‘ — ‘ ¢ t \ ; k f ‘ % ‘ . ; Yooh } ; : i wy, ™ . ‘ \ \A>o VAG THE PHILIPPINE J OURNAL OF SCIENCE | VOLUME 16° JANUARY TO JUNE, 1920 WITH 61 PLATES AND 35 TEXT FIGURES MANILA BUREAU OF PRINTING 1 171585 EDITORIAL BOARD ELMER D. MERRILL, M.S., Editor R. C. McGreGor, A.B., Associate Editor ALBERT H, WELLS, A.B.; GRANVILLE A, PERKINS, PH.D.; A. P. WEST, PH.D. T. Dar JUAN, A.B., PHAR.D.; F. Accaomui, A.B. ¥ Chemistry and Geology H. W. Wane, M.D.; OTTo ScHOsL, M.D. F. G. HAUGHWOUT; STANTON YOUNGBERG, D.V.M. - Experimental Medicine LiBoRIO GOMEZ, M.D., PH.D.; F. CALDERON, B.A., L.M. . VICENTE DE Jesus, M.D. Clinical Medicine W. H. Brown, PH.D.; C. F. BAKER, M.A.; H. S. Yates, M.S., PH.D. O. A. REINKING, B.S.A., M.S.; L. M. Guerrero, PHAR.D. Sam F. TRELEASE, PH.D. Botany C. F. BaKsr, M.A.; S. F. Ligut, M.A.; C. S. BANKs, M.A. L. D. WHARTON, M.A.; W. SCHULTZE; H. O. Beyer, M.A. Zoblogy and Ethnology A. B. BANYEA, Copy Editor CONTENTS No. 1, January, 1920 [Issued April 20, 1920.] HAUGHWOUT, FRANK G., and HoRILLENO, FE S. The intestinal animal parasites found in one hundred sick Filipino children... One text figure. HAUGHWOUT, FRANK G., and YOUNGBERG, STANTON. A trypanosome associated with a fatal disease in the carabao................---..20000---- Three plates and two text figures. FERNANDEZ, RICARDO. Remote manifestations of focal dental in- fections, with case reports.................-...-- ANGELES, SIXTO DE LOS, and VILLEGAS, ANASTACIA. A case of human mrniophtha lle icin nid Two plates. REVIEW No, 2, February, 1920 [Issued May 29, 1920.] TAYLOR, EDWARD H. Philippine turtles Seven plates. COCKERELL, T. D. A. Some bees from Panay FISHER, WILLARD J. Low-sun phenomena in Luzon bs Two text figures. REINKING, OTTO A. Higher Basidiomycetes from the Philippines and their hosts, II SANTOS Y ALVAREZ, FRANCIscO O. A biochemical study of copra meal SCHULTZE, W. Eighth contribution to the Coleoptera fauna of the Philippines be One colored plate and one black plate. COCKERELL, T. D. A. Supplementary notes on Philippine bees............ REVIEWS . No. 3, March, 1920 [Issued June 29, 1920.] TAYLOR, EDwArD H. Philippine Amphibia Ten plates and nine text figures. Page. 77 89 99 109 213 av WYItUUIitvsd No. 4, April, 1920 [Issued August 5, 1920.] McGrecor, RICHARD C. Some features of the Philippine ornis with notes on the vegetation in relation to the avifauna Thirty-five plates. No. 5, May, 1920 [Issued September 18, 1920.] HEISE, GEORGE W., and CLEMENTE, AMANDO. Corrosion of iron in sulphuric acid. Effect of chromium compounds. One text figure. MERRILL, ELMER D. On the identity of Aegiphila viburnifolia Jussieu One plate. ESPINO, RAFAEL B. Some aspects of the salt requirements of young rice plants One plate and nine ae figures. REINKING, O. A. Higher Basidiomycetes from the Philippines and their hosts, ITI....... No. 6, June, 1920 [Issued October 15, 1920.] MERRILL, ELMER D. Notes on Philippine Euphorbiaceae, IIT QUISUMBING, FRANCISCO A. Determination of glucose and starch by the alkaline potassium permanganate method Six text figures. TRELEASE, SAM F. The growth of rice as related to proportions of fertilizer salts added to soil cultures Five text figures. — CocKERELL, T. D. A. Supplementary notes on the social bees of the Philippine islands HAUGHWOUT, FRANK G.; DOMINGO, ELIAS; and DE LEON, WALFRIDO. Protozodlogic and clinical studies on the treatment of protozoal dysentery with benzyl benzoate. II. Treatment of a case of acute balantidiosis; recovery; death from other causes; failure to find the parasites in the bowel lumen and gut wall at autopsy.. REVIEWS ERRATA INDEX Page. 361 439 449 455 527 539 581 603 631 633 647 649 651 THE PHILIPPINE JOURNAL OF SCIENCE | VoL. 16 JANUARY, 1920 No. 1 THE INTESTINAL ANIMAL PARASITES FOUND IN ONE HUNDRED SICK FILIPINO CHILDREN ' By FranK G. HAuGHWOUT Protozoélogist, Bureau of Science, and Professor of Protozoilogy, University of the Philippines and Fé S. HorRILLENO Assistant in Pediatrics, Philippine General Hospital ONE TEXT FIGURE Surveys to determine the incidence of intestinal parasites are not a novelty in the Philippine Islands. Several excellent sur- veys have been made, the results of which are familiar to workers in tropical medicine. So far as we have knowledge, however, nothing approaching a survey by recent methods has been made among young Filipino children. This study can hardly be said to rank as a survey, for the number of cases considered is too small, but they have been studied with such care and thorough- ness as to warrant us in the belief that we have missed few if any of the latent positives. One hundred twelve cases were studied, but twelve of these were dropped because of the death or discharge of the patient before investigation of the case was complete. The study of these cases has involved the examina- tion of more than four thousand five hundred microscopic prep- arations and more than five hundred stool concentrations. In undertaking this study we believed it possible that we might secure some suggestive data that might lead to an in- vestigation, on a more extensive scale, into the possible influence on infant mortality in the Philippine Islands of infestation by 1 Contribution from the Bureau of Science and the department of pedi- atrics, College of Medicine and Surgery, University of the Philippines. 