GENUS STRONGYLOIDES

GENUS STRONGYLOIDES
by
HIROSHI TANAKA

Hiroshi TANAKA, Dr. Med. Sci.
Assistant Professor, Department of lVledical Zoology, Tokyo
Medical and Dental University
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standing pathogenicity of this worm. Often with case reports, experimental
treatment has been included, for example, in those of YOSHINO (1939) and TANAKA,
SHIROMA et al. (1957-60) in human cases, SATO, S. (1933) in dogs with S. stercoralis,
FUJITA et al. (1953), WATANABE (1956), OSHIO(1958) in pigs, and TANAKA
& AMANO (1959, 60) in albino rats with S. ratti. On the various species of
Strongyloides parasitic to animals, several studies on comparative morphology
and ecology were reported by FUJITA (1938) in S. papillosus, TANABE (1938, 39),
TANAKA & AMANO et al. (1959, 60) in S. ratti, TOMITA (1937-41), OSHIO et al.
(1954-58) in S. ransomi and TOMITA (1939-41) in S. fulleborni.
The improved technique for detecting Strongyloides made by SASA et al.
(1957, 58) and TANAKA et al. (1957, 58) came to be applied to the group examina­
tion of human stool and enabled epidemiological studies. By recent examination,
the island south of Kyushyu were found to be widely spread with foci of human
strongyloidiasis, and the studies on human strongyloidiasis in this country are
developing from the case reports to the resolution of a problem in the public
health.
II. SPECIES OF GENUS STRONG YLOIDES
A. List of Species
After the discovery of Strongyloides stercoralis (BA V A Y, 1876), numbers of
species belonging to Genus Strongyloides were reported from the warm blooded
vertebrates. The identification of the species was usually made by examining
the morphological difference and host specificity, but little difference has come
to be revealed between different species in morphology in consideration of
morphological variations. CHANDLER (1925) integrated species hitherto published
into three species, S. stercoralis, S. papillosus and S. westen', mainly for the
observation of the morphological differences and considered the other species
were race or subspecies of those three ones. On the other hand, SANDGROUND
(1925) expressed his opinion on the identification of species by morpholegical
difference and peculiar behavior of host specificity. This method of identification
is still widely accepted. The species thus accepted are listed in Table 1, though
some may be eliminated as synonym and further definite classification may be
difficult. Among species used in some older times and eliminated in this list,

Table 1. List of species of Genus StTongyloides
Strongyloides stel'coralis ( BA VA Y, 1876) STILES et HASSALL, 1902
S. flilleborni von LINSTOW, 1905
S. cebus DARLING, 1911
S. simiae HUNG et HOPPELI, 1923
S . canis BRUMPT, 1922
S. stercol'alis felis CHANDLER, 1925
S. cati ROGERS, 1939
S. tumefaciens Price et Dimand, 1941
S. vituli BRUMPT, 1921
S. ovocinctus RANSOM , 1911
S. papillosus (WEDL, 1856) RANSOM, 1911
S. westeri IHLE, 1917
S. nasua DARLING, 1911
S, mnsomi S CH WARZ et ALICATA, 1930
S. ratti SANDGROUND, 1925
S. allbal'i MIRAZA et NARYAN, 1935
S. mlti ondatl'ae CHANDLER, 1941
S. sigmodontis MELVIN et CHANDLER, 1950
S . agouti GRIFFITH, 1940
S. robustus CHANDLER, 1942
S. chapini SANDGROUND, 1925
S. avium CRAM, 1929
S. oswaldi TRA VASSOS, 1930
S. ophidae PEREIRA , 1929
S. longus (GRASSI, 1884) is a synonym of S. papillosus, S, suis (L UTZ , 1885) von
LINSTOW, 1905 was erroneous expression, because no paper was published by
L UTZ himself and S. vivzparus (PROBSTMA YER , 1865) and also S. bovis (VRYBURG,
1907) were pointed out by RANSOM (1911) as false identification and transferred
to the other genus.
The species of Strongyloides found and reported in this country were six;
S. stercoralis, S. jiilleborni, S. papillosus, S. ransomi, S. ratti and S. westeyz·.
B. Identification by Morphological Difference
Morphological difference has been often studied between the species considered
widely distinguishable, but the information was hardly obtained as to
their difference. CHANDLER (1925) reported the difference in the shape of tail
of females in parasitic stage between S. stercoralis group and S. papillosus group,
but SANDGROUND (1925) disagreed. The shapes in various stages, first published
as peculiar to certain species, were later mostly ignored. The shapes peculiar
to a species were often reported in the observation of body length, position of
organs, ratio of length from head to each organ by the body length, cuticular
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striation, shape of tail, number of head mamillae, shape of uterus and ovary
in parasitic female and type of branch in tail ending of filariform larva, but
later difference was scarcely found from the observation of variations. There
may exist a room to make comparative studies on morphology among species,
because there are some morphologically characteristic species like S. westeri of
which body length is largest and like S. stercoralis which is evacuated in human
stool in rhabditoid larvae. Much attention should be paid for comparison on
the body length, position of organs and shape of ovary of the parasitic females.
C. Relationship to the Host
The species of this genus have many problems about identification and
specific independency because of less morphological difference between species.
However, considering with the relationship to the host specificity, choice of a
species can be limited to a restricted range. Naturally a species of Strongyloides
does not always infect on one species of host animal but it selects only a few
animals as hosts. For instance, S. stercoralis of man can infect on monkeys,
dogs and cats, and S. ratti of Rattus norvegicus has a conspicious ecology hardly
to infect on mice. By those reasons, identification is not always difficult when
the choice of hosts is considered with the morphological observations. The
species lately accepted are the result selected by the above mentioned reasons
and convenient to classify the species of Strongyloides. In this situation there
may be still somewhat confusion among species related to S. stercoralis, those
to S. fiilleborni, those to S. papillosus and those to S. ratti, and integration will
be made in those groups in future.
III. HOST SPECIFICITY
From the experimental infection made by AUGUSTINE (1940), the host speci­
ficity of a species of this genus is important for identification. In this respect,
experimental infection has been carried out on the various species on animals.
S. stercoral is was first transferred from man to animals by FOLLEBORN (1911)
and successfull infection took place on a dog. TASHIRO (1912) also made a
successful experiment of percutaneous infection of S. stercoralis on three dogs
out of five and the incubation period was 16 days. OHIRA (1918) transferred
from man to mice, laboratory rats, guinea pigs, rabbits, dogs, cats and monkeys

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concerning with recent classification. In the experiments made by OSHIO &
FURUT A (1954) and OSHIO (1956), infective larvae of S. ransomi from pigs could
invade hide of rabbit, guinea pig, mouse, laboratory rat, hen and frog but real
infection took place only in rabbits. In observation of 20 rabbits with succes­
sful infection, the course of infection differed a little from that in pigs as in
prolonged incubation period, 10 to 13 days, less number of eggs in fecal pillets
and delayed development of eggs in culture. From this viewpoint, rabbits were
thought to be inadequate host for this species.
As a peculiar nature of S. ratti, SANDGROUND (1925) expressed it did not
infect on rabbits, guinea pigs and mice. ROMAN (1956) made experimental
infection to mice in detail. From his result, young mice were susceptible for
the infection of S. ratti, mature mice were resistant and also the mice injected
with a large dosis of cortisone were susceptible. TANAKA et al. (1959) experienced
transient infection in five mice out of six. As the natural hosts besides Rattus
norvegicus, VANNI (1937) recorded Mus musculus, ROMAN (1951) added Microtus
arvalis, Apodemus sylvaticus, Clethrionomys glareolus and AMANO (1959) found
Rattus rattus.
S. sigmodont£s discovered by MELVIN & CHANDLER (1950) from cotton rat
could not infect on hamsters, guinea pigs, mice, rabbits nor on rats. That
peculiar choice of host was thought to be the differential point of this species
from S. ratti.
From the experimental infection as mentioned above, the host specificity
of each species of Genus Strongyloides is thought to be definitely restricted.
The host specificity becomes more confirmed when the erronous identifiction
hitherto published is adjusted following the recent knowledge of classification.
Each species of Genus Strongyloides hitherto found selects only one or a few
kinds of closely relating animals as the adequate host even though a kind of
animal is susceptible to the infection of different species of Strongyloides or a
certain host, first thought to be resistant to a species, was later found to be
susceptible to the same one.
IV. MORPHOLOGY
Strongyloides develops both in parasitic and free living generations and

