XII, B. 1 Garcia: Common Intestinal Parasites 29 



genie in many cases, still it aids greatly in the aggravation of 

 other diseases. That the whipworm is pathogenic in some cases 

 has been illustrated in the report of Musgrave, Clegg, and Polk. ^ 



Four detailed cases of trichocephaliasis were mentioned: two 

 producing severe progressive secondary anaemias followed by 

 death in one and no improvement in the other after one month 

 of treatment; the third producing the symptoms of diarrhoea, 

 muscular cramps, dizziness, oedema, and indigestion; and the 

 fourth a variety of symptoms, which on autopsy showed no cause 

 other than an embolism of the left coronary artery by an adult 

 Trichuris trichiura. The above illustrations and the fact that 

 Trichuris trichiura has been found in the appendix after opera- 

 tion at the Southern Islands Hospital, which confirms the state- 

 ment in several textbooks ^ that it occasionally causes appen- 

 dicitis and wounds which serve as entrance for microorganisms 

 into the blood stream, indicates that more attention should 

 be paid to whipworm infection than it receives at present. 



Ankylostomiasis. — In the great majority of cases the presence 

 of hookworm is demonstrated solely through the routine stool 

 examination of every patient admitted to the hospital rather than 

 because of any symptom of its presence. All the symptoms pro- 

 duced by hookworm infection as described in the textbook of 

 Castellani and Chalmers are seldom observed in the Filipinos 

 admitted to the Southern Islands Hospital. Anaemia was seldom 

 present with hookworm infection among Filipino patients, and 

 those who were anaemic were mostly so due to malarial cachexia, 

 tuberculosis, or some other cause. 



We have had several cases, however, which we diagnosed as 

 true cases of ankylostomiasis. In these cases our diagnosis was 

 based upon the history of eating nonedible materials, such as 

 earth and coal, feeling of laziness of the patient, and the symp- 

 toms of secondary anaemia. On examination of the stools diag- 

 nosis in all these cases was confirmed. 



Ascariasis. — The infection of Ascaris produces mostly no 

 symptoms among Filipinos, and if it does, the symptoms are very 

 variable and not characteristic. One symptom that may be 

 suggested of Ascaris infection is a dull abdominal pain which 

 may or may not be accompanied by fever. Few cases of this com- 

 plaint were observed in this hospital that could not be attributed 

 to causes other than that of infection by Ascaris and in which 



^This Journal, Sec. B (1908), 3, 545. 



s Castellani and Chalmers, Manual of Tropical Medicine, 2d ed. William 

 Wood & Company, New York (1913), 1301. 