169496 g Philippine Journal of Science 1920 intestinal animal parasites. On reviewing our results and con- clusions, we believe that we have at least been partly successful and that we have developed some suggestive matter. At this time we desire to express our gratitude to Prof. José Albert, chief of the department of pediatrics of the Philippine General Hospital, and a leader in the movement to reduce infant mortality among the Filipinos, who has freely placed the patients on his service at our disposal, and who has in other ways aided and encouraged the work. Of the one hundred children who remained under our control sufficiently long to admit of a thorough examination of their feeces, 92 per cent were found to be parasitized. This is 3 per cent under the number reported in 1909 by Garrison and Llamas(23) in their examination of the stools of one hundred fifty-eight Manila children, but sufficiently high to warrant en- dorsement of the statement by Garrison in 1908? that— The population of the Philippines presents a higher percentage of infection with intestinal worms than has ever been definitely reported from any other people and the condition is essentially a chronic one, the results of which manifest themselves indirectly in the general physical impoverishment of the people and the high rate of morbidity and mortality accredited to other diseases. If there is any one point that has been made clear by this brief study, it is the need for careful investigation of the effects produted by eack parasite we have found. We have studied cases in which we have found as many as six species of para- sites—multiple parasitism has been exceedingly frequent. In the presence of such an array of infesting organisms, showing such a variety of conduct as to mode of life and nutrition, it is exceedingly difficult to analyze cases with respect to the effects produced by the individual parasites. Another striking point is the absence of infections with obli- gatory tissue parasites, such as Entameba histolytica and Balan- tidium coli,* no case of infection with either having been en- countered in our series. Furthermore, Professor Albert informs us that in his practice he has rarely encountered entameebiasis ? Philip. Journ. Sci. § B 3 (1908) 73. *We apply the term “obligatory tissue parasite” to Balantidium coli with a mental reservation. We are of the opinion that Balantidium is rather closely adapted to tissue parasitism, but the fact that the motile forms are frequently found in cases exhibiting no symptoms of colitis implies that it may be capable of living in the lumen of the intestine and deriving its nourishment from the contents thereof over comparatively long periods of time. 16,1 Haughwout and Horrilleno: Intestinal Parasites 3 among children under 15 years of age. He has been able to recall only a very few cases in an experience extending over nearly thirty years. The senior author, in several years’ observation, has seen only one case of infection with Balantidium in a young child. The child was under treatment for bacillary dysentery at the time the ciliates were discovered in its feces; and, al- though the case has since been observed from time to time, no further dysenteric symptoms have been noted. Obligatory tissue parasites, such as Entameba histolytica and Balantidium, when they give rise to trouble, usually produce symptoms of a fairly positive character; not so with the para- sites we have found in this series. We feel we cannot go beyond the statement that the association of Ascaris and Tri- churis seems to evoke a more or less constant symptom-complex which, however, is subject to confirmation by the microscopist. The physician is forced to lean heavily on the microscopist for diagnosis of these cases, simple as they seem, for we have a record of more than one patient in this series to whom santonin had been given for ascarids that were not present in the intes- tinal tract. In only two instances have we failed to detect the ova of Ascaris in the feces of cases that later were shown to be infected through vomiting or defecation of worms. The possible reasons for our failure to detect these infections will be discussed later. Leaving aside, for the time being, a discussion as to the patho- genicity of the parasites we have encountered, it is perfectly clear that they are, to say the least, undesirable guests. The utter misery and wretchedness, if not actual suffering, they produce, apart from any other harm they may inflict upon their unhappy little hosts, are sufficient in themselves to bring about a vigorous repudiation and condemnation of the statements made in so many textbooks of medicine that these parasites are, for the most part, neither important nor particularly dangerous. In dealing with the general problem of intestinal parasitism, we believe that the parasites may injure their hosts in many ways. Among the possible effects that may be produced by them are: 1. The production of antigrowth vitamines or growth-inhibiting sub- stances. 2. The production of substances directly toxic, cytolytic, or hemolytic. 8. Unfavorable effects upon the host through the liberation of the products of metabolism of the parasite. 4. Mechanical irritation of the mucous surfaces by the parasites when present in large numbers. 4 Philippine Journal of Science 1920 5. The conveyance of pathogenic organisms from one part of the body to another. 6. Interference with absorption in the intestine through the adherence of large numbers of parasites to the surface of the epithelium, as in the case of Giardia. 7. Actual invasion and destruction of the tissues with all its concom- itants and sequelz. The children included in this series ranged in age from 7 months to 13 years. The girls numbered fifty-three, and 86.6 per cent of these were parasitized. There were forty-seven boys, 97.8 per cent of whom were parasitized, the incidence of infection in the boys being higher by 11.2 per cent than in the girls. Considered in groups, 66.6 per cent of the children under 1 year of age were found to be infested. This was a very small group, consisting of only nine cases, and we are not inclined to generalize on that incidence. It does show, however, that even breast-fed children are not free from parasitism under the conditions obtaining here. The second group, formed of children between the ages of 1 and 2 years, was shown to be infected to the extent of 73.6 per cent. This gives the total incidence of infection in our series of children between the ages of 7 months and 2 years as 71.4 per cent. We may add that we had no opportunity to examine any child under the age of 7 months. The third group, comprising children more than 2 years and not more than 13 years of age, showed 100 per cent infection. This.group was formed of seventy-two children, all of whom, without exception, were infested with one or more parasites. Notwithstanding the group was small, the results are rather startling. We can only say that there was absolutely no selec- tion of cases, and this fact was discovered only when we began to tabulate and study our results at the conclusion