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Fig. 2. A-F : S. stel'c01'alis A, B : rhabditoid larva, C: filariform larva,
D : male in free living stage, E : anal part of male, F: female
in free living stage, G: S. fiilleb01'ni, female in parasitic stage
presents complicated life cycle. The shape varies distinctly in stages, parasitic
female, rhabditoid larvae, filariform larvae, male and female in free living stage.
Figure 1 presents the whole course of life cycle, root of infection and relation­
ship of all stages. Shapes of all stages are illustrated in Fig. 2.
Morphological observations of each stage were often reported, but consi­
deration was little paid in the individual variations. The method of measuring
criteria is not still confirmed. FAUST (1933) used three criteria; a (body length/
body width), f3 (body length/length of esophagus) and r (body length/tail length)
and others presented the position of organs using two values, distance from
head to each organ and its ratio to the body length as FENG (1933) applied to
the differentiation of microfilariae and COBB (1945) to the classification of the
free living nematodes. COBB'S method of measurment is thought to be conve­
nient for the morphological studies on Strongyloides because there needed a
delicate differentiation for comparison between the hard distinguishable species,
for morphological alteration in following the course of development and for
comparison between the larvae of many other species. Morphological studies
with measurement in detail were reported by those workers, FUJITA (1939) about
all stages of S. papillosus, TOMITA (1939) about all stages of S. fiilleborni and of
S. ransomi, DESPORTES (1944, 45) about all stages of S. stercoralis, SANDOSHAM (1952)
and TANAKA (1957 c) about free living stage of S. stercoralis, SANDGROUND (1925)

about parasitic female of S. ratti and TANAKA et al. (1959) about filariform
larvae of S. ratti. When those measuring values are compared among different
species, difference is scarcely seen in free living stages, but only slight diffe­
rence may exist in body length of the parasitic females among species as
reported 1.85-3.03 mm in S. ratti (SANDGROUND, 1925), 1.75-2.35 mm in S. stercoralis
(DESPORTES, 1944, 45), 2.65-3.84 mm in S. fiilleborni (TOMITA, 1939), 3.36-4.26 mm
in S. ransomi and 4.98- 5.56 mm in S. papillosus (FUJITA, 1938).
Often difference was observed in size between eggs in parasitic females and
those after oviposition. SHIMURA (1919 a) described that the eggs in the uterus
of S. stercoralis did not develop there, measured 56-64,u x 22-30,u in dogs and
60-77,u x 28-32,u in men and the eggs after oviposition were 60 x 40,u in dogs and
70 -43,u in men. ITO (1932) reported the size of eggs in the uterus of S. stercoralis
were 66 -83,u x 36-45 ,u and those after oviposition were much larger, measuring
75 -88,u x 40-60,u. MATONO (1931) expressed the size of eggs were 44.8-70.0,u x 16.8-
26.6,u . TANAKA et al. (1959) measured eggs of S. ratti in feces immediately after
evacuated and the size was smaller than that of S. stercoralis and was 53.0,u in
an average of long axis with unbiased variance u 2 =15.12 and 27.4,u in an average
at short axis with u 2 =2.45.
KREIS (1932) and FAUST (1933) reported the discovery of the males of S.
stercoralis in parasitic stage, but there has not yet been such report in this
country.
Eggs from parasitic females grow up to rhabditoid larvae (rh 1) and then
to filariform ones (f 1) in direct development and eggs from adults in free living
stage also develop to rhabditoid larvae (rh 2) and filariform ones (f 2) in indirect
development. Comparison was often made between those larvae in direct and
indirect developments. FUJITA (1938) reported the size of genital primordium
of rh 1 in S. papillosus was 10-17,u and somewhat larger than that of rh 2
measuring 10-12,u . LEE (1930) observed the same results in S. stercoralis and
LUCKER (1934) noticed no difference in S. ransomi. From the observation tried
by NISHIGORI (1938) in S. stercoralis, the difference was clarified as following;
in f 1, bodies were 450-549,u (486,u in an average), in length genital primordium
measured 21-27,u (25,u in an average), and consisted of 12-22 cells (18.9 cells in an
average), while in f 2 they were 560-635,u (612/l) in length, and genital primordium
was 8.4-12,u (9.1,u) in size, and consisted of 3 to 4 cells. TOM IT A (1939) found
the difference in S. fiilleborni and in S. ransomi, but no remarkable difference
was proved by LEE (1930) in S. stercoralis, nor by FUJITA (1938) in S. papillosus.
The split of the tail ending is characteristic in the filariform larvae of
Strongyloides. FUJIT A (1939), having observed the larva of S. papillosus ventrodorsally,
found that the tail was divided into three points. The same results
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were revealed by AucATA (1935) in S. papillosus and by SANDOSHAM (1952) in S.
stercoral is.
In discussion about the existence of spear like structure around mouth
cavity of the adults in free living generation, FUJITA (1938) proved the existence
of such structure, three in number, in S. papillosus. The eggs in the uterus of
females in free living stage were 51.1 x 39.4fL in size in an average of 58 eggs
in S. stercoralis (TANAKA, 1957).
Histochemical observation has recently been studied. YAMAGUCHI (1958)
examined distribution of DNA, RNA, polysaccaride and phosphatase on rhabdi­
toid larvae, fillariform larvae and on migrating larvae in lungs in S. ratti, and
also the alteration of those distribution along the development. TSUKASA
(1959) made a similar observation on the free living stages of S. stercoralis.
By the observation of KOBAYASHI & T AKIKAW A (1959) on the excretory
system of S. ratti in all stages, completely developed excretory system in para­
sitic females composed H shape as a whole, cervical gland opened at excretory
bridge, connecting to the oesophageal gland and oesophagus, and those structures
were cosely related to those of genus Rhabditis.
INATOMI et al. (1963) observed structures of the filariform larvae of S. stercoralis
using electronmicroscope, clarified peculiar flatten lateral alae, absence
of sheath and structure of fine cuticular striations.
v. THE ROUTE OF INFECTION
A. Peroral Infection
Peroral infection was first proved by LEICHTENSTERN (1898) with S. stercoralis.
Later, FOLLEBORN (1911) clarified the invading site of larvae was the level higher
than stomach at the peroral infection in dogs. TANABE (1938 c) tried successful
peroral infection in 7 rats with S. ratti. KAWAMOTO (1961) examined and knew
that the filariform larvae could be alive only a short period of time in gastric
fluid, 50 per cent of larvae being dead in 2 or 3 hours and all within 5.5 to 6.5
hours. In comparison of the rates of establishment of parasitism among
the different origin of infection, using S. ratti and albino rat, 44.9 per
cent reached to the intestinal mucosa by cutaneous application, 33.8 per cent
by subcutaneous injection, 7.7 per cent by dropping on the mouth cavity and

