STUDY OF INTESTINAL PARASITES. 91 



death rate fell to 13.5 per 1,000 per annum. The routine work has been 

 continued and the death rate has remained loM^ In addition to this gen- 

 eral finding, the Director of Health tells me that the fall in the death 

 rate occurred in brigade after brigade of the prison as the examination and 

 treatment progressed from one to another; this is more convincing than 

 the general findings that the fall in the mortality was due to the expulsion 

 of animal parasites from the intestinal tract. Prior to the inauguration 

 of this work deaths had rarely been attributed to intestinal parasites 

 excepting Amoeba coli. This is in keeping with the generally accepted 

 opinion among medical zoologists that the chief influence of helminthia- 

 sis is so to lower the vitality of the host that he is more susceptible to 

 other diseases. 



The statistical results of the examinations at Bilibid Prison were 

 reported by Garrison. (Table III.) It is noteworthy that the hook- 

 worm ranked second in point of frequency. If the treatment for in- 

 testinal parasitism was an important factor in the remarkable decrease 

 in the mortality at this prison, it is impossible to believe that the hook- 

 worm did no injury, as compared to that done by Ascaris, Trichuris and 

 the other parasites present. 



The fact should not be overlooked that Garrison found 142 infections 

 with intestinal worms per 100 persons examined. Considerable work at 

 Bilibid has convinced me that the hookworm is almost invariably as- 

 sociated with one or two, and sometimes more parasites. The results 

 obtained at the prison must not be attributed to the expulsion of 

 hookworms, but to the cleaning of the intestinal tract of parasites in 

 general. It is quite possible that the hookworm occurring alone is of 

 little significance and the same may be true of Ascaris and Trichuris, 

 etc., but that when several infections occur in one individual, they are 

 of considerable importance. I am persuaded that were 10 (instead of 

 one) cover-slip preparations of the faeces of each case examined at Bilibid, 

 fully 98 per cent of Filipinos entering the prison for the first time 

 would be found to harbor one or more intestinal parasites; and that 

 there would be very few single infections. 



It seems incredible that the remarkable fall in the death rate at 

 Bilibid Prison was alone due to treatment for intestinal parasites. The 

 general hygienic conditions at the prison have been improved year after 

 year since the Bureau of Health was given control of the health problems 

 of the jail. In my opinion, some of the sanitary measures introduced 

 contributed to the low death rate during the year in which the routine 

 treatment for intestinal parasitism was inaugurated. On the other hand, 

 the immediate fall in the mortality upon the institution of the routine 

 treatment is quite "too remarkable to be considered as a mere coincidence. 

 The writer believes that the results obtained prove that intestinal para- 

 sitism is of no inconsiderable significance among the Filipinos. 