of the exami- nations. The earliest infection was found in a child 7 months old, which was found to harbor Spirochzta eurygyrata and Ascaris lumbricoides. Allowing for the period of development of the worm before ovulation, this infection took place certainly not later than between the fifth and sixth months following birth. Unfortunately we were unable to secure data as to the feeding and other habits of the child. The infection apparently was light, for it was detected only on the second concentration of the stool, and the ova were few and far between. Another child showed an infection with Trichuris trichiura at the tenth month which, allowing for the development of the 16,1 Haughwout and Horrilleno: Intestinal Parasites 5 worm, must have been contracted not later than the ninth month. This, also, was a light infection, although it was detected on the first concentration of the stool. Further reference will be made to this case later on. The protozoal and helminthal findings are recorded in Table 1. In this table are considered only protozoa in the strict sense. “Blastocystis” and Spirochxia eurygyrata are excluded; but, in view of the recent work of Kofoid, Kornhauser, and Swezy (35) and of Brug(5) we include Wenyon’s “I Cysts” under the pro- tozoa without at this time expressing an opinion as to whether they are the cysts of Hntameba nana (Endolimax nana) or “En- tamceba williamsi.” So far as “Blastocystis” is concerned, we record it as a para- site without regard to its pathogenic or nonpathogenic possibil- ities. It was found alone, to the exclusion of all other parasites, in only one of our cases. In each case where we have recorded “Blastocystis,” we have done so only after satisfying ourselves, beyond a reasonable doubt, that we were not dealing with aber- rant cysts of some definitely known protozoén. We have class- ified all intestinal spirochetes as Spirocheta eurygyrata for we were unable to determine, without a tedious and time-consum- ing series of measurements, whether or not we were encounter- ing any of the other spirochetes that have been reported from the human intestine. TABLE 1.—Protozoal and helminthal findings. Total Cases. infec- tions. WESUA DPORUNO A aks BACs; ace Gee oe ee he 33 41 Ith Srl nine ck = ok eek cis ewe ere Seer ee OE CE ar Py eis NTO i ee oa aa cae haw. pe ah ae ae ome 80 138 Ache Bee cy ictlie fe Ge cpg sae ete pte aia pula rte Metco hte Sete i wera ILI Bie See A S - Rices ap ast Mixed protozoal and helminthal infections____._.._--..__-------------..----- OE} ccosteuss Spirotheia euvvourats sleme.c..xicics- 5c: 565 ss ade on ce SF Bcc ee. Petite” MNO a ee ae a 1d focccnecnc, The parasites recorded by us in this study lie in thirteen genera and as many species. We have adopted Brug’s designa- tion(5) of Entameba nana as Endolimax nana, and in the case of hookworm infections we have made no attempt to distribute them between the genera Ancylostoma and Necator, but have simply recorded them as “hookworm.” The incidence of the various parasites is set forth in Table 2. Table 2 shows Trichuris trichiura to be the most prevalent 6 Philippine Journal of Science 1920 TABLE 2.—Incidence of protozoa and helminths. Parasite. Males. |Females.| Cases. Spirochzta eurygyrata “Blastocystis” POMEL UN re eae eae abe ns Semstiocisias Witwer e Sae ow cone wee ce ackdes Drennan Treirael > Ss Se, ss oo es i Be wan Ca ome Trichomonas intestinalis CFCC Un et SPORE a cg ew wn ca ck wee eces ee nee Sean e Gie Orh s o s eeeeee Chilomastiz mesnili 8 2 34 to o Orme & oO & wo cs oad oo te m 9 em Broornwanm > Loud oo parasite in the series. Spirochxta eurygyrata comes next, and Ascaris lumbricoides, third. Table 1 has shown the compara- tively low incidence of protozoal as compared with helminthal infections, a condition we shall discuss farther on. It is to be noted that no evidence of either cestode or trematode infection was discovered in any case. By far the greater number of patients studied resided in Manila, only twenty-three having come from the provinces. Ob- viously we have dealt with too few cases to enable us to draw any conclusion regarding either geographical distribution or the incidence of any particular parasite in the several localities. In- cidentally, we might remark, however, that previous work has shown that the geographical distribution of animal parasites in the Philippine Islands is somewhat irregular, the trematodes, with the exception of Echinostoma ilocanum, for instance, being found in the southernmost provinces only. A thorough bionomic study would undoubtedly reveal the reason for this seemingly anomalous condition. Be that as it may, however, 92.2 per cent of the children residing in Manila were found to be infested with parasites. Only one child in the provinces was uninfested, thus giving us a provincial incidence of 95.2 per cent. This child was 1 year old and had always been breast-fed. The locality from which it came is not renowned for its sanitation, but the immediate sur- roundings of the child were, nevertheless, “clean.” We have made careful inquiry into the immediate home sur- roundings and habits of these patients and the water drunk by them—as to whether it came from wells, the city water supply, or some other source. We are led to the conclusion that the 16, 1 Haughwout and Horrilleno: Intestinal Parasites 7 immediate surroundings and the water drunk have less bearing on the incidence of parasitism than is generally believed. We have recorded children living under the best hygienic conditions as regards cleanliness of surroundings but who, notwithstanding, were more or less heavily parasitized; and, in contrast, we have found instances where the children lived in surroundings that were filthy and overcrowded, but who survived the ordeal and failed to exhibit the slightest evidence that they were parasitized with either helminths or protozoa. It is perhaps easier to ex- plain the first than the second condition. The geographical distribution of our cases is set forth in Tables 3 and 4. TABLE 3.