2.5 per cent by forced introduction into stomach, and concluded the main route
of natural infection was percutaneous.
B. Percutaneous Infection
There have been tried several experiments of percutaneous infection of
Strongyloides by van DURM (1902), Looss (1905) and RANSOM (1907). TASHIRO
(1912) successfully infected S. stercoralis to dogs percutaneously. KOSUGE (1924)
studying the invading mechanism of filariform larvae, proved that those larvae
could penetrate paper, cool hide of warm blooded animals and frog's skin, and
no warmth was needed at the site of infection and nor choice of host was seen
at the invasion. OSHIO & FURUTA (1955 a) found the spreading factor in the
extract of larvae of S. ransomi using intradermal injection of the extract with
indian ink on the hide of mouse and rabbit and also found the faint existence
of hyaluronidase by the methode of reduction of viscosity of hyaluronic acid.
Furthermore, they considered the participation of hyaluronidase at the invasion
of larvae besides larval activities because the larvae could invade in larger
number at the presence of hyarulonidase.
C. Perianal Reinfection
LEICHTENSTERN (1905) assumed certain kind of internal reinfection when he
met a patient who discharged Strongyloides continuously for 14 years. And the
way of reinfection was thought to be from perianal region similar to the hook
worms because the perianal reinfection (Autoreinfektion) had been just clarified
at that time as one of the roots of infection. FOLLEBORN (1926) agreed the
assumption of perianal reinfection of Strongyloides from the two reasons; one,
the existence of perianal erruptions in patients of Strongyloides and the other,
his negative experiment (1914) to the intestinal reinfection proposed by OHIRA
(1913). But little proof is seen from the recent know lege in the experiment
tried by FOLLEBORN (1914) to neglect the intestinal reinfection.
D. Autoinfection (Intestinal Reinfection)
OHIRA (1913) observed the peculiar picture of histology, the filariform larvae
penetrating into mucosa of colon till muscular layer in two autopsy cases of
human strongyloidiasis and constructed a new type of reinfection, in which
rhabditoid larvae developed to filariform larvae in the intestinal canal, and
the latter invaded into the mucosa of colon. Then OHIRA (1918) detected filari­
form larvae in the stool of dogs immediately after evacuation, and SHIMURA
(1918 a) also found filariform larvae in 10 per cent of discharged larvae in human
stool at evacuation, and proved larval transformation in the intestines. SHIMURA
(1918 a) observed in a patient continuous avoiding of filariform larvae in his
sputum even after perianal cleaning was lasted. SHIMURA (1919 b) also introduced
the stool, containing merely rhabditoid larvae, into the intestines of the intact
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dogs, made the dog infected and proved the intestinal reinfection. NISHIGORI
(1928) further proved intestinal reinfection from dog infections, in which the
rate of infective larvae in stool increased when the dog was constipated by the
use of large dosis of subnitrate of bismuth and the filariform larvae were detected
in large number from the peritoneal cavity, pleural cavity, liver, lungs and
trachea when the lower portion of colon was made tight or constipated. And
he clarified that the development of rhabditoid larvae into filariform larvae
was readily completed in other organs than intestinal canal, by detecting
filariform larvae in lungs after rhabditoid larvae were introduced into the
femoral vein of dogs or into peritoneal cavity of mice. Autoinfection thus
proved by those serious experiments is an important root of infection to.
consider pathogenicity of this worm and the treatment of strongyloidiasis.
E. Internal Migration
FDLLEBORN (1911-14) studied on the internal migration and proved the larvae
nessesarily once passed through the lung. At the intestinal reinfection,
ASKANAZY (1900), OHIRA (1913) and NISHIGORI (1928) found the larvae invading
into lymphatic vessels and in autopsy of dogs, and NISHIGORI observed thedestruction
of mesenchymal lymphatic nodes at ileocoecal region. Nishigori,
furthermore considering with the fact, observed that the filariform larvae could
be detected from the peritoneal and pleural cavities, a nd arranged the course
of internal migration into following three series;
1) mucosa of colon-lymphatic vessel-vein (or peritoneal cavity)-lung
2) intestinal wall-peritoneal cavity-liver-vein-Iung or peritoneal cavitydiaphragm-pleural
cavity-lung
3) capillary vessel of intestinal wall-lung
From the result of the histological observation of percutaneous infection of
S. ransomi to pigs, OSHIO & FURUTA (1955 b) found the larvae penetrated along
capillary vessels and veins and then entered lymphatic vessel. OSHIO (1956)
detected larvae in the above mentioned experiment at profound cutaneous layer
after 5 minutes, at skin and local lymphatic node after 4 hours and at only
liver and lungs after 24 and 47 hours. Similar process was seen when S. ransomi
was transplanted into rabbits, mouse and guinea pigs and the migrating root
was revealed as lymphatic vessel-vein-Iungs at percutaneous infection.
The course after the lungs was clarified by FOLLEBoRN (1914), YOSHIDA
(1918) and FAUST (1933, 35), the larvae passing through trachea, esophagus and
stomach, finally lodge at Lieberkiin's gland in duodenum establishing full
development. FOLLEBoRN (1914) and FAUST (1933, 35) pointed out the fact that
the larvae in the course of internal migration parasitized and developed com­
pletely in the epithelium of the respiratory tract (heterotopic parasitism).

604
from the experiments that eggs from feces of a rat infected with a single larva
of S. ratti grew up both in direct and indirect developments, and such infection
with a single larva continued in 33 generations successively, concluded that the
existence of parasitic male was doubtfull and unnecessary for maintaining
generations and that the parasitic females were homogonic in nature without
diciding whether hermaphroditic or parthenogenetic. YOKOGAW A & MORISHITA,
K. (1953) also described a negative expression to the existence of parasitic
males. From any study, no decision has not been rendered to the character
of the parasitic females as yet.
The eggs in uterus reported by OHIRA (1913) and SHIMURA (1919) were
monocellular, on the other hand, MATONO (1931) observed in eggs of various
stages from single cell to larva and eggs becoming larger near vulva. In the
mucosa of duodenum, eggs encapsulated by the sheath structure were found in
S. stercoralis by SHIMURA (1919 a) and ITO (1932) and in various other species of
Strongyloides. Rhabditoid larvae of S. stercoralis had been known to molt once
before evacuation, and OHIRA (1913) found that the molting took place
immediately after the larvae hatched.
B. Development in Free Living Generation
The eggs or rhabditoid larvae in stool, being molting, develop either to
filariform larvae (direct development) or to adult worms (indirect development).
From the observations of partial development of body in S. stercoralis (TANAKA,
1957, 58; MIY AGAMI, 1960) and in S. ratti (T AGAW A, 1960), the elongation of the
body takes place mostly at the esophageal part of the rhabditoid larvae in the
direct development and, on the other hand, the body grows up in almost the
same rate or rather more at the intestinal parts in the indirect development.
The temperature at which S. stercoralis enables to exist was reported as
15° -40°C. by NISHIGORI (1928). In the observation of the development at 20°C.
in rhabditoid larvae of S. stercoralis, it took two days for the complete develop­
ment of filariform larvae, two or three days for males, and more than three
days for females, a little later than males.
In S. ratti which is evacuated at the stage of egg, hatching began 4 hours
after discharge and did not all finished after 24 hours and thus the period of
time till hatching varied in wide range and was 13 hours in an a verage (TAN AKA,
1959). Successive cultivation of free living stage was made by BEACH (1936) in
S. simiae for three generations on the slant similar to the bacteriological
study. The result showed that a female layed 60 to 80 eggs in whole life, the
eggs from the unfertilized female were deformed and no hatching was seen.
The optimum temperature for the development varies by species, as being
around 30°C. in S. stercoralis (TANAKA et al., 1958) and a little lower 24° to 28 °C.

in S. mtti (TANABE, 1938 a).
C. Direct and Indirect Development
The resolution has not yet been attained for the mechanism which decides
the development of larvae either in direct type or in indirect one, though the
problem was tendered at the beginning of the studies of Strongyloides and
various examinations and theories have already been performed.
1. The difference of strain
By the difference of strain, some strain trends to develop directly and the
others indirectly. This theoretic consideration was supported by LEICHTENSTERN
(1889), SANDGROUND (1925, 26), FAusT (1930), GRAHAM (1935-39), CONTACOS (1957)
from different reasons by their experiments.
2. The fertilization
SANDGROUND (1926) concluded that the parasitic females were hermaphloditic
111 nature and KREIs (1932) and FAusT (1933) thought those were females in
bisexual parasitic generation. Those workers without experimental proofs
thought that the direct development took place from the fertilized eggs and
indirect development from the unfertilized ones.
3. The environmental influence
On the other hand, there have been numbers of reports in which the larvae
hatched from the eggs were genetically homologous and the types of develop·
ment were determined by environmental influences.
HASEGAW A (1924) reported that S. stercoralis developed mainly directly at
7-11 °C. a nd mainly indirectly at 30-37°C.. In the observation of NISHIGORI (1928),
S. stercoralis similarly developed mainly indirectly at the temperature between
28°C. and 34°C., and mainly directly at the temperature warmer or cooler than
the above mentioned temperature. The other influences pointed out by
NISHIGORI were that the direct development occurred in the media of little nutri­
tion, and the development was almost arrested or, if did not all arrested, only
direct development was seen on the following conditions; replacement of air
in the culturing chamber with hydrogen, carbon dioxide, methan or sulphurous
acid gas or addition of mercuric chloride or cresol. On the other hand, by
addition of oxygen gas to the culturing chamber or basic solution to the
media indirect development occurred in larger chance. Therefore he thought
conclusively that the direct development took place on the suitable environmental
conditions for the worms. TANABE (1938) also examined the influences of the
environmental conditions using S. ratti, and difference was hardly observed in
the ratio of direct and indirect developments at the temperature between 11 °
to 37 °C. neither at pH 6.8 to 8.6. Little influence was also scarcely seen when
he used tap water, spring water, Lock's solution, half Lock's solution, 1.0% KCI
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and 0.5% KCI solution as the liquid of media. But the ratio of indirect develop­
ment increased in the presence of much broth (stool 2 g, 10% broth 8 cc and
water 4 cc).
The environmental influences were also accepted by BRUMPT (1921) using
S. papillosus, KAGY (1933) S. stercoralis, SANDGROUND (1926) S. fiilleborni and S.
stercoralis and BEACH (1936) S. simiae respectively but disagreed by GRASSI,
LEICHTENSTERN, Looss, BRAUN (1899), GALLIARD (1951), and final conclusion has
not yet been attained.
D. Ecology of Filariform Larva
Relationship between the temperature and the movement of filariform larvae
of S. stercoralis was observed by SHIRASAKA (1958). This relationship was ex­
pressed as a formula log Y =0.322 t+ 1.0761 , when Y was the frequency of the
pendulum motion of the head per minute and t was temperature, the optimum
condition for movement was 20° to 25°C. The highest temperature tolerable
was 45 °C. while at O°C. larvae could be alive for 16 days. In the experiment
made by KAWAMOTO (1961), the larvae of S. stercoralis and S. ratti could keep
alive for 5 days at 38°C. , 2 days at 40°C., 110 minutes at 44°C. and 6 days under
10°C. And at 40°C. S. stercora lis could be kept for longer period of time than S.
ratti, but at cooler condition than lOoC. the result was reversal. In 10% solution
of hydrochloric acid, the larvae of both species died immediately but in 0.25%
solution, S. stercoralis lived for 4 hours and S. ratti for 5 1/2 hours.
SATO, S. (1933 b) affected chemicals to the larvae of S. stercoralis and che­
micals which showed larvicidal effect were absolute alcohol, 70% alcohol, 3%
labon, 5% carbol solution, Lugol's solution respectively in stronger order. Dead
• time of 0.1 % mercuric chloride solution was 60 minutes and those of Stibnal
and Fuadin were 3 to 4 days. The larvicidal effect was seen in 9 kinds of dye
chemicals among which mercurochrom and flavicid were strong and rivanol,
trypaflavin, chrystal violet, dahlia, gentian violet, pyronin, methyl violet were
weak. Similar examinations were made by KAWAI (1935) using S. stercoral is
and by TOMITA (1938) with S. ransomi. The results, almost similar in both ex­
periments, indicated that the larvae were susceptible to halogens, especially to
iodine, being dead immediately in tincture of 1% iodine or Lugol's solution,
and also to acids, alkalines, disinfectants and anthelmintics (carbon tetrachlo­
ride, nematol, thymol) but resistant to the sterilizing dyes.
OSHIO & TAKAHASHI (1958) observed the reduction of hatching rates of eggs
of S. ransomi in participation of various kinds of chemicals. The reduction
was most remarkable in the tincture of iodine and then in 5% HCI , BHC
(hatching rate 0.7%), 5% NaOH, 5% carbol, 5-1% Neo-Gikuron cresol solution.
For general practical application, spraying of 3% dust of BHC in a density

