(1) Although toxins for the experimental reproduction of the
disease have not actually been obtained from the nodular worms,
there is very strong circumstantial evidence that during the course
of the disease poisonous substances are formed and that these can
produce the symptoms, lesions and death in the absence of bacterial
and other complications.
(2) Although insufficient cases were available for haematological
study, there seems to be a possibility that the toxic action of the
parasites may also produce a certain amount of atrophy of the
haemopoietic tissues leading to oligocythaemia, but a deficiency of
the red cells to the extent of a clinical anaemia was not observed.
In some cases there is an eosinophilia. Whether this is due
to their increased production in the myeloid tissues and their subsequent mobilization, or, whether they are produced locally in the
walls of the intestine and are released temporarily into the circulation
at the conclusion of the active tissue verminosis, cannot be stated
(3) In some cases bacterial complications producing various
forms of superficial and/or deep enteritis, as well as peritonitis, are
contributory factors in the causation of symptoms and mortality in
(4) In some of the lesions there is a definite anatomical basis
for the development of partial stenosis and intussusception. Apart
from such accidents, the nodules themselves, even though they may
be responsible for very extensive tissue destruction, do not seem to
produce nutritive or other disturbances, in the absence of parasites
in the lumen of the intestine and in the absence of bacterial complications.
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