242 . GOMEZ. 



per cent, eosinopliiles 14.1 per cent. The faeces were negative for ova 

 of the hookworm. 



The eosinophilia is possibly due to a toxin secreted by the worm. 

 According to Ashford aad King(8) tliis was isolated by Lnssano by 

 evaporating at a temperature of 60° to 70° the urine of a patient in- 

 fected with hookworms until it became sirupy, then extracting with 

 absolute alcohol and dissolving the extract in distilled water. He made 

 subcutaneous injections of this supposed toxin into rabbits continuously 

 for eight days, causing a diminution in the number of red cells, poikilo- 

 cytosis and rapid formation of fibrin, all of which symptoms disappeared 

 upon the cessation of the injections. The parasites were then expelled 

 from the patient and a similar preparation from the urine afterwards 

 had no effect. 



Bohland(9) also believed a breaking down of the body albumin to 

 occur, due to a poison. 



The persistence of eosinophilia after the removal of the worms is 

 explained by Leichtenstern ^ as a result of the hypertrophy of that por- 

 tion of the bone marrow concerned in the production of eosinophiles. 



The comparative absence of clinical symptoms in hookworm infections 

 in the Philippines probably does not mean the presence of racial immu- 

 nity among the Filipinos, as the infecting organisms are few. Accord- 

 ing to Thomhill,^ there must at least be 500 present for from six months 

 to one year, in order to produce such symptoms, and other patients may 

 develop anaemia and debility as a result of only from 100 to 300 para- 

 sites. 



In Porto Rico, where the disease is evident clinically, Ashford and 

 King (12) counted the number of hookworms expelled from twenty-two 

 patients with the following results : In 9 cases there were less than 300 

 worms, in 8 cases between 300 and 1,000, in 3 cases between 1,000 and 

 2,000, in 1 ease 2,749 and in another 4,397 hoolc^^orms. Therefore, the 

 disease in the Philippines corresponds to the light type of Stiles, (13) 

 in which the patients show ova in the stools, but do not exhibit any, or 

 sufficiently marked, symptoms to attract especial attention. 



CONCLUSIONS. 



1. The most frequent and only subjective symptoms in these cases 

 of uncinariasis occurring alone or in association with other intestinal 

 parasites were vague abdominal pains and loss of appetite. 



2. Eosinophilia was found in a majority of cases, the lowest eosino- 

 phile count being 0,3 per cent, the highest 21.90 per cent. 



3. Hookworm infection among the Filipinos corresponds to the light 

 type of Stiles, that is, patients have the ova of hookworms in their 

 stools, but no' symptoms. 



= Cited by Boycott and Haldane.dO) ^ qj^jJ i,y Seheube.dD 