30 g/m 2 was recommended to protect the pigs from the infection of S. ransomi
and the protective effect lasted for 2 weeks.
VII. METHOD OF DETECTION
For the detection of Strongyloides, the stool was generally used while JONES
(1950), JOHNES & ABADIA (1954) showed examination of duodenal fluid was more
sensitive. On the other hand, COUTINHO (1954) reported worse result in the
detection from duodenal fluid. As the indirect method of detection, intradermal
reaction was sometimes examined but the study has not yet completed for
practical use.
A. Distribution of Rhabditoid Larvae in Stool
The distribution of the larvae of S. stercoral is was examined by TANAKA,
TOKURIKI et al. (1958). The number of larvae was counted in 10 mg of stool
samples collected from various parts of a fecal column, parts being distinguished
advancing or rear sides and superficial or inner parts. As the results, the
distribution was Poison's type or normal type at the transversal plane of a
stool column and also recognized as Poison's type in a column as a whole. On
the finer calculation, density of larvae differed between advancing and rear side
and also between inner or superficial parts and more larvae presented at the
advancing side and superficial parts.
B. Techniques for Detection
The detection of S. stercoralis by smear method was made by microscopical
discovery of rhabditoid larvae, and it was hard to find out at low tern·
perature below 20°C. because movement was hardly seen at cool condition.
By addition of water in smear specimens, morphological difference was made
ease even if the density of larvae was reduced. The pathway of larvae was
often observed as light line in the fecal smear so larvae could be detected chasing
along those pathways (TANAKA, 1957).
Floatation techique in the saturated brine solution was applied to the detec·
tion of S. ratti, S. ransomi, S. fiilleborni which were discharged into feces as the
form of eggs (WATANABE, 1956; OSHIO & TAKAHASHI, 1958; AMANO, 1959).
At the condensation technique by means of centrifugalization, care should
be payed to use the adequate mesh of the screen net in the procedure of filtra-
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tion of fecal emulsion because detection was sometimes failed especially in S.
stercoralis when fine mesh was applied (TANAKA, 1957).
Detection by means of extraction of larvae into water has been sometimes
tried. NISHIGORI (1928) put a stool mass in a side of a Petri dish which was
filled with some lukewarm water, transfered the water into centrifuging tube
after a while and then obtained larvae by concentration with centrifugalization.
TANAKA (1957 b) put 3 g of stool on a metal screen which was settled on a Petri
dish filled with warm water at 40°C., kept the whole apparatus in an incubator
at 37 °C. for 30 minutes and then after removing the wire net observed the
bottom of the Petri dish with a stereomicroscope (Fig. 3). And also numbers
of methods similar to the Baermann's apparatus were applied and showed
satisfactory results.
Polyethylen sheet
Rubber band
_++-_Filtration paper
A
Water
B
Warm water
Fig. 3. A: Test tube cultivation method
B : Warm water extraction method
Petri dish
Among numbers of cultivation technics, a method using filtration paper and
test tube, improved by SASA, HAYASHI, TANAKA et al. (1957) from the method
originated by HARADA & MORI (1951) for the purpose of detection of hook worms,
was convenient for mass examinations for its simple procedures and satisfactory
detection. In this procedure, first approximately 0.5 g of stool is smeared on a
half side of a tape of filtration paper, the paper advancing the unpainted side
is introduced into the bottom of a test tube which contains 3 cc of water. The

tubes, after the opening is covered with plyethylen sheet and rubber band are
incubated at 25 °C. for several days then the filariform larvae gathered in the
water and can be detected (Fig. 3).
When the test tubes were incubated at 28 °C. (TANAKA, 1958) the ratio of
daily occurring numbers of larvae to all appeared within 8 days was 78.0%
within 2 days, 90.5% in 4 days and 99.2% in 6 days respectively and the appearance
of Strongyloides was faster than hookworms. In comparison of incubating
conditions among temperature, 20°, 30° and 37 °C. and among period of days,
2, 4, and 8 days (TANAKA, TOKURIKI et al. 1958, TANAKA 1958) the largest number
of larvae appeared at 30 °C. for 8 days then 20°C. 8 days, 30°C. 4 days, 37°C. 4
days in order but the larvae were all dead and degenerated at 37"C. for 8 days.
C. Comparison of Techniques
Comparison was made among different techniques of detection from the
same stool samples (TANAKA, 1958; TANAKA, TOKURIKI et al., 1958), after 3 hold
examinations, average number of detected larvae was 500.0 by Stoll's counting,
2.1 in a specimen of smear technique, 3.3 in a smear slide by the concentration
with centrifugalization, 183.6 using 3 g of stool by water extraction technique and
227.4 by test tube cultivation technic using 0.5 g of stool respectively and the
latter two techniques were known to be satisfactory. In comparison between
smear and test tube cultivation techniques for the practical use at mass
examinations, SASA, TANAKA et al. (1958) found 5 cases (35.8%) by smear technique
and 13 cases (94.0%) by test tube cultivation technique among 14 carriers
of S. stercoralis. In the similar comparison, SASA, TERUYA et al. (1958) detected
6.8% by smear technique and 99.1 % by the test tube cultivation technique among
138 carriers and TANAKA, KUMADA et al. (1959) found 69.4% by the smear and
61.1 % by the cultivation among 36 cases.
TANAKA & AMANO (1959) and AMANO (1959) compared quantitatively among
smear methods, the floatation technique with saturated brine solution and the test
tube cultivation technic using S. ratti. When the volume of feces used was
10 mg in a smear, 100 mg at the floatation and 300 mg by the cultivation, and
large numbers of fecal samples were compared among three techniques,
correlation was known to be exist between egg counts detected by the smear
technic (X), those by the floatation (Y) and by the cultivation (Z) as the following
formulas: Y =40.3 X+653.0 and Z=4.3 X+353.5.
D. Immunological Studies
SATO, S. (1933 a) tried intradermal reaction with 3% aqueous solution of
filariform larvae of S. stercoralis, with successful result of 7 strong positives
among 8 carriers while negatives in 9 control persons. In the dogs and guinea
pigs sensitized with this antigen solution, intradermal reaction appeared strong
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positive but did not always show remarkable specificity. TOMITA (1941 e)
observing short longevity of the filariform larvae of S. ransomi and S. fulleborni
in human serum and also that of S. fiilleborni in the rabbit serum thought that
the congenital immunity should exist in the serum of the inspecific hosts.
SHELDON (1937) experimentally proved the development of aquired immunity of
the rats against S. ratti.
VIII. EPIDEMIOLOGY
A. Distribution of S. stercoralis in Japan
After HATORI (1898) reported a case of strongyloidiasis in Tokyo, case re­
ports appeared from various localities in this country. As a whole, in the north
of Chyugoku area it is rarely found, fairly many in number in Kyushu area
and as high as nearly 10 per cent on such southern islands of Kyushu as Yaku,
Tanegashima, Amami Islands and Ryukyu Islands. Reports now available were
presented as following from northern localities.
SASA, HAY ASHI, TANAKA et at. (1957) found at the examinations of coal
miners in Hokkaido area 2 out of 448 in Chashinai and 1 out of 808 in
Ashibetsu.
T AKEKA w A, SUGANUMA and EN DO (1958) reported at the examinations of coal
miners in Fukushima Prefecture 8/404 (1.98%) at Jyoban mine, Yumotobe and
6/119 (5.04%) at Taisyo mine, Nakoso City.
MATSUBA Y ASHI (1951) and OSADA (1952) found 3 cases among 395 pupils of
a middle school at Izumi Village, Shioya Gun, Tochigi Prefecture, and obser­
ving those three families consisted of 9, 5, and 7 persons respectively, all 17
persons among 21 except children younger than 9 years old were found to be
carriers. Those three families neither contacted each other nor had possible
common root of infection and were independent dense infection in each family.
In Tokyo, a case reported by HATORI (1898) and another case by KUROKAWA
(1951) were known, but the source of infection was not clarified. The other
cases found in Tokyo were mostly people from Amami and Ryukyu Islands.
SUGANUMA (1958) reported a case among 49 farmers in the suburbs of
Yokohama City.
MIYOSHI & UCHINO (1951) examined 10,281 school children, from kindergardens