—Incidence of parasitism in Manila, [ Para- ‘Not pal District. Cases. | sitized. | sitized. Pah ae eet ek os oc) eae eee aes bn heeds saee 2 1 1 TOUTE Ste es ee GAG te ea Ce on buet caanal ad ak cue 5 @ feos Pe PGeenivee oe . e e ea e 1 Riladeeece LOO iiss 5 a va, a tiene ae bons Hed oeeaaewes mae ae 7 sf CE ee rs So a sas a le eee eaceakne see 10 1 Bataan DROID oe es ee ig pannisnblac ene beedaealigs 1 be Patten s tes Rultipe os. a kes aoa Skee 1 | ae eee aa UNO gigi ooo i ee re ea ic renin ss Snes Sei eS ener 9 8 rt FO tha ind DEO Re eager oe no oh re mee oy fama nn A 2 1 1 Pome WOON ee ase er oe ee, Se eS ae 1 5 Ree ee Dts Ae ee ee ees 4 tg are gi WO SATIN SS eh ee Baca bap ae Roane 1 Ay ea ee eee Pench UE oo oe ce a ae eae eee ee ee ee aes 12 9 3 atte Missi ooo ee a ee ee 8 8 eek SR Ca or ig eee eee 6 Dk et Eater SRN ob pilin snc ee Sea ese ae er EE on on ee de ee 5 DS Bee sears ONS Cota. Somas Seti a eee ok ee bl eee eege poe umece 2 _ 5 Rar es MOAT ITNED oo oes 5 sa es ee wn We ec 5 Cite TNO os os ac Saisie eae cs kaw ae cums aaa ey 7 71 6 TABLE 4.—Incidence of parasitism in the provinces. Province. Cases. ginny gard rag fT Be a een GSE eae Dem oe penn eral Ree, oe | ee 1 UAC oe eee er ce ee 1 Ee amen aren Te A So ee. a ee a ee 1 Pisa Ria i a aa te cepa pened iad ant Sateen ost meee 5 Paes ent 2 Sl gS seen apes Seer econ Ie Kwa ei Z 1 5 Plewic eaatean te Nueva Ecija ie se ene pe re oe ee oe eee es eee 1 be Say ea on RT ee ae occ ek See ce ebiee 2 Ee ager oe on PNG oe ae Sig on, 2 | i BRE aeee RR a a a a es a ee a a ae on ae, 9 . g eee setae, x a ae ear wcanie ec cue 23 22 1 8 Philippine Journal of Science 1920 MATERIAL AND METHODS The cases were all drawn from the pediatrics ward in the Philippine General Hospital. There was no selection, the pa- tients simply being taken as they were admitted. The larger proportion included children admitted for the treatment of dis- orders of the digestive and respiratory tracts, which prepon- derate over other diseases treated in the children’s wards; but there were cases of malaria, beriberi, chorea, and other maladies. One or two developed cholera (a_disease notoriously difficult to diagnose in children) during their stay in the hospital. Rela- tively few came in for treatment directed specifically against parasites. The general plan comprehended at least five separate stool examinations, extending over seven to ten days, as circum- stances permitted. At each examination three cover-glass prep- arations of the fresh material were carefully studied, five slides were fixed and stained for subsequent study, and at least 1 gram of the stool (samples being taken from different parts of the stool) was concentrated by the method of Cropper and Row. (10) In the examination of the fresh specimen the feces were diluted, when necessary, with physiological salt solution faintly tinted with neutral red. Cysts were studied with double strength Gram’s iodine solution containing a small amount of glycerin, and with Aragao’s modification of Hayem’s solution. The former was found to give the best results. A careful study in each case was made of the cellular exudate, and in nearly every case the microscopic diagnosis of bacillary dysentery was confirmed by the clinical course of the disease. The feces were not examined bacteriologically. The stained preparations were all fixed in Bouin’s picro-aceto- formol solution. Two of the five were stained in Mayer’s hem- alum, which is admirable for cysts, and the other three by Dobell’s iron-hematein, which gives beautiful results with tro- phozoites. Occasionally smears were treated by the Benians Congo-red method for the demonstration of spirochetes. The latter were very frequently detected in the fresh material and always appeared in the stained preparations. Smears from cases infected with flagellates were occasionally stained by Giem- sa’s method after methyl-alcohol fixation (following brief ex- posure to the vapor of osmic acid), because this gives an ex- cellent demonstration of the flagella which can then be readily counted. 16, 1 Haughwout and Horrilleno: Intestinal Parasites 9 We used the ether-concentration method of Cropper and Row in preference to any of the excellent flotation methods, because our experience bears out that of Cropper and Row that solutions of high concentration have a tendency to distort protozoan cysts, thereby rendering their identification more difficult. The flotation method is unquestionably an excellent and convenient one when the search is restricted to ova of helminths. In no case did we detect cysts of protozoa on concentration that we failed to find in the course of examining the slides of fresh or stained material. Our method did not differ essentially from that of Cropper and Row, except that we emulsified the feces in a test tube. The lumps of feces were transferred to the tube with a small amount of saline solution and then thoroughly broken down and emulsified by stirring with a glass rod. Saline solution was gradually added and the stirring continued until there was complete emulsification of the mass. The maximum amount of solution was then added and the tube thoroughly shaken for several minutes. The entire sediment left in the centrifuge tube was examined microscopically. This method, of course, necessitated careful attention to the cleansing of all utensils. This was not entrusted to the labor- atory attendant, but was performed by one of us. All the ap- paratus was thoroughly washed off in a strong stream of running water, carried into a jar of strong lysol solution, and repeatedly scrubbed out with a stiff test-tube brush, the lysol being changed several times, after which the apparatus was again subjected to running water and carefully dried with absorbent cotton rolled around a small stick of wood. Notwithstanding our figures are not widely different from those recorded by careful workers in the Philippines in the past, . we would, had we not employed concentration methods, have missed 32.6 per cent of the helminthal infections. Table 5 shows the infections picked up on concentration that were missed on direct examination. TaBLE 5.