472 The Philippine Journal of Science 1921 - 
ciation for 1919, seven cases in overseas and four in home- 
service troops are recorded in the accompanying table under 
the term Sporozoa. I am assuming that the second paper 
represents an extension of the work reported in the first and 
therefore have considered that Kofoid and his coworkers found 
eleven cases in all, four of which are under suspicion as being 
autochthonous. 
I think we may safely assume that the case reported by me was 
autochthonous in the United Sates, because there was small 
chance of its having been picked up in Japan en route to the 
Philippines, and I doubt exceedingly the presence of human coc- 
cidial infections in the Philippine Islands prior to this case. 
In the United States there is a very suggestive history of contact 
at the munitions works in Nitro, although the method by which 
infection might have been brought about is not so clear. At 
the front the conditions for the dissemination of intestinal para- 
sites were rather favorable, and that, coupled with the thorough 
system of stool examinations carried out by the allied armies, 
explains the comparatively large number of cases that were 
discovered during the course of the war. ; 
Taking all these things into consideration and adding the 
interest in and knowledge concerning these parasites that is 
certain to follow recent work on them, I think we may expect 
to hear of other cases in the United States as well as elsewhere. 
Turning back to the Manila case, we find a state of affairs 
that is not without promise of future developments. When this 
patient stopped at Cotabato in the course of his trip, he lived 
at the local hotel. The sanitation there he reports as very bad, 
the water closet being located next to the kitchen. At Parang 
and Reina Regente, which he also visited, the sanitary condi- 
tions were somewhat better. The method of disposal of excreta 
at these places is what is known as the “can system.” By this 
method, the feces are passed into large gasolene cans to await 
the convenience of the attendant delegated to look after them. 
In well-regulated households the cans are kept covered and are 
emptied rather frequently, and thus secured against invasion 
by flies, cockroaches, and other itinerant scavengers, put not 
all households are well regulated, so that the system sometimes 
breaks down and becomes a serious factor in the dissemination 
of intestinal infections. The methods of disposing of the con- 
tents of the cans is not always what it should be. 
‘TI have not, so far, seen this paper. 