to high schools, at coal mine villages of Ube, Onoda and Shimonoseki Cities
in Yamaguchi Prefecture, and found 2 cases out of 10,281. KAWAMOTO (MIYOSHI
and UCHINO, 1951) also expressed that strongyloidiasis was not rare at mining
areas of Ube City.
In the northern Kyushu, TASHIRO (1912 a, b) described a case in Yatsushiro
and 12 cases out of 265 coal miners, 11 having come from Kumamoto Prefec­
ture and 1 from Saga. SHIMURA (1918) in his study observed several cases in
Saga Prefecture, and Iw A Y A (1914) reported a few cases from Goto Islands,
Nagasaki Prefecture. SATO, S. (1932) and MISAO (1941) treated the cases from
Fukuoka Prefecture, MIYAZAKI (1947) recorded 3/382 (0.8%) among school children
near Yatsushiro City and SASA, HAYASHI, TANAKA et ai. (1957) detected the 3
cases out of 10,182 coal miners in the northern Kyushu.
In Miyazaki Prefecture, MIYAZAKI (1947) found 0.1%, UCHIZONO (1954) 6 cases
out of 1.000 people in Nichinan City and Nagayoshi 1 case among 956 outpatients
in Fukushima Town, Minaminaka Gun.
In Kagoshima Prefecture, MIYAZAKI (1947) reported a case from Nishisakura
zima Village, 4 cases in Kanoya City among 3,175 school children. UENO (1948)
found a case in Komenotsu Town and TERASHI (1953) 19/3,809 among school
children in Oguchi City. ABE (FUKUSHIMA & YAMASHITA, 1955) reported in
Kagoshima City 1/117 in Jimpu dormitory, 4/275 in deaf school children, 1/645
in Ushyuku school, 1/1,255 Jissen Girls' High School and ODAWARA (1954)
recorded a fatal case. Fukushima observed a case on Shishi Island, Higashinagashima
Village and TERASHI & NAKAMURA (1954) reported 0.5% positive rate
at Isa Gun.
Y AMASHIT A recorded 2/19 among school children and 12/44 among the
dwellers on Yaku Island, and NAGOE & YONEZAWA (1954) treated several cases
on Tanegashima Island.
On Amami Oshima Island, FUKUSHIMA & YAMASHITA (1955) found 18/1,320
(1.36%) in primate and middle school and 5/519 (0.96%) in the dwellers. TAN AKA
(1957 b, 58) reported on the same island 28/3,741 (0.83%) in school children 5 to
18 years of age and 53/721 (7.4%) in the dwellers of Setouchi Town. SASA et
at. (1958) using the smear and test tube cultivation techniques detected 6/423
(1.42%) in the Asahi primary school, Naze City and 42/1,583 (2.72%) among the
dwellers.
Island.
KOGA (1955) found 42/1,583 (2.72%) among the dwellers on Tokunoshima
In Okinawa Island, SHIROMA (1956) detected 116/2,026 (5 .7%) among primary
and middle school children near Yonabaru Town, SHIROMA (1959) also 129/1.361
(9.5%) in outpatients at the same locality and SASA, TERUYA et at. (1958) 138/1,250
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(11.0%) in the dwellers at farming villages of the southern Okinawa.
TANAKA, KUMADA et al. (1959) recorded 38/744 (5.7%) on Miyako Island, and
YOSHINO (1932, 39) observed and treated numbers of cases of strongyloidiasis on
Ishigaki, Yaeyama Islands.
B. Distribution in the Epidemic Foci
In Amami and Ryukyu Islands, the epidemic foci of strongyloidiasis are
widely spreading but the positive rates differ widely among villages, as reported
0-17.8% in Amami Oshima Island (TANAKA, 1957 b), 2.0- 23.6% in Okinawa (SASA
et al. 1958) and 4.6-17.9% in Okinawa (SHIROMA, 1959).
In Amami Oshima, shight difference in age was proved by TANAKA (1957)
but in Okinawa, positive rates elevates in older age groups (SASA et al., 1958,
SHIROMA, 1959). In Miyako Island, the highest peak of the positive rate was
seen at 5 to 9 age group (TANAKA, KUMADA et al., 1959). In the examination
of SHIROMA (1959), positive rate was higher in man than in woman.
In the results reported by SATO, S. (1932) and OSADA (1952), many persons
in a family suffered and serious infection seemed to occur inside a family.
Though those cases of the serious family invasion were often met in the epidemic
foci, proof could be little obtained for family accumulation of the Strongyloides
infection in the statistical examinations made by SASA, HAYASHI et al. (1958 )
and TANAKA, KUMADA et al. (1959).
When correlating infection of Strongy.loides with other nematodes was statisti­
cally examined from the record of SASA, TERUYA et al., the correlation exists
closely between Strongyloides and Necator americanus and fairly with Ancylostoma
duodenale and Trichuris trichiura.
IX. HUMAN STRONGYLOIDIASIS
A. Early Reports of this Country
Of all available reports, the first one may be the case observed by HATORI
(1898). The patient, a vagabond, was forced to be isolated into the Komagome
Hospital, being assumed as a patient of dysenteria, and neither bacteria, nor
amoeba was found from stool. In the further fecal examinations the correct
diagnosis was made detecting the larvae of Strongyloides and clearly distinguishing
from the larvae of hookworms and other free living nematodes. The