—Infections detected only on concentration. Trichuris 31 Hookworm 8 Ascaris 5 Oxyuris 1 Total 45 Furthermore, two cases (Nos. 20 and 34) were missed in the laboratory, but later proved to be infested with Ascaris through 10 Philippine Journal of Science 1920 the vomiting or passage of worms by the patients during their stay in the ward. Several factors, some of them rather remote to be sure, may intervene to defeat a laboratory diagnosis in certain cases of nematode infection. The parasites may be present in exceed- ingly small numbers; but in such cases, unless one or more of the other conditions to be mentioned is present, the infection is almost certain to be detected sooner or later, especially if con- centration methods are employed. The worms may be too im- mature to produce eggs. In such an event a wait of three or four weeks at the most, in a suspicious case, will probably settle the matter. Such cases would hardly be likely to develop symptoms, however. All the worms present may be males— a remote pdéssibility, but one that has been shown by Hall (25) to exist in lower animals. Added to these is the difficulty ex- perienced in handling dysenteric stools, especially those contain- ing considerable mucus; but we believe it is possible, in the greater number of such instances, to pick up helminthal infec- tions during the course of a series of examinations such as we have conducted. We failed to detect the ova of helminths. in six individuals among the twenty-two cases of ileocolitis that occurred in our series. Of these six negative cases, four were found in the group of children between the ages of 1 and 2 years, eight cases of ileocolitis having occurred in that group. This group has been shown to have yielded 26 per cent less infections than the other higher groups and about 7 per cent more than the 7 to 12 months group. However, it must be admitted that stools of that character are trouble- some and uncertain to deal with, but as we were taking the general run of cases, we had to deal with conditions as we found them. Incidentally, we might remark that we were un- able to determine any marked tendency to expel worms during the course of a febrile disorder. It did occur in some instances, but it was not an invariable event. For some reason or other the ova of Ascaris and Trichuris occasionally failed to come down on centrifugation. This oc- curred ten times in the case of Ascaris and five times in the case of Trichuris. The infections, however, were either detected on the slides or were thrown down in subsequent—or, in some cases, earlier—concentrations. One very odd situation was afforded by a case that was persistently negative for Trichuris on concentration and on examination of fresh cover-glass 16, 1 Haughwout and Horrilleno: Intestinal Parasites 11 preparations. It was marked negative until a solitary egg of Trichuris was found on one of the stained preparations. It would probably take careful study to determine the exact reasons for these occurrences. It seems likely that they were due to some error in technic such as insufficient dilution on shaking of the emulsion, or slowing down or speeding up of the centrifuge, which at times ran irregularly. In the case of Ascaris it has occurred to us that possibly the gelatinous coat of the egg may at times absorb ether and prevent the ova from settling in the separatory funnel. Out of the twelve hookworm infections found, four were diagnosed on direct microscopical examination of the fresh feces, the remaining eight being found only on concentration. Many of the protozoal findings were not made until the stained preparations were studied; because, for the most part, they were light infections with the exception of those with Tricho- monas intestinalis, which usually were fairly heavy. It was necessary, however, to study the stained preparations for the identification of Endolimax nana and Dientameba fragilis, and to count the flagella of the trichomonads. The hemalum prep- arations served as a check on encysted forms of the ameceboid group, but Dobell’s method gave the best pictures of the cysts of Giardia and Chilomastiz. Before passing on to a detailed consideration of the various groups of children, it seems worth while briefly to mention those cases that were not parasitized. As has been said, all of these occurred in children under the age of 2 years. Of these (eight) cases, one (case 32) is known to have been parasitized in the past, for it gave a history of having vomited an ascarid before admission. Like the others, this case was persistently negative on repeated examination, so there exists the possibility that the worm vomited was the only one with which the child was infested. The data on these cases are presented in Table 6. It is interesting to note that, notwithstanding five of these children were seriously ill, there was only one death in the nonparasitized group. This was the case of a girl (No. 52) with a severe ileocolitis that ran a protracted course of more than a month. The child developed a secondary stomatitis and finally died of exhaustion. She had been ill for three weeks before coming to the hospital. There were nine deaths in the series, only one of which oc- curred in a nonparasitized child. This was the case (No. 52) 12 Philippine Journal of Science 1920 TABLE 6.—Cases not parasitized. [R, recovered; I, improved; D, died.] Case.) Age. | Sex. Diagnosis. pin ioe oe yr e eeu ese So aes Speers eee eer — Mos. | 3 24} ¢& | Meocolitis with secondary bronchitis; severe_____..-.-_.------------...- R 5 le} 9} Heoeohtia: moderately tevere —-<. 2025s Sa eee I 32 22} @ | Bronchial asthma; rachitis; indigestion. (Vomited an ascarid before I admission.) 76> 4 Seon tes SOCOnUeSy AOGIMMMUILIN. oo i eeeeue D | 57 Beh tor eatiors ee ec eee R SORE Sse Fs Bees ee re Se es aa ed R |. 8 18} co | Bronchopneumonia; moderately severe __........--...-..-..------------ I 100 12} 2 | Malaria with secondary splenomegaly _..-..-..__.-.-_---..