunch of podcasts on how to make a podcast. By the time we got back to

Minnesota, we were well on our way to starting Tall Tales and Travel, our podcast about adventures in the outdoors. I don't know if it's L-A-R-R-E. I can't remember if it was Lair or Larry. Lair is probably short for Larry. Maybe. L-A-R-R-E. Which is short for Lawrence, so it's doubly short. I'm going to call him Lair or just L. He has decades worth of stories which have mostly taken place in Alaska. He's been a bush pilot, a charter boat captain, a police officer, and general outdoorsmen to name a few adventure settings. That's a Lair, if I've ever heard of one. Lair does most of the talking and Joyce does most of the behind-the-scenes tasks.

It's a division of labor that we've mastered over the last 30 odd years together. We have a website, TallTalesandTravel.com, where we post photos and videos from Lair's huge archive. Now that we're up and running, we'll be putting more work into sorting and sharing the collection more regularly. By the way, we used Squarespace. Thanks for the dip. Nice. Anyway guys, we're just writing in to thank you for the inspiration and to let you know that we haven't given up on seeing you live again. We're going to keep our ears open and here where stuff you should know will be up next. Plan an adventure to see you there. All the best. That is Joyce Olsen and Lair Broward. Again, check it out at TallTalesandTravel.com

or at TallTalesandTravel.LibsonLibSyn.com. They were just really sweet and nice and supportive and the notion that these people in their retirement would follow us around the country just kind of knocked my socks off. I haven't listened to show yet because this just came in, but I'm going to give it a whirl. Yeah, thanks you guys and congratulations. It's pretty awesome. I guess if we've inspired you, like Joyce and Lair, to do something neat, let us know about it. You can tweet to us at SYSKpodcast. You can join us on facebook.com slash stuff you should know. You can send us an email to stuffpodcast.howstuffworks.com and as always join us at our home on the web stuffyoushouldknow.com. Stuff You Should Know is a production of iHeart Radio.

For more podcasts on my heart radio, visit the iHeart Radio app. Apple podcasts are wherever you listen to your favorite shows. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help and a different hot sexy teen crush boy bander each week to guide you through life. Tell everybody, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple Podcasts or wherever you listen to podcasts. I'm Munga Chauticular and it turns out astrology

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