symptoms of the patient were diarrhea, tenesmusm severe emaciation and the
patient died and autopsyed after 100 days due to obstinate inappetency, bloody
mucous discharge and emaciation.
After the report above mentioned, records of case study were published by
NAGASAWA (1902), KIMATA (1903), YAMADA (1907), HASEGAWA & CHIKADA (1903)
SHIGA (1909), IMAIZUMI (1911), TASHIRO (1912) and IWAY A (1912). OHIRA (1913, 14)
published his opinion that false identification was enclosed mostly in the early
records of Strongyloides besides that made by HATORI (1898). But in the recent
re-examinations through those originals, correct strongyloidiasis was seen in a
part of the cases of Iw AY A (1912) and in all cases reported by TASHIRO (1912).
Since 1914, any false identification has scarcely been seen in most papers in this
country.
B. Clinical Manifestations
1. Incubation period
In the experiment of human infection of S. stercoralis made by TANAKA
(1957 d), symptoms of the respiratory organs appeared after 6 days and the larvae
were found in stool after 27 days, using the smear method. In the experiment
with dogs and S. stercoralis, the period was 16 days at minimum by TASHIRO
(1912 b), 5 to 7 days by NISHIGORI (1928) and 10 days by FAUST (1933) respectively
and all the results seemed to be comparatively short.
2. Early symptoms
The human experimental infection was successfully made by TANAKA
(1957 d, 58) applying 300 larvae with cultivation medium for 2 hours on the
palmer side of the forearm. At the inoculating site of the skin, tiny itchy
erruptions appeared at the removal of the medium, enlarged in maximum size
after 9 days like itchy rising erruptions of prurigo and disappeared after 27
days. Cough appeared after 6 days for 3 days, slight tenderness on pharynx,
irritation of the trachea and there occurred such symptoms of the alimentary
tract as abdominal fullness, discharge of the soft stool and uncomfortable inte­
stinal irritation after 17 days, watery diarrhea after 19 days, on the contrary
constipation after 23 days and abdominal pain after 24 days. Thus alimentary
symptoms began after 17 days with uncomfortable intestinal irritation and
abdominal fullness developed later to the pain, diarrhea or diarrhea accompanied
with constipation. After 25 days cough appeared again, the larvae were found
first on the 27th day and stubborn inappetency took place. After 32 days slight
dischrge of bloody mucous stool was experienced with cramping pain on the
ileocoecal region. On the 39th day, bloody mucous stool was discharged several
times with tenesmus. Clinical symptoms became severe after 29th day showing
incessant cough, abdominal tenderness, occasional occurrence of the cramping
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pain of the ileocoecal region, diarrhea and stubborn inappetency. The cramping
pain usually occurred in the late evening and lasted for 10 to 30 minutes. The
bloody mucous stool looked homogeneus strawberry jelly without pus and was
discharged immediately after the cramping pain. The alimentary symptoms
reduced and gradually disappeared after administration of diethylcarbamazine.
3. Chronic stage and acute exacerbation
Symptoms of the carriers found at the mass examination and those of the
outpatients of the hospital were mostly in the chronic stage or acute exacerba­
tion. Symptoms and occurring cases of 9 carriers examined by FUKUSHIMA &
YAMASHITA (1955) on Amami Oshima Island were diarrhea 6, epigastralgia 8,
anemia 8, pain on the lower abdomen 6, emaciation 5, chest pain 5, edema 5
and cough 4 respectively. In the similar examinations about 37 cases on the
same island, TANAKA (1957 d, 58) reported no symptoms in 6 cases, slight disorder
in 16 and moderate disorder in 15 and symptoms and occurring number were
abdominal pain 17, soft discharge 14, inappetency 9, cough 8, emaciation 8,
bloody mucous discharge 7, borborygmus 6, chest pain 4, constipation 4, edema
4 and vomitting 2 respectively. In the similar observations of MIY AGAMI (1960)
about 60 cases on Amami Oshima and Tokunoshima Island, symptoms and
numbers of cases were soft discharge 48, borborygmus 22, epigastralgia 18,
physical weariness 16, pain on foot 13, anemia 10, inappetency 9, pain on the
right hypochondrium 9, edema 8, constipation 5, pain on the chest 5, cough 4,
oversecretion of saliva 3 and bloody mucous discharge 2 respectively.
SHIROMA (1959) treated 102 cases of outpatients in a clinic of Okinawa Island,
Ryukyu and 67 cases had slight disorders, 23 moderate ones and 12 severe
symptoms by which 7 cases out of the latter 12 cases were dead. Symptoms
and frequency were anemia 40, physical weariness 35, watery diarrhea 32,
epigastralgia 23, abdominal pain besides epigastral region 22, edema 22, palpi­
tation 18, emaciation 15, cough 14 and inappetency 7 respectively. Extruding
other symptoms than in strongyloidiasis, the symptoms peculiar to this disease
in high frequency were thought to be watery diarrhea, epigastralgia, emaciation,
cough, vomiting and pain on foot and then the additional disorders accompanied
with the severity of the disease were thought to be inappetency, physical
weariness, edema, anemia and palpitation.
4. Severe cases
YOSHINO (1932) observed 25 patients of severe cases, among which 13 cases
were dead and the cause of the death was expressed as high grade of emacia­
tion due to the lasting diarrhea with occasional bloody mucous discharge for
long period of time. Diarrhea occurred at all cases, bloody mucous discharge
in 10 cases and abdominal pains frequently at bot h lower regions in 13 cases

often at the patients with bloody mucous discharge. In two cases, abdominal
pain occurred at the cease of diarrhea and bronchitis presented at 14 cases.
The filariform larvae could be detected from the sputum of two cases and in
a patient rhabditoid larvae and eggs were detected from the sputum during 15
days before his death. This case seems to be the first report in human cases
of the parasitism at the respiratory mucosa. Among 15 severe cases observed
by SHIROMA (1959) alimentary symptoms were remarkable, diarrhea and abdominal
pain existed, cough was mostly complained with physical findings on the
respiratory organs, and high grade emaciation, edema and pain on the legs
were often observed. There were various courses of severe cases, case with
several repetation of the acute exacerbation during long period, one with sudden
emaciation to death in a shorter period, one with hydrothrax, with pneumonia,
pyothorax and with paralitic ileus. In patients whose sputum was examined,
filariform larvae were found in all cases and also rhabditoid larvae and/or eggs
were detected in three cases and the frequent occurrence of the autoinfection
and parasitism in the respiratory tract was clarified in the severe cases.
5. Clinical examinations
SHIROMA (1959) examined hematology in 8 severe cases and 6 moderately
severe cases. As a whole, anemia was remarkable, numbers of red blood corpuscle,
hemoglobin and hemoglobin index were reduced, and leucocytosis with
increase of neutrophilic granulocytes in moderately severe cases and with
reduction of them in severe cases, normal count of monocytes, nuclear shift to
the left were seen. Urobilinogen in the urine presented in the 6 severe cases,
reduction of serum protein, positive Gloss' reaction, slight increase of index of
jaundice, sometimes positive Lugol's reaction in the urine. The positive BSP
reaction in a case out of three were observed and from those results, slight
disorders of the liver were considered. MIYAGAMI (1960) examined 60 cases of
carriers and found anemia with less than 4 million red blood corpuscles in 8
cases, leucocytosis with more than 8,000 leucocytes in 28, reduction of hemoglobin
less than 80% in 41, eosinophilia in hemogram, positive protein in urine in 5
cases each, urobilinogen in urine in 9 and positive Gloss' reaction in a case.
C. Miscellaneous Cases
In many cases, filariform larvae were found in sputum and other organs
as they migrated through various organs. Discovery of filariform larvae in
sputum might be first reported by SHIMURA (1918) and ONODERA (1922), and later
KAW AJI et at. (1956) found filariform larvae, rhabditoid larvae and parasitic
females in the bronchial abscess in an autopsy. ITO (1932), MIYOSHI & UeHINo
(1951) and KAWAJI (1959) detected filariform larvae in the liver and correlating
to those cases, a case with liver cirrhosis was reported by TANI & UZAWA (1954)
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and the complication of ascites was shown by MISAO (1941), TAKAHASHI (1942)
and UMEKI (1951). The larvae also were found from such various organs as
heart muscles by ITO (1932), kidney by MIYOSHI & UCHINO (1951), epirenal cor­
puscle and pancreas by ITO (1932) and thyroid gland by KAWAJI et al. (1956 )
respecti vely.
KOGA (MIYOSHI & TAKABAYASHI, 1951) and YOSHINAGA (1950, 51) reported
fatal cases due to the intestinal perforation. SHIMURA & OGAWA (1920 b)
obtained numbers of rhabditoid and filariform larvae from the vomit. In a case
with liver cirrhosis observed by UMEKI (1951) filariform larvae were seen in the
pleural and abdominal effusion. A case reported by ODAW ARA (1952) was
hospitalized with clinical manifestations of anemia, swelling of abdomen,
emaciation and vomiting showed positive reaction of protein in urine and
filariform larvae in the abdominal effusion and died after 1 week. ONODERA
(1922) experienced frequent occurrence of the transcient glycosuria in a patient.
FORNARA (1923) and WHITEHALL et al. (1944) described about the discovery of
the larvae of Strongyloides in the urine, but little proof was clarified in both
reports about the identification of the larvae. The presence of larvae of
Strongyloides in urine is doubtfull from the consideration of the study made by
HAYASHI et al. (1958) who clarified the detection of the larvae of the free living
nematodes in urine of 7 cases. YAMAGUTI (1925) observed petechial bleeding in
cerebrum and cerebellum in dogs with experimental infection.
SHIROMA (1959) and SATO, S. (1932) found a baby patient 11 months old and
12 months old respectively.
TOMITA (1941) experimentally infected S. fulleborni from Macaca cyclopis to
man with success. In four human voluntary infections, no skin reaction occurred,
urticaria appeared within 10 days with fever in 2 cases and eosinophilia was
seen in all cases. Eggs began to be evacuated after 16 to 32 days, reduced in
number after 7 months and were detectable using cultivation technique till 11
months later.
D. Pathological Studies
In coincident with the life cycle, the organs of remarkable changes were
skin as the site of invasion of larvae at infection, duodenum as the lodging
site of the parasitic females, lower portion of the ileum and colon as the site
of internal reinfection and the lungs, liver and parenchymal organs associating
with larval migration.
1. Human autopsies
Human autopsy cases were seen in those reports of OHIRA (1913), SHIMURA
(1918 a), HATANO (1925), KAWASAKI (1924), MATONO (1931), YOSHIDA (1932), MIYOSHI
& TAKABAYASHI (1951) and KAWAJI et al. (1965). In the report of MIYOSHI &