---------_--- I that has just been mentioned. Strangely enough, not one of these was infected with protozoa sensu stricto. The data on these cases are presented in Table 7. The age distribution and incidence of the several parasites together with the number of cases in each group are presented in Table 8. Inspection of Table 8 will show that infection with Spiro- cheta eurygyrata, “Blastocystis,” Trichuris, and Ascaris takes place exceedingly early in the life of the child, and these parasites are found in children of every age up to our limit of 13 years. Hookworm infections in Manila and the vicinity apparently do not get a fair start much before the sixth year, only an isolated ease having been picked up between the third and fourth years. Protozoal infections begin to take place after the first year and are more or less uniformly distributed through the series there- after. Tables 9 to 21 summarize the laboratory and clinical data throughout the entire series. It has been found interesting to break the series up into thirteen groups representing each year of the child’s life, for it was felt that such an arrangement might form a useful basis for comparison in later work. The parasites recorded represent only those found in our laboratory examinations, without reference to the passage or vomiting of worms before the child entered the hospital, or to the cases where children vomited or passed ascarids in the ward when laboratory examination had failed to discover the ova. There were only two such instances. The clinical diagnosis is that made in the ward and does not necessarily include the laboratory diagnosis. It is mainly a record of the salient features of the diagnosis as made when 13 Intestinal Parasites . . Haughwout and Horrilleno 16,1 Spampey’ Sepanepepay, [sneer eee pr nn ere eed ica i male ky ete ae BuoUMaUdoYysUOIG ‘syyoo0eT| 6 | 0 8 | 86 SY re ne ne ee ee, es ee 813}Aj3u4S GnoussSues ‘eyj ooo] | 18 TT | 16 OaaEeY Tange AL To ee eee ee ee ee osey souay [wuyseju; ‘ploydsy | P |O OL | 9 Srocenns eae ete nee enc rore e eE et ae ae nee ee ee eee uoRsneqxe ‘sjyo00q1T | 6 |B TT | a9 erimosy eLenyor4y j-~-~-""~-"==|eoro mn way, rere. | ee wjuounsudoyoucrg | P /0 fT | 9 a sang af 9 2 IS Te RM BRT eee ae ee SAyuoyjzod snojmoseqny,| P |O0 8 | 88 “ULIOMIOOY ‘opLvgey’ ‘etsnyoRaL j-~~—°" 9" net | - Sean orn ase ose esnnnan ore mere nse | mao ancestries «ae uolsnye puv Astinefd ‘aysojnoseqny, |; 4 (0 Lb tad OPANYOPAE [on errr ene enen ee ea eit ee ee Bywesdi7das tayypwUIOys *e19}]0900]] | 4 | 0 8 st “ORO SRAM AL Te ee re ee ee SHASups eQyoooyy) § |O 8 | IT "BOUL “BAX | “sy}UyUTeH “BOZOJOIg “snoaus[[90s]]q iain “eaneg *xog ‘By =| ‘esND “punoj sejjsurvg *s28nDvo 7D wolf 8yve—T—'), TIAV], 14 Philippine Journal of Science 1920 ¢ TABLE 8.—Age distribution and incidence of parasites. : sees es 3 S 3 ts 3 “ia = PS 8 3 A oe ee ‘ 3 lsi18i21el8 28 ga 5 & 813; 8) "/& 21'S 2 ‘ = ~ * = 5) se aS 8 > =| -8 BT | a oS ee eS ae ie 3 |b = Age. s|$i8/ 3) 2) 8| 3] & =| 5 5 Sieit| cletaeli erates Sri el $ bigsimi 8) 8/818) § Sic |e] 3s 7 FS e/2| 8/818) 8) 8lsl2| si) a] 8]s1s]2 SISiSlelsl sl sisi S| slal sl Bl elt ais] a 3 = ee ag ee ee “ais v S18 i 8Risei & STs Sislio;ys Pires % S| SIME EIS EIS Ss Si al Fl si sis SlalP gS SAS lS( Solr isi stasis oe BEES Gece 7 months to 1 year -._._.-_--__- O64 Pea ee ol Se ee 1202 PORN. Se Py AO Pe ee Rese tcc et oe eects Pape SORE Soo Sh eS Pas lecal Ae wecteecs] oe Le a ee eee Stout ST Si Blt A 8 ato 9 vena os pe ee Re el eee eet | a eae a dea ee oe a es ee to 6 yee. cos Se ee ee ee a, oe Be 6-UG7 FORPS . os 8k he ce UB peR Ge © me Se ce ea See en ee oe 33g, SEERA ee SS Sr 6. £9 ST 0 ae tt 4 a Sto 0 years 226 S28 8 ee ee ee el ET SS 8 ewee 0 to 0 years... oo ay BG Oe es ee ee 6 ee cee 100 ti ees. SSS oo 6 ee Boke Se gis eee Onn, Sa Bee AS ioe RS itm Bere. Ce air te we Epos SS et ee 8 es Sue te VOR Since nse eee a Re ad Bat fae eS prec a a | ee ee Jase ee A foe ekes MAS BAS oo cece 100 | 61 | 84 41.74 8720 8) 1) 3 2|69|56/12/1 1 the patient was received in the hospital. The termination re- cords the status of the patient at the time the entire series of observations was concluded. It was necessary to record them thus, because several patients remained in the hospital after the work was completed and others were transferred to other institu- tions and thus passed out of our control. By physical development should be understood the condition presented to the physician on admission—that is to say, the gen- eral physique and nutrition of the patient as brought out in the usual physical examination. Circumstances made it impossible for us to make an exact determination of the mental development of these children, such as the application of the Binet-Simon test. The mental fitness of each child was simply appraised after watching its conduct with its toys and with the other children in the ward, the readi- ness with which it answered questions, and its general ability to talk, walk, and otherwise behave in harmony with its age. In later work it would probably be found desirable to enlist the codperation of a specialist in child psychology, or, failing that, it might be found convenient to use the Standard Score Card for Babies as outlined by the American Medical Association. This has already been employed in an interesting series of obser- vations on Filipino children by Albert and Arvisu.(2) i ‘pon 16, 1 Haughwout and Horrilleno; Intestinal Parasites 15 Unless otherwise noted, the column devoted to abdominal symptoms records the symptoms observed by the patient or those with whom he lived prior to the onset of the disease that led to his being brought to the hospital. So many of the children included in this series were suffering from diseases of the alimentary tract, that in themselves give rise to more or less positive abdominal symptoms, that it was realized that this distinction must be drawn. Symptoms referred to the nervous system presented some difficulty; but we followed the same general rule, eliminating, so far as we could, all phenomena clearly referable to some condition other than parasitism. We realize that we may not have been entirely successful in our treatment of this factor, but we have done the best we could under the circumstances. When it came to collecting information as to the vomiting or passage of worms before the patient was admitted to the hospital, we had to rely largely on the statements of parents or others with whom the child lived; but we have felt perfect secur- ity in so doing, for it would probably not be easy to find a Fili- pino mother who did not know a round worm when she saw it. In all cases where reference is made in the table to the passage or vomiting of worms, it should be understood that the worm to