204 ^^6 Philippine Journal of Science im 



cles of fsecal matter. This is especially true if the worm is more 

 or less decomposed, when it is rather flabby and pale; it is 

 relatively easily recognizable when fresh or when suspended in 

 formalin solution as passed with the stool. It then shows a 

 grayish color, usually with injected coils along the median line, 

 plainly visible through the cuticle. 



To obtain better specimens than the first eight, on which no 

 spines on the cuticle were seen, as described by Odhner, except 

 one, which showed them around the oval sucker, male fern was 

 again given the same two patients from whom we secured the 

 first batch of worms. This time the stools were collected in 

 vessels containing 10 per cent formalin solution, and eight ap- 

 parently well preserved flukes were recovered from both. They 

 were immediately examined under the microscope; only one 

 showed cuticular spines. In December, 1916, ova of identical 

 description were found again in the course of routine examination 

 of fseces from three charity patients, who were admitted in the 

 free wards for diseases alien to the presence of the worm in the 

 intestines, such as adenocystoma of ovary. Of these only one 

 was treated with male fern, but the specimen was lost, owing to a 

 mistake on the part of the personnel in charge, and further treat- 

 ment could not be undertaken because of the patient's poor condi- 

 tion. 



The symptoms presented by these five cases at the time their 

 stools were examined were anaemia, fairly marked in one of them, 

 with occasional headache and dizziness. The blood picture 

 showed no other changes, outside of a more or less marked de- 

 crease of the haemoglobin percentage, moderate diminution in 

 number of red blood corpuscles, and eosinophilia in some cases. 

 In two cases Ascaris and Trichuris ova were found as well; in 

 one case, Ascaris, Trichuris, and hookworm, and in two the fluke 

 was present alone. All the cases are natives of Zambales, Luzon, 

 the towns whence they came being San Felipe, San Antonio, 

 San Narciso, and Cabaiigan. 



No definite pathological changes have been described as yet 

 as being brought about by the invasion of the intestines by this 

 worm. The fact that it apparently thrives on the host's blood, 

 as shown by the constant presence in the hosts of varying degrees 

 of anaemia associated with reflex symptoms and slight variation 

 in the blood picture peculiar to blood-sucking intestinal parasites, 

 and the perfusion of the digestive tract of the fluke, which has 

 been observed on examination of the fresh specimen, are very 

 significant. 



That the fluke is a common parasite in the intestines of natives 



