168 The Philippine Journal of Science isw 



some leucocytic infiltration and oedema, the cells of the glandular tubules 

 being largely converted into goblet cells. At the point where the Trichuris 

 was in contact with the mucosa several ova are found in the crypts of 

 the mucosa. 



HOOKWORMS 



In considering the incidence (16.6 per cent) of hookworms 

 in our series, it must be borne in mind that the majority of 

 our cases are derived from a hospital where careful examina- 

 tion of the faeces is a routine clinical procedure and active treat- 

 ment of this disease is the rule. Willets' percentage based on 

 the work of different investigators in the Philippine Islands 

 was 30.57, while his own clinical examination of 4,288 cases 

 gave him a percentage of 54.37. 



Chamberlain, (14) as a result of his own investigations, 

 concludes that "Uncinariasis is found among the Filipinos in 

 probably not over 15 per cent of the general population and is 

 mild in type and of small economic importance." 



While anaemia, the chief symptom in hookworm disease, has 

 been a prominent feature in a large number of our cases, no 

 case has been encountered in which the hookworm was con- 

 sidered an important factor, and the death of the patient has 

 always been ascribed to other causes. However, a not infre- 

 quent finding in our cases has been punctate haemorrhages in 

 the mucosa of the upper part of the small intestine sometimes 

 with slight erosion or, if not actual haemorrhages, minute pig- 

 mented spots. These latter have been interpreted as evidence 

 of residual blood pigment from previous haemorrhage. One 

 case which exemplifies the condition we have encountered, and 

 in which the number of hookworms found was unusually great, 

 is here reported. In this case the bacillary dysentery was the 

 cause of death, and the previous malarial infection along with 

 the dysentery may have accounted for the severe anaemia. 

 Nevertheless, neither of these caused the condition described 

 in the small intestine, and the case does serve to illustrate our 

 findings, at the same time emphasizing the presence of other 

 diseases as being the ones to cause death. 



CASE BEPOBT 



A 24-year-old male Japanese was admitted to hospital four days before 

 death with symptoms of bacillary dysentery, marked anaemia, and an 

 enlarged spleen. The temperature range was between ST'.S and 39°.5 C. 

 Pulse 110 to 140. Fseces contained ankylostoma ova, blood, mucus, and 

 pus. The urine contained a trace of albumin and numerous casts. The 