which reference is made is Ascaris lumbricoides. The youngest group of children is recorded in Table 9. With the exception of cases 46 and 56 none showed abdominal symp- toms of any importance. Case 46 was infested with four para- sites; while case 56, which showed the most marked symptoms, was rather lightly infected with Trichuris. Case 87, which was infected with Ascaris, had never, so far as we could ascertain, shown symptoms referable to the abdomen or the nervous sys- tem. The infection was light and, as has been said, was detected on the second concentration of the stool. Case 46 had been breast-fed from birth to the time of ad- mission, but after the eighth month the mother reénforced its diet with bread and rice. Case 56 had been bottled-fed since birth. We were unable to obtain reliable data on case 87. With the exception of case 63, which had been given other food from time to time, all the children had been breast-fed from birth to date of admission. One of the most interesting cases in Table 10 is No. 83, a 2 year old girl who was admitted for treatment of an acute bronchitis. This child was infected with “Blastocystis,” Endo- limax nana, Trichuris, and Ascaris. The physical development of the child was only fair. She was abnormally quiet and, not- 1920 rence Journal of Se lippine 4 Ph “SULIOA. pessEg “SULIOM peyIUIO A s OF OF "OD OF % OF OF & ++ -dwAs snoalayy “uo! A vende op? ----|--7r orn => ApBBauroUepdg |------> Op----=|---- 77777 poos ATABT een tet TY -aapenasgnicss opi inne aren neces eceee eeeees etuoggy [nnn opmrana|eanenn enone eennes opmeamn| at [ooo ao-= "= sa Tyouoag egnoy Nese eae Quon [--7---7-- -SpUBdUTdy 3yBIG |--~~--~ OP ==> >|" poo cen doyouorg “8983 -38 @AIS[NA sana temennag bt euon [7-7-7 opr-n--[-ee-2e naa poos Ayayeg | y [77777 u01}803{puy *peysiznou A[400d saeenasenam auoyy | -*777 77-77" -= APBBoulouetdg |------- op---~-| ‘padojaaep jam Ajzreq sane anes esneeen =" 9" BLT RPY arn Se e[quzaay |----7--eouetnzey [BUOPBBIIG |7-7-~77 OP"====|-A TT nn a soceneners=----=- 901489 S1PUT “ATIGUI -Buyyyuroa = ne gaa CB a a serous pooy | y |---ejuoumeudoyouoag |-~~"|7-77 |---| | | | BT | 29 ek Eset nc eR bsicaca 3, i Re a nee cans 359 PROM Game ORs Lge eee Opsee ret Rio 825" a a a £19 | 69 “ssouqy! — fe errr afqeiary | uesead 03 a]qurejay "~*~ ~~“ on* garage eg Sh casas! et mauled aahenga ‘moon rer eos (ee ao “uoTedysu0D 0} AI oe at ens suojsynAuoy |~~---- worjueysip WSS |---- > sigagbep iy <9 Dies wate oe eee avg | a | -epuooes uopeorxoguy |-~~-0--- 777] | | P| S| ii pater Tee? aUON |" eUe[Nzwy [eUoIsBIDg [~~~ ODE ee poor | y |---wruoumneudoyouorg | + [| | TS | "aqquaia “s80uq|! — | —|-a Appeuorewo0g | yueserd 0} a[quaezoy [--~>--- de oameas ran hea pei aegq | a | saeu0ys srq1;000077 |-~~*|"-7- 7777] + | S| OT | 98 "SULIOM Sul AQIQuaa {Bur | -y1WOA UO pedAetfer | “uonsazip — | Q)|-380M8 esnjorg | uoMUeysIp pue ueg |----- “vawuntony 1-77-5077 °5 5 op-----| 1 | -up feryyowa seurygsy [7] fem pin & | me | 88 ‘uado [[138 Ss} ejaumzuoy S3Ie3 "s1It1 Pa Ps gh aiek osha a a ---yorqueqsIp pue uyeg | ou seop ‘pawmyowg [-------"" ------go0g | p | -oo0011 ‘sysopnozeqny, | + | + [| | | OT wi ar fy Mt ua LENE ct AER ake Te aie ae sei‘ Eauatel is eanomati dN" ogee) Uber Pe DOME erence HNN a eo el) ee ~wiuoumneud ge PO ag. tees ees: rake Lapa gta 4 1 eee ones —iien spit lene zoog | y | -oyouorq ‘s1qsjoo0eqy |--~~|--=~|--77}- | BL] “podopaaep A]aIBy — | — prs etqeajaay |----7-7-"-- uoryaeqsiq |7-~-~~ ie yeuon | nq = pagwjoeurgy | J |-~“uorsedypuy ayuoayy [---=|-m-}mme yn) | OP ile rd ys eiZIEISiS iF 3) E ap | : HL . . . “queur , ; : : duke snoazeN -durcs jeuyuropqy -dojeaop [eHU9W -dojosap jeorsAyg g SSOUBETP TEOTUHO : 3 : 2 | : p f - el | } | : . : | [‘Teydsoy Ul s24n98y passed IO pozIW0A ‘supah ¢ Laa0 10U pun T UNY? 210m Uaspprys UL SBuLpLy—OT TTAVL *H{ ‘ UOysstuIps ar0jeq BunosY passud 10 ! payuroa ‘QO | palp ‘d { paaordurun ‘fp ‘ paaoadury ‘T t pataaovat ‘y] 19 Haughwout and Horrilleno: Intestinal Parasites 16, 1 “u01Ue4 “SIP pus “Bay.iep ‘ured [wuols80009 “4IB} 20 34 B1w148 dn 318 JoUUBO ‘ prBA YOR “sSuy -punosins 03 919943 -ede ‘dn 318 40 4]e} jou seop ‘paemyoug wee teed meee eee ere eee ee mewn mee eee ween tee eee ee amen ew ewe ee eee een eee ene -0909|! ‘s]s0[NIIeqny, -sISulaBosE isn tyouorg “spjuape 'w} woumneudoysuoag |--~~ OS ed eee eee ae 1920 Philippine Journal of Science 20 “BITBYAIBIBS BIFTA _ ca | Ty Sica TEE EN OP rte ae UO!}UdZSIP FYUBYS TRUMON er ee ie pooy | y | -younfuoo ‘spsoungg | + | + On | Pe) 6 *gi}140] U9 {s13 ee ee ees euoy |--~-uol}UezsIpP pexteyy | HL[B} JOU BEOGT [~~ -" zo0og | | -ofnoszeqn, Aasuouyng | + OE | | 68 “sIqIyo MS eG (ol ec areata at eae Ce ee se pean aE op te eae op-----} | -woaq eqnowisvjodiséag | + | te] P| 8h “stqrulya Be 24 Ge os ohne atria ara OUON TT ie TOO GONL TS rt) ve ARs, emia Ss ae ears poo | Wj ofuoayo ‘syyouorg | + | + PO | gL *SOUII} 4B “SuULyyeA Ul ssa[deo[s ‘esnvo yNO By ‘snuisiqesys O | — | “WM ses ‘ssopjsey [-----" ~~ ured quenboag [----- "~~ oR ‘yquog pg sous faye,g | J |7-~~-"syeulrwose ‘watoyD | + 6 , 09 SASS BeOS ban ata nue air GUON ree GUO fOree ere op"**>* iene aetat seine ke f3 poor) | J |*7"--- Buoumneud aeqgoT | + |b) t+ rt 3 | 6 *ss8008qB IBlOOA 4 ee Pee ne e[quytay |-""~7> Uyed peuojsEoDG |-~~"~~ el. une arma aaa 56 “aye | I | “le sey doqouosg | + fb | *Agiane]d fer “uIstuBdULAR -oumneudoyouolq ‘ss SSA EH crlencaaie a Ch a op--"""} puw ‘uoruazsip ‘ureg |------ rere a he ee ae ----- z00g | q | -o[nozeqny Areuowjng | + PO | P| 88 “Y}UOUL YIBT 9YF eae Woe Yaa sours uled yuenbeag [------~~ op. 7"* mie acre," ---- op-----| J [> stewizese ‘eqiyouorg [-~-=| + f+ Oe | BIUaZd14¢ $ 1319 4 | | eae bs RBS ENTAe LAU rs eat ia a Vase "MUGRE (oC 7, op? 7" pret amines ich I op---~"| @ | snousrBuws fsrz1joo0eq] "=" } & | st “sy LAIsuys Lie — |Q br salad i wane beaten Gis ics peutoyt |-----"--— Gas water) ayeg | | snouerBues ‘enyoooeyy | + | +), | a : SAISRGM Can ae | 3 a d Bie) | ~7 | . 4 “gio, dUIAS SNOATON ‘ae os poe ne ee ‘ doquamn tae nas E ‘sIsOUSULp [BOUT =| * PS 3 : B |g P PIR Sie | ? 