T AKABA Y ASHI (1951) histological pictures were described in all organs and are
thought to be representative descriptions of this disease. The patient was 41
years old coal miner, hospitalized as high grade emaciation due to the 2 years
lasting diarrhea and died after 45 days in the hospital. In autopsy, parasitic
females found were 141 and filariform larvae were detected from intestinal
contents, ascites, pericardial effusion and urine and also found in histological
observation in the stomach, intestinal wall, liver and kidney. Erosion with
bleeding, ulcer and lymphatic follicular proliferation were seen in duodenum,
upper portion of jejunum and rectum, the parasitic females were seen in the
crypt between intestinal epithelium and basal membrane and filariform larvae
in the epitheliar, submucous, muscular, subserous layers and in the lymphatic
nodules. The histological pictures of the invaded portion were the congestion
with infiltration of lymphocytes, plasma cells, histoplasm, polynuclear leucocytes
and eosinophilic leucocytes, and also appearance of the giant cells and dead
filariform vessels were frequently seen in those pathological changes. Congestive
edema and localized pneumonia were seen in the lungs and the larvae in the
alveola, interalveolar connective tissue, capillaries in the alveolar wall, subpleural
lymphatic lumen and in the pneumonial focus. Changes of liver were conges­
tion, atrophia of the liver cells, peripheral fatty degeneration, scattering nodules
consisted of lymphocytes, plasma cells, fibroblast and giant cells in parenchym
under liver capsel. Those of kidney were congestion, remarkable bleeding under
capsel and in the renal tubules and turbidity of the tubules, nodules consisted
of lymphocytes and plasma cells, congestion and reticular proliferation in the
connective tissue. The focal catarrh was seen in the mesenterial lymphono­
dules and brown atrophia in the heart muscles.
2. Changes in skin
Little report was available about the change of skin in human cases. OSHIO
& F URUTA (1955) observed the invading process of S. ransomi in the skin of
pigs. The invasion of the larvae took place not only at the openning pores of
the skin but also at the cuticular layer directly in histological observation,
inflammation was seen at superficial and profound cutis but not at subcuticular
connective tissue and changes were infiltration of eosinophilic small mononuclear
cells and capillary dilatation but no bleeding existed. Observing the dilatation
of lymphatic vessels, edema and inflammation around the capillaries, the larvae
were considered to invade into the lymphatic vessels along capillaries and small
veins.
3. Changes in the intestinal wall
The change of the lodging portion of the parasitic females appeared in the
several reports since OHIRA (1913). In the report of KAWASAKI (1924), macros-
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copic congesting spots were seen at the mucosa of duodenum, parasitic females
parasitized in the Lieberkiihn's gland on the mucosa of Kerckring's crypts and
hatching rhabditoid larvae presented in the gland and/or in proprial layer and
less in submucosa and none in muscular layers. Surrounding parts of the
parasitic females, infiltration of the small round cells and a little number of
polynuclear leucocytes were found and atrophia of mucosa and defect of villi
at the gathering part of the larvae. In Lieberkiihn's gland, changes were
dilatation of the canal, flattened gland cells, disarrangement and necrosis of
gland cells, increase of collar cells, dilatation of arterioles and infiltration of
small round cells. MATONO (1931 a) experienced the polyposis spread widely at
duodenum in a human autopsy case. TANABE (1939), in experimental infection
of S. ratti in rats, observed the infiltration of eosinophilic cells at the superficial
mucous layer of duodenum after 3 or 4 days since the infection when adult
worms reached duodenum and also found the similar infiltration in the profound
layer after 15 days.
Histological changes of larval reinfection at the lower portion of small
intestines and colon were described by NISHIGORI (1928), using many experi­
mental infections on dogs. When considerably many larvae invaded mucosa,
the increase of collar cells, mucous atrophia, epithelliar exfoliation, erosion
and congestion of vessels were seen. And in further developing changes, ulcer
appeared, the base of it penetrating till muscle layers with invading pictures
of filariform and rhabditoid larvae and appearance of leucocytes and pustration
cells. Filariform larvae presented in lymphatic space between the surface and
the muscle layers and changes were found in the infiltration of leucocytes and
dilatation of lymphatic vessels and capillaries. In muscle layers, larvae existing
around lymphatic and blood vessels or nervous fibers, the degeneration of muscle
fibers and cellular infiltration were seen. Larvae invaded into the mesenterial
lymphatic nodes, especially into those at ileocoecal region, destroyed the nodular
parenchym, and dilatation was seen at the peripheral lymphatic vessels.
The changes of larval reinfection examined in human autopsies by TAKEUCHI
(1905), HATANO (1925), KOGA (1951) and YOSHINAGA (1950, 51) were found in the
inflammatry changes at duodenum and the upper portion of small intestines.
And in the reports of OHIRA (1913) and KAWASAKI (1924), multiple ulcers were
seen at ileocoecal region to colon, and also in those of SHIMURA (1918 a), MATONO
(1931) and YOSHIDA (1932) changes were observed at the lower portion of small
intestines to colon. In a case of the study by HATANO (1925), having rhabdomyoma
at the lower portion of small intestines, the larval invasion and changes
were observed at the upper portion above the neoplasma, but none below it.
In a case by KOGA, (MIYOSHI & TAKABAYASHI, 1951), it was observed that a

part of small intestines, 2 meters below the beginning, was edematous, dark
purple brown and perforated in the middle of that area, and filariform and
rhabditoid larvae were invading, till submucosa around the perforation. In a
case reported by YOSHINAGA (1950, 51), 3 parts of small perforation were found
at duodenum and single perforation at intestine, 130 cm below the beginning,
but none at colon.
4. Changes in lungs
KAW AJI et at. (1956) observed in a human case numbers of miliar abscesses
in both lungs, in which larvae and parasitic females were detected, slight
inflammatry and bleeding changes and giant cell nodules in histology. NISHIGORI
(1928) in an experiment with dogs, noticed macroscopic bleeding spots and
maculae in lungs and then found in histology of the parts around larval invasion,
capillary congestion, bleeding, epithelliar exfolliation on bronchioles and
effusion containing larvae pustlation cells, leucocytes and epitheloid cells,
chocking respiratory tract till large bronchus. At thickening alveolar wall,
infiltration of small cells, capillary congestion and nodules consisted of epitheloid
cells and fibroblasts were seen.
5. Pathogenicity
The existence of pathogenicity of this worm had been discussed in the past
years, but neither extreme exaggeration of pathogenicity nor its absence is
dicisively considered in recent years. The appearance of pathogenicity depends
upon the individual physical sensitivity, differs case by case, and not always
parallels with the density of parasitized worms. As various reports clarified,
severe and fatal cases appear only among patients with dense parasitism and
heavily parasitized carriers incline to fall acute exacervation. In observation
of carriers made by TANAKA (1957 d), the severity of symptoms did not correlate
to the density of parasitism, and no age difference was observed about the
severity of symptoms, though children below 15 years old harboured more
worms than older persons. On the other hands, SHIROMA (1959) found severe
cases presented in old men more frequently.
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620
X. STRONGYLOIDIASIS OF ANIMALS
A. Strongyloides ransomi
This species infesting pigs has short period of days from infection to
maturity. OSHIO & FURUTA (1954) found 5 days old pig evacuated the eggs.
In the experimental infection to pigs, OSHIO (1956) found the evacuation of eggs
after 5 days, and the larvae marked with p 32 appeared in intestines 4 days
after infection.
In the course of egg evacuation followed by FURUTA (1954), numbers of
discharged eggs suddenly increased between 5 to 10 days after infection till
maximum and reduced immediately to 1/10 of the maximum value after 40
days. From the mass examination of pigs made by WATANABE (1956), pigs
were infected naturally immediately after birth, the ratio of infections reached
100% after 1 month, and then positive rate was reduced approximately to 50%
after 8 months. The discharge of eggs increased suddenly till the end of the
1st month, 12,000 E. P. G. in an average, then suddenly lowered approximately
to 3,000 after 2 months, less than 100 after 4 months and kept the same condi­
tion after 7 months. OSHIO & FURUTA (1954) reported the discharged eggs were
more in number in the pigs of spring birth.
WATANABE (1956) examined relationship between evacuation number of eggs
and symptoms, and described the pigs in less than 50,000 E. P. G. had no clinical
symptoms, those in more than 100,000 E. P. G. showed inappetency, discharge
of soft feces and delay of growth and those in more than 1 million E. P. G. fall
into malnutrition, took only water and died within 10 days.
From the studies of treatment made by NAKAJIMA (1955), WATANABE (1956)
and OSHIO & TAKAHASHI (1958), gentian violet has been used effectively in
practice. For the protection of infection, WATANABE (1956) suggested the construction
of the concrete made stall with dried environment and OSHIO &
TAKAHASHI (1958) advised the diminish of the infective larvae from the stall by
spraying BHC dust.
B. Strongyloides ratti
1. Detecting method
Though the detection of Strongyloides ratti has been hitherto made by

