162 The Philippine Journal of Science wis 



As has been emphasized by many clinicians and pathologists 

 dealing with this subject, in by far the greater number of cases 

 the individuals harboring these parasites present no derange- 

 ments which can be attributed to the presence of the parasites. 

 That they can in some cases produce harmful action, either 

 mechanically or by wandering from the intestine to other parts 

 of the body, has been definitely established. Their toxicity is 

 a matter still under active discussion. 



Flury(9) in a chemical and toxicological study of the horse- 

 and pig-ascaris found numerous substances both in the body 

 substance and in the excretions which caused local irritation 

 or necrosis. He was able to demonstrate volatile aldehydes of 

 fatty acids and even the free acids, the principal ones being 

 valerianic and butyric acids, and in smaller amounts formic, 

 acrylic, and propionic acids, alcohols and esters of the ethyl, 

 butyl, and amyl series. All of the symptoms of irritation of 

 the mucous membranes noted by zoologists and the digestive 

 disturbances in ascariasis he attributed to these substances. All 

 of the disturbances of the central nervous system attributed to 

 Ascaris (hallucination, hysteria, chorea, epilepsy, cramps, teta- 

 nus, delusions, psychic disturbances) may be explained on the 

 basis of chronic aldehyde poisoning. A nitrogenous compound 

 was found which caused death with severe haemorrhages in the 

 intestine after subcutaneous injection in the dog. This was 

 ascribed to its action as a capillary poison. Flury concludes 

 that Ascaris produces not a single poison, but a number of phar- 

 macologically active substances which may produce very dif- 

 ferent and at times very severe symptoms. 



Cases encountered in our series exemplifying the wandering 

 of the Ascaris both before and after the death of the host and 

 one where there was a possible toxic action will be recorded. 



CASE 1 



Ascaris in the vermiform appendix. — This case came to us from the 

 operating room of the Philippine General Hospital. A 21-year-old Fili- 

 pina was operated upon to relieve symptoms due to a prolapse of the 

 uterus. In the course of the operation the appendix was found to be en- 

 larged and congested and was removed by the routine method, a ligature 

 being placed about its base. When received at the laboratory the follow- 

 ing record was made: "The specimen consists of an appendix 7.5 centi- 

 meters in length and 1 centimeter in diameter; it is stiff and blue. The 

 superficial vessels are rather prominent. On section through the proxi- 

 mal end the mucosa bulges, and a small amount of thick turbid substance 

 exudes. On opening the appendix it is found to contain a large living 

 Ascaris, the body of which has been cut, apparently a small part having 