3 | mys ca ? | i [{‘yeyidsoy ul stuvosy passed to pazitoa ‘supaft g 1000 20U pun Z UDY? e10W Uauppryo wm sbuYpity—TT ATAVL ‘HT { uoIsstumpe atojoq Siinosy passed ao payzuroa ‘O : pap “d £ paaoadutiun ‘f) f peaoadurt ‘T { pataaoved “yy) 21 l Parasites Intestina . . Haughwout and Horrilleno 16,1 “SUIIOAA JO eseseed uo podall oO eens hresare cs euon | -er ‘ured yuenbarg j--""~*"~"" Be. Aachen nt ah aaa poor) | Y [-~** Bruoumnaud aeqory (---") | [orion] + | 2 | 06 “BIUIOSU! ‘Saulty | 78 880]}S801 ‘ssou *u0l}U94sIP “rood uor}1aynu 3nq H —|-1sMorp jo sz1q | pues ured quonbery |---~----~ “"[BUWION | JUaUIdOTeAap aye | oy feocusstsrecetrs seaogg Po ey ee ot ee] 8 hon ‘pouoqy say ueyaA salq “ABI d jou H — | -weay, *e1qezjsay |--uyed pus uonuezsiq | Se0p ynq “jeultoNy [>= page T Oe BOS) oer Susseoey net ote oes Toe “94310 “daas 4e@ sulBaedios jo sso] Suisnvo ured ae — | pue dn sayeA | [Buoised00 ‘uolqUeysiqT |-~~~ Wiad poor) | J |--""> ssoosqe aBpoeary [7-177] | ot +e] 2 | 99 *SO1}{Ul01}Xe JAMOT bi sitar OEE ore seme peal cocinatt auoNn |--""-~ Bred paucjsEIIG [°° IRR eq | [ | puwaszeddn jo sisareg [---"|--~“|----|-- mmm] +e ron], & dL | "SISBIIBO *sOUrty “Apoq Jo Zuryozimy *suonsenb -88 ieruoulneudoyo HO | H/ 3¥@8s9}80103 [nq | pue ured yuenbezg | JaMsue you [tM [~>7-7 om arial 100g | [ | -uorq ‘sisojnozoqny, |---| + | + [--7] + 1 +] +) OP | op _ or og iE Saag suoN [7 ured [BuoIsBa9Q [~~~ --" ~~ BR aa (4s eo aa aera pop |, Hi Teeny SHNTEGOR OT ee | 2 oe “B18 Oar Asmoiq |" uonueysip puw ured | ~----* TOR ta mee I | ~B1teose ‘syqyyouomg |--~") + | [mimi] & | 68 *A[BSowous]ds = ee neers we. © on = ‘ured [wuols¥oadQ |---~-"-- 7-7" ees * eaataaat aay Sere Bs Gt lie eel meaning ic: ToT MERE Te eee | ob Ee oe “uol1jua4ysIp ~ TE (ceercser eaageh se «eae pus uled jeuolsv00Q sd ‘fil ite ee a | ae ee SIpyouorq aynoay |-~~"\--) emi) | SL TB ee eS aloes stamens SUON [85st et quan [te [BULION, [emo m enn enmnere es aye | x [---7 Bpuoumneud aeqory | + [--=*] 4} oom | S| 8s a") < =| mi) > : fi i PEGE E . “ . =] ‘ * * 4 = RIP geen RC “sunog dass [eupmong y caosecep panies cidbacop poojntua = |) “Seeueerp TeorsinD : 3 4 ° 5 hie # 2 : [‘leydsoy UL stuposy passed 10 pazyutoa ‘fy | UOISsHUUpE as0Joq Stuposy passed Io pozUIOA ‘GQ ! peAorduay ‘] { pasarovar “QY) ‘sunah ¥ 4200 J0U PUD F UDY) ALOUW UauppLYyo Ut shuLpULy—ZI ATIAVI, iat athe: 1920 Philippine Journal of Science SUNS ae _ Ree i i -edde pus AIAN -08 JO SSO[ /s}¥eMS *SULIOM foz" syjzuow jo odussud Aq pasosl] | re) —|9 pazupeEz oug | -e1 ‘ured pBUOIsBDDQ |-~- | Sep ematical 5 oo IE a adage aA erinoncen 88) ea £ | 16 *UOISSIUL - -pe uo ured yy oped H Meme es ce ey opr: Burypizm sem queyeg joo OPS pueuiyyyng‘pooy | WP sauimosy | 4) ae P 118 "sUIIOM jo aZussud Aq paadal] HO a ri camper areata aa op -oruled guanbedg |-- aera Swissair $422 395 0 poor)| J sisulawose ‘sryiqouoig | + | ¢ [TT FB | BL neh Bo ac circ seam glem na OD ho ured peuoiswog [7-77 7 (ss pasate beach t cti 05 6 oO ie Gi” Ae: Paha ina gjuouneud szeqory | + | + [Tt | S| 88 — aah: Lap weeaean cRne ORR) ene ROR es PRUMON toon Bo spyoooayy | pt Op 08 “ple siveké Z GOUIS S14D0 “RUOpe ‘sIziaydeu oO se baler hea BI op -sP possed oo1m} seyy qoinb aog, [09ers op N | Axepuooes ‘s1y1]000e]] |---| 4 |” eo eT eh Oe ee ie Nisa cnewenh seh quewenel sanene enact MME Ro AQUALOYJNSUL [VIIA een Ss: Fae op uo1}ue4s{p pue We op ag \f I leone] + 12 i pier akan SI}{JOD0aT] ie Be 5 ) oO or in GaSe OP aaeie sn ogee OR ace ee Lg SR DB ay OP Ge aE RIE GE Sis. Apes OS Pe we EE eee ee ae noel CCE EDN SION ae MEO Do es ea AOS: of Po ene eae eT DOOEy GE ct, 2 eas 7 See rece) 8, 0) mies MEM en ok a ke ae ba MOU sie creer tala Be or uled [wuoIsBv9Q |~77 [RULION [O° oD Pat ese Sreoeer eC i | a P | OL *suol? -sanb JaMsuB jou THA “Peq ure! _ See raceme UL: J (ean taste ==" saylosy | Ooy, “4[8} JOU S80q [~~ BU We eae ee ea ‘purapa ‘siqpoooary |--~7] + | FH] FH] +] oT er rj s/n} r |i reyeieige|F/E 3 3 <7 - r *pul0, UAB "suo, dw 48 “quourdojaAep “yuouldojeAep ; ‘ Z z snoadon yeuywopqy ye ueyy [eorssyg é sysousBIP [BUH - 2 : & 3 5 p & 8 s F = 3 es ’ : ['peyidsoy ul s1up9sy passed ‘supa ¢ W0a0 JOU pup fF UDYZ oLom Uauppyo wu shupUty—ET ATAVL IO po}WOA ‘F{ ! UOISsTWIpe arOjaq sluposy passed 10 poqtuoa ‘O ‘peaordunun ‘f ‘ peaoidum ‘[ ‘ peraaovar ‘a] 23 es : Intestinal Pa rrilleno Haughwout and Ho 16,1 | “suL0m | jo oBussed puv SZuryiwoa 2 guerre oun | 431M ujwd oxanes Josyou;yy |-------- Cee Sapam pe dimers Gh phoaetntehs cs ae | “BUIIOM | | jo eSussed Aq peaaoyer | Ue Co aaa @[q¥3}41! 419, | “uyed oxeA08 pus uopuaysiqy |--~-->-- as Sia baeae poor | y ** wruourneud zeqor] “SULIOM JO aessud >-~ op-->>> > gyuresue yng ‘apeg | yo ttt Bey “SULIOM Jo oSussud Aq peaaifes “aeaoz YIM ued “81901 HO | me freer euoN | [BUoIs¥I20 puw U0;QU2q8IG ~~~" ~*-~ repeat Nonpdahea 400d zoyjey | 7 | -awose !u0178e3)puy “suIJOM BuyyTWOA Aq a AQ hens O[quz1OXm | peasijer ured [Bucjses0gQ |---~-~~ SRRIRNE tet cree non <*> eg} tes BlByVY } ~ |< 3 poi | i : “sulojduA8 sNOATONT | “sw0jdULAS [BUWOpq Y page a wecaiha ” E “s[soUBeIp [wOLUTTD Fig | | . teen arr ones anon mane anon tet -eee wee wee + ++ on BB : . SIgsAD038EIg,, [‘[eqdsoy ul siuposp passed 40 poyrU0A ‘FY ‘ UOISSIUIPe e10Jeq Stuposp passed Jo pazwOA ‘GQ ‘ peaoaduat ‘] { pateaooer yy] ~ ‘sina g 4200 20U pun ¢ UDYZ a4OW Uauppryo Ut shulputy—Pl ATAVL 1920 Philippine Journal of Science "suIOM Joosessed Aq OG [ea SR pesos ued yuonbal J *proyd — | — {7777 opt77- | -4} OR 03 B[QuLOFOY SERA ee NREL LL ured [BUuoIs¥900 *sULIOM jo odessed Aq peadal| 1 Brae ane | aia -a1 ured [BUuoIsBI0O Ray Oe) poaiately | pleteaal belatueomen a ued [BUuoIsBI00 *sULI0M JO odessud Cine oo YIM $[0073 [BaYLIBI ‘sulIOM jo oSessed pue Suryiui0oA YIM ‘siqtuBdursy pus ‘U0lz OVO Te eee -uaqsip ‘aed [BUoIsBIIg “st}1]09 PI, GEO el ts aUON | -oa]} 03 a[qureyor Ue 0 e 3 é. Fy *swozduAs | . 4 | | snoaseN sumo, duds [euWwopqYy aE Lay eae rrel oranda Seam ee op -7n7|t7rttrr7777" poo | a [77> Bfuoumeud zeqor7] paghick soap ho iia op ss--|-entescenn-none ate | oy [777777 a8a03 proqdaL “eruoumneudoy> peer aad eit a op-----|--------77 77> peg | 1 | “aaaq sepsormoteqny ities haters tees Ps paid Gaemursimmammmanians,cuebor: (SO RAIN ie | see Ra aS asa ang qeuusony [7090-707 POM Lae re “soul? ‘uorsnye Yuta Ast 48 [[Np nq ‘PeULION |" pueysqouuLHe ‘100g | -nejd {s1soynoseqny, ‘][np isuoysenb | *peystinou Ajr100d suwemsue ul mojg | ‘pedojeaep =A | Fp -"SI}[O909T] “s8ulpunod -ins 0} JuaTayIp