74 Human Intestinal Infections observed in Malta 
In this group worms were of rare occurrence, and the only men of any 
interest were the two infected with Strongyloides stercoralis. One, an officer, 
had lived in Ceylon and was admitted to hospital for amoebiasis. Examination 
showed the presence of S. stercoralis larvae in large numbers. This officer 
suffered no ill effects, and on blood examination no appreciable eosinophilia 
was present. 
The other case was a sergeant who was very heavily infected. Extracts 
from his case sheet may be of interest: 
Age 30. Admitted to Hospital from — Battery, to be kept under observation for 
anaemia. History: Mauritius 1910. Had slight attack of malaria and occasional diarrhoea 
with blood and mucus at times. Headache, and pain all over body and stomach. Malta 
1915. Xo illness. Khartoum 1916. Xo illness but severe headaches. At present complains 
of frontal headache which is continuous, with sudden sharp exacerbations chiefly felt over 
eye-brows. Tenderness over points of exit of superior and inferior orbital nerves. Suffers 
from visual troubles manifested by the appearance of zig-zag lines and distortion in shape 
of objects looked at. Such troubles usually occur during a spasm of pain. Eyesight normal 
during intervals. 
General condition: Thin and anaemic. Left varicocele. Xo abnormal physical signs in 
heart, lungs, and alimentary system. Blood count: Red corpuscles 5,920,000. Haemoglobin 
45 per cent. Differential leucocyte count: Polymorphs 37 per cent., lymphocytes 30 per 
cent., large mononuclears 3 per cent., eosinophils 29-5 per cent., and a few mast cells. 
In view of the possibility of helminthiasis examination of stool was made, and Strongy¬ 
loides stercoralis and Entamoeba coli cysts were found. 
Treatment. The patient was instructed to disinfect his hands each time he used pan. 
He had calomel gr. iv on 14. xii. 17, and gr. v on 15. xii. 17, and the eosinophilia dropped to 
14 per cent. Stools swarming with embryos. Thymol treatment as follows: From 18 to 
29. xii. 17 Sod. Bicarb, yii daily, to clean duodenum of mucus as much as possible. Evening 
of 28. xii. 17 dose of salts Nothing in way of nourishment. On 29. xii. 17, at 6 a.m., Thymol 
20 grs. in capsules; another dose at 7 a.m. and another at 8 a.m. Dose of salts at 10 a.m.; 
a little black coffee and tea at 11 a.m. During this time the patient was instructed to lie 
on his right side, and to abstain from taking any fatty substances all day. 
5. i. 18. Living embryos still present in stools. Calomel treatment, gr. i t.d.s. 
10. i. 18. Still on calomel treatment. Living embryos of Strongyloides still being passed. 
15. i. 18. Calomel dose changed. To start with calomel gr. v on alternate days. 
22. i. 18. General condition not improving: embryos still present. Calomel discontinued. 
23. i. 18. Sulphur ;,ii t.d.s. 
30. i. 18. Strongyloides still present in stools. Off sulphur and put on milk treatment, 
i.e., absolute milk diet and calomel gr. v on alternate days. 
11. ii. 18. Embryos still found. Treatment stopped. 
Group II. 
(See Tables II-V.) I 
This group may be divided into four sections: 
(1) K.A.M.C. and Nursing Staff. 
(2) Other Garrison Troops, including Northumberland Fusiliers, West 
Yorks, A.S.C. and their relatives. 
(3) Maltese Garrison Troops. 
(4) Civilian employees. 
