108 The Philippine Journal of Science im 



make certain that each subject was infested with hookworms. 

 In no instance was evidence secured of the existence of renal 

 disease, malaria, filariasis, or beriberi. Details of the physical 

 and laboratory findings in each subject are given in a series of 

 protocols at the end of this paper. 



Of the eleven subjects studied, nine were males. Ages ranged 

 from 10 to 68 years. Nine were laborers or had been occupied 

 as such in the past, one was a housewife, and the other was a 

 schoolgirl. Five patients came from Carcar, while the city of 

 Cebu, and the towns of Liloan, Mandaue, Pardo, and San Nicolas 

 in Cebu, and Ormoc, Leyte, each furnished one subject. Four 

 subjects (cases 1, 2, 5, and 7) had recently undergone chenopo- 

 dium treatment for hookworm infestation. We recovered small 

 numbers of hookworms from each of these after they had been 

 treated by us with carbon tetrachloride. All four still pre- 

 sented evidence of pronounced anaemia at the time we treated 

 them. 



Study of the blood of these patients showed a high-grade 

 anaemia in all. The total erythrocyte counts ranged from 

 1,380,000 in a heavily infested case to 3,334,000 in a patient 

 previously treated, from whom we recovered only three worms 

 after carbon tetrachloride treatment. 



Haemoglobin estimations, made with the Tallquist scale, ranged 

 from a point below the 10 per cent mark to 70 per cent, the 

 latter in a patient who had been treated before our arrival 

 and from whom we recovered two worms. 



Differential counts were made with some difficulty because of 

 the anaemia, and we regard our figures as only approximately 

 correct. No blood parasites were encountered, and in this con- 

 nection it should be noted that the spleen of only one subject 

 (case 2) was palpable, and that barely at the costal margin. 



No case presented an eosinophilia above 7 per cent. Five 

 cases yielded us no eosinophiles on counting 200 leucocytes. 

 These low figures are in harmony with the general picture noted 

 by other observers in severe hookworm disease. Other counts 

 are shown in Table 2. 



Most of the cases presented a blood picture that might readily 

 be mistaken for that of a primary anaemia. Marked poikilo- 

 cytosis and anisocytosis were present in nearly all of the cases, 

 and nucleated red cells were found in cases 2, 3, 5, and 9. All 

 these details are set forth in Table 1 and appear in the protocols. 

 Preliminary to a discussion of the blood picture and worm 

 counts, it should be stated that stools were collected from the 



