Nov. 19. 19" Hematoxins from Parasitic Worms 385 



Seidelin, and Leon (Guiart, IQ14). Guiart and Garin (iQog) found that the presence 

 of Trichuris eggs in the feces of human subjects is correlated with the presence of blood 

 in the feces as shown by a positive Weber test. 



As to the presence of hemotoxic secretions in whipworms, Whipple (1909), who ex- 

 perimented with extracts of these parasites, found that they contained a hemolytic 

 substance destructive to the red blood cells of the dog and of man. Whipple states 

 that the hemolysin left some samples of human red blood cells intact but was destruc- 

 tive to others. Garin (1913) performed similar experiments with Trichuris extracts 

 and confirmed the presence of a hemolysin in these parasites. According to Garin, 

 the whipworm hemolysin is tliermostabile, being destroyed by 30 minutes' heating at 

 56° C. The inactivated hemylosin can not be reactivated by normal guinea-pig serum 

 (complement) , according to this investigator. Garin states , furthermore , that whereas 

 he obtained positive results with human red blood corpuscles the results of experiments 

 with the erythrocytes of rabbits and guinea pigs were doubtful. 



A survey of tlie literature relating to tlie pathogenic role of Ascaris lumbricoides 

 reveals the fact that this parasite may be responsible for anemia, which is sometimes 

 mistaken for hookworm anemia or for pernicious anemia. The clinical reports of 

 Demme (iSgi) have become a classic illustration of this fact. In brief, Demme found 

 a child suffering from severe intestinal catarrh, with a high-grade pernicious anemia 

 showing a red blood coiuit of 2 ,450,000 and a hemoglobin content of 40 per cent. Two 

 weeks after numerous worms (A. lumbricoides) had been expelled from the child's 

 intestine the red blood corpuscle count rose to 4,200,000 and the hemoglobin content 

 reached 70 per cent. In a second case of apparent pernicious anemia, which resulted 

 in death and in which the erythrocytes had diminished to 1,650,000 per cubic milli- 

 meter, numeroiis ascarids were found on post-mortem examination which were appar- 

 ently responsible for the death of the child . Kuttner {1865) found that in a girl aged 12 

 blood destruction occurred and that this was cured by expelling a number of ascarids. 

 According to Filatoff {189'/), Karaven cured a case of pernicious anemia in a child by 

 expelling a number of ascarids from its intestine. Francois {1906) , in the course of his 

 investigations on anemia of miners, found many cases of severe anemia in which hook- 

 worms were not present but which showed numerous Ascaris eggs in the feces. A 

 number of observations by different investigators on hogs and horses infested with 

 ascarids and on man infested with A . lumbricoides bear out the fact that symptoms of 

 anemia are frequently associated with such infestation. 



As to the manner in which species of Ascaris cause anemia two views have been 

 advanced, which are not mutually exclusive. Guiart {1899), who accepts the view 

 that worms of this genus secrete a hemolysin, inclines strongly to the view that they 

 also lacerate the mucosa, thus causing hemorrhages. In support of this view Guiart 

 describes and figures Ascaris conocephala attached to the stomach of a dolphin, the 

 head of the parasite being deeply embedded in the mucosa. Guiart refers to the ob- 

 servations of Leroiix, who found lesions in the intestine of a human being infested with 

 ascarids resembling lesions produced by ascarids on the mucosa of the dolphin . Fried- 

 berger and Frohner {1895) also support this view and state that dogs that harbor 

 numerous ascarids show on post-mortem examination of the intestine numerous 

 roimd, dark spots, surrounded by an inflamed zone, due, in their opinion, to bites of 

 the worms. According to Garin {191 3), several observers, including Weinberg, have 

 found ascarids attached to the mucosa. Garin admits, however, that despite the 

 fact that he made numerous post-mortem examinations of human subjects infested with 

 A. lumbricoides and of dogs and cats infested with ascarids, in the latter cases shortly 

 after death, attached parasites were never observed by him. He confirms, however, 

 the presence of reddish points sturounded by an ecchymotic area in the mucosa of the 

 intestine of infested subjects, both human and animal. Thaler {1918) has recently 

 reported a case of persistent intestinal hemorrhages in a human subject which did not 



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