﻿PARAGONIMIASIS IN THE PHILIPPINES. 57 



the intestinal mucosa, the eggs may be found in the fseees and there may 

 or may not be diarrhoea. This fluke may possible at times be the 

 etiologic factor in chronic appendicitis, but the infection will hardly be 

 found confined to this organ. 



(d) Cerebral paragonimiasis. — This important type of paragonimus 

 infection was first recognized by Otoni and Inouye and since that time 

 has received considerable discussion, particularly in its relation to 

 Jacksonian epilepsy, of which it is one of the causes. Other prominent 

 nervous symptoms consist in various forms of neuritis and even paralyses 

 have been observed in this infection. Unfortunately, the brain and cord 

 were removed in only two of my cases — in one because epilepsy was a 

 prominent symptom during the short time the patient was under ob- 

 servation. 



C. PARAGONIMIASIS OF THE LOWEB ANIMALS. 



P. westermanii is known to infect the tiger, cat, dog and hog, but as 

 has been pointed out by Stiles and Hassall, very little is known of the 

 symptomatology and pathology of the disease in these animals. Since 

 the discovery about one year ago of the first case of this infection in man 

 in the Philippine Islands, the following animals have been carefully 

 examined for fluke infection: 



Thirty-two eats with 1 positive result for P. westermanii and in 17 others 

 0. felineus was encountered; 23 dogs with no case of infection with P. wester- 

 manii; 10 rats and mice with no case of fluke infection of any kind. 



Paragonimiasis of the cat. — The case of one animal in which this 

 infection was encountered in the Philippines is interesting. The animal 

 was purchased from a native and was placed in a large cage with several 

 others and left for about one week. When received it was rather thin, 

 but otherwise apparently healthy. At the end of a week it was brought 

 to me by the animal care-taker in a dying condition. Emaciation was 

 marked, food was refused, there was diarrhoea and partial paralysis of 

 the hind quarters. The animal was chloroformed and autopsy performed 

 at once. Paragonimus lesions with eggs and parasites were found in the 

 lungs, intestines and omentum. The lesions were not extensive and 

 both these and the parasites were apparently identical with those found 

 in man. 



IX. DIAGNOSIS. 



A direct, positive diagnosis of paragonimiasis can only be made by 

 the finding of parasites or eggs. Under favorable conditions the eggs 

 may be encountered in the sputum, fseees, scraping from ulcers, and in 

 fluids and tissues removed by operation. 



The sputum should be examined as a cover-glass preparation of a 

 fresh specimen and, in suspected cases, the examinations should be fre- 

 quently and carefully made during considerable periods of time. The 

 eggs are easily recognized under the lower powers of the microscope; 



