﻿PARAGONIMIASIS IN THE PHILIPPINES, 17 



importance. All flukes are considered to be disease producers, regard- 

 less of the stage of the life cycle of the parasite or of the nature of the 

 host in which they are found. The adult parasites with a very few 

 exceptions, whether in man or other animals, are found only in diseased 

 tissues, and the miracidia and cercaria may produce disease of snails 

 and other hosts in which they may be living. 



So far as 1 have been able to determine, only two cases of trematode 

 infection have previously been reported from the Philippine Islands. 

 One of these was a case of infection with Opisthorchis sinensis Cobbold, 

 reported by Dr. Mallory at the last annual meeting of the Philippine 

 Islands Medical Association, in which the diagnosis of the egg was 

 made by Dr. Strong ; the other was one of schistosomiasis by Dr. Woolley. 



The following paper is the first of a series to be published during the 

 year on material which is already available, as follows : 



One case of infection with Opisthorchis noverca (?) Braun, in a 

 Chinaman; 2 cases with autopsies, in which the infecting flukes, though 

 not thoroughly identified, are probably Fasciola gigantica Cobbold and 

 F. hepatica Linn., respectively; 8 cases infected with Schistosoma ja- 

 ponicum Katsurada, with 2 autopsies ; 18 with Opisthorchis sinensis 

 Cobbold, with 1 autopsy, and 17 with Paragonimus vo ester manii Kerb., 

 with 8 autopsies ; the total being 46 cases in human beings. I have also 

 studied quite a large series of infections in the lower animals. 



These reports appear in monographic form because the observations 

 have included too many points, not only about the parasites but also 

 particularly about the diseases caused by them, to allow of a satisfactory 

 presentation of the findings in any other manner. 



I wish to express my thanks to Dr. Edwin C. Shattuck, resident 

 physician to Bilibid Prison, for many courtesies and much assistance 

 in the observations on the clinical material, much of which is from his 

 service. 



IT. DEFINITION. 



Paragonimiasis is a chronic or subacute, general or local infection, 

 with a species of the genus Paragonimus, only one species of which 

 genus, P. westermanii, is known to infect man. The disease is charac- 

 terized anatomically by the production of peculiar, bluish, slate-colored, 

 necrotic, cystic lesions with rather dense, fibrous walls which contain 

 a material resembling anchovy sauce and usually, but not always, the eggs 

 or adult Paragonimus. Other types of lesions are often present and 

 many different organs may be involved. The most frequent are bron- 

 chopneumonia and bronchiectasis; cystic abscess of the brain, spleen, 

 omentum, pancreas, muscles, lymphatic glands, and skin; and infiltra- 

 tion, ulceration, and abscess formation in the intestine. 



The symptomatology in general is that of a chronic inflammatory 



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