16,1 Haughwout and Horrilleno: Intestinal Parasites 69 
particularly if they are complicated by Trichuris infection. 
This occurs through vomiting or defecation of the worms, or 
both. 
Helminthal infections were restricted to the Nematoda. No 
infections with either Cestoda or Trematoda were encountered. 
Respiratory diseases other than tuberculosis, influenza, and 
pleurisy were met in 33' per cent of the children studied, and in 
this connection attention is drawn to the recent work of Stew- 
art and others on the life history of Ascaris, it being suggested 
that the lung stages of the worm may be responsible for much 
of the respiratory disease among Filipino children. The dif- 
ficulty of diagnosing these cases is pointed out. 
It is planned to study the faeces of a series of children admitted 
to the hospital for treatment of respiratory diseases (other than 
tuberculosis and influenza). Those children who, on admission, 
are found to harbor Ascaris will be rejected from the series. 
The stools of the others will be followed for several weeks to 
discover if the ova appear in the faeces following the pulmonary 
trouble. Such evidence while not absolutely convincing will, 
nevertheless, be highly suggestive. 
Infection with hookworm was found im 12 per cent of the 
series. Only one severe case is recorded, but it is suggested 
that the traditional mildness of hookworm disease among the 
Filipinos should not bring about a false sense of security with 
regard to it. 
A comparative study of the clinical symptoms attending in- 
fections with Necator and Ancylostoma is suggested with a 
view to discovering if one is more harmful than the other. 
It is also suggested that there should be a reexamination of 
the evidence regarding eosinophilia in all the helminthiases. 
Sanitary conditions are a heavy factor in the infection of 
children, but the weak link lies in the failure to educate mothers 
in the principles of domestic hygiene. A given city may be 
“clean” to educated people but insanitary with respect to the 
child. Campaigns through the schools, visiting nurses, and phy- 
sicians should be instituted and maintained. 
Parasitism starts coincidentally with bottle or artificial feed- 
ing and even breast-fed children do not escape in all cases. 
Domestic animals such as dogs and cats apparently are not 
an important factor in the spread of parasitism among Filipino 
children, so far as our present knowledge goes. 
We believe that intestinal parasitism, both directly and indi- 
rectly, contributes heavily toward the high death rate in young 