obtaining parasitic females from the intestines, TANAKA, AMANO et al. (1959)
constructed the simple method of detection applying stool examinations. Eggs
were found in the smear technique and the floatation technique in satulated
brine solution and filariform larvae in the test tube cultivation technique, but
differential identification was needed from those of Nippostrongylus brasiliensis
(TRAVASSOS, 1914) in either methods. Comparison of detecting counts of eggs
or larvae was made among the three different techniques, smear, floatation and
cultivation, using 13 samples of feces and averages of counts were 17.0 in 3
smears, each containing 10 mg feces, 60.7 in 3 hold floatation technique each
100 mg and 217.9 in the three test tube cultivations each 300 mg, consequently
the cultivation techuique was most satisfactory. In comparison of cultivating
conditions made by TANAKA & AMANO (1958), AMANO (1959), the optimum condition
was the incubation at 26°C. for 3 to 6 days.
2. Distribution
AMANO, KANO & TANAKA (1958) and AMANO (1959) examined infestation
among Rattus norvegicus and Rattus rattus in Tokyo, using fecal examination
and positive rates of S. ratti were 62.5% in 280 R. norvegicus and 13.3% in 98
R. rattus. On the other hand, detecting the parasitic females of this species,
TANABE & T AKEISHI (1936) found 66.9% positive among R. norvegicus in Tokyo,
NISHIMURA (1943) 54.9% in Fukuoka and MIYAZAKI (1946) 44.0% in Kagoshima
respectively. ABE et al. (1960) examined in surrounding areas of Kagoshima City
and on Tokunoshima Island, rates were 51.7% in R. norvegicus and 26.3% in R.
rattus. In both studies of AMANO et al. (1958) and ABE et al. (1960), no sex
difference existed and the higher rates were found in the groups of heavy
body weight.
3. Experimental infection to laboratory rats
TANABE (1939) injected the infective larvae of S. ratti subcutaneously and
observed the period of appearance at digestive tract and lodging portion. No
worm was found in intestines till the end of 48 hours, a few worms in the
stomach and intestines after 60 hours, and after 72 hours two each in oesophagus
and in stomach, 802 in the first 1/4 part of intestine, 2 in the second 1/4 part
and a few in lower half part. TANABE (1939) also infected 9 rats, and found
the beginning of egg evacuation after 4 days in 4 rats, and 5 days in 5 rats,
and evacuation was lasting for 87 to 126 days.
TANAKA & AMANO (1959) and AMANO (1959) infected 5 rats applying 500
larvae subcutaneously, evacuation of eggs began after 6 days in 3 rats and 7
days in 6 rats. In the quantitative measurement of evacuation with the test
tube cultivation technique, the count amounted to reached the maximum after
10 to 15 days, became only a few after 40 days, then lasted in a few number
621

28 °C. , 75 hours at 24°C., 100 hours at 19°C., 200 hours at 11-15°C. respectively,
and no development of eggs appeared at the temperature lower than 7°C. and
higher than 41 °C.
The optimum condition for the cultivation of the free living phase with
stool examined by TANABE (1938 d) was yielded by the method using the medium
of 5 g. of finely smashed stool and 20 cc water deposited into a Petri dish 3 mm
in depth and under the excellent ventilation. In comparison of the culturing
temperature, the average numbers of the larvae available from the same fecal
examples were 0.8 at 3TC., 264.2 at 32 °C., 889.7 at 28°C., 712.4 at 24°C., 407 at
20°C., 65 at 11-15°C. respectively and the temperature between 24-28 °C. was the
optimum condition of the temperature which was considered to be somewhat
lower than that measured in S. stercoralis by TANAKA, TOKURIKI et al. (1958).
Little influence was seen at the pH between 6.8-8.6 to the development of larvae.
TANABE (1938 b) observed the rates of directly developing larvae and indi­
rectly developing adult worms on large numbers of cultures. The rates of
apperance of indirect development were 1/130-1/821, 1/7-1/824, 1/7-1/2,119 and
1/52-1/169 in four strains, and showed wide deviations but little influence could
be effected by the environmental conditions.
A. Reports of Anthelmintic Studies
1. On S. stercoralis
XI. TREATMENT
Numbers of chemicals have been hitherto tested and applied to the treatment
of the human strongyloidiasis. The first report in this country was made
by TASHIRO (1912 b) who applied peroral administrations of Lugol's solution,
quinine hydrochloride and atoxil in vein. NISHIGORI (1928) clarified the disadvantage
of use of constipating medicine, especially of bismus subnitricum, to
the diarrhea of this disease from the experiment with dogs, because constipating
medicine promoted heavy autoinfection. From this standpoit, YOKOGAWA (1929)
recommended the lasting administration of mild purge, Laxatol 0.5 g with
sulphur powder 1.0-1.3 g daily. As the result, in a case, larvae came to reduce
after 3 months, almost disappeared after 8 months and diminished after a
year.
623

624
YOSHINO (1939) studied the application of gentian violet successfully in seve­
ral cases as described below. MISAO (1941) observed no activity on Yatren, and
by the use of 4% emetin hydrochloride 1 cc daily for 6 days and 2 cc daily for
6 successive days in a case, larvae diminished and a parasitic female was dis­
charged. MORI & KURODA (1948) proved disapperance of larvae using gentian
violet in a dosis 60 mg three times a day totaling 3.3 g, and also KISHIDA &
HONMA (1952) with gentian violet 150 mg three times a day for two days, and
two hold injection of Stibnal and found negative after 14 days with the detec­
tion of the concentration technique of centrifugalization. TERASHI & NAKAMURA
(1954) expressed value of thymol, neglecting the effect of gentian violet. NAGOE
(1954) applying carbarsone found the diminish of the larvae in a case and
proved valuable application to the symptomatical treatment in several cases.
TANAKA (1957 d) observed gentian violet had effect enormously to reduce the
larvae and diethylcarbamazine had slight anthelminthic effect though it eased
clinical manifestations of the alimentary tract as a symptomatical medicine.
SAITO et ai. (1959) failed to treat with piperazine chemicals, I -bromonaphthol
(2), emetin hydrochloride, Stibunal and Yatren, and successfully treated with
gentian violet in a dosis 180 mg daily for 6 days totaling 3.6 g. SHIROMA
(1959) testing numbers of chemicals found no anthelmintic effect on carbarsone,
ethylen tetrachloride, I -bromonaphthol (2), piperazine chemicals, Stibunal,
Fuadin. Atebrin and diethylcarbamazine, much satisfactory effect on gentian
violet and symptomatical effect on carbarsone, and further clarified the admini­
stration of constipating medicine for short period did not promote the severity
of strongyloidiasis, rather aided to complete the succeeding anthelmintic treat­
ment. Treatment with dithiazanine originated by Sw ARZWELDER et ai. (1958)
was studied by MORISITA, T., KOBAYASHI et al. (1959) and by FUKUSHIMA &
TSUKASA (1960) with successful results. The anthelmintic effects and the rela­
tionship among effect, side reaction, coating type of tablets and method of
application were clarified on gentian violet by SHIROMA (1959) and TANAKA,
SHIROMA et al. (1960) and also on dithiazanine by TANAKA, SHIROMA and AMANO
(1960).
Studies on the anthelmintics of S. stercora lis were also made using experi­
mentally infected dogs. On the experiments of numbers of such infected dogs,
SATO, S. (1933 b) found no anthelmintic effect on the injection of Fuadin in a
dosis 0.05-0.1 cc per 1 kg body weight neither on the administration of oleum
chenopodii and Yatren. Slight activity was proved on the peroral administra­
tion of Livanol and remarkable effect on gentian violet in a dosis 20-30 mg per
1 kg body weight but the effect was reduced in a dosis 10 mg per kg and less
in 5 mg per kg.

626
after certain days from administration and the period was 4 to 6 days in the
report of YOSHINO (1939) and 3 to 6 days in that of TANAKA, SHIROMA et al.
(1960). The course of larval counts in the treatment of a case, for example,
shown in TANAKA et al. (1960) was that the larvae were 470.2 in a smear speci­
men in an average at beginning and succeeding daily counts after treatment
were 600.9, 204.2, 14.3, 0.2, 0, 0 respectively.
YOSHINO (1939) found the parasitic females evacuated in the stool in a course
of the treatment with gentian violet in 4 cases out of 16 and TANAKA, SHIROMA
et al. (1960) also observed the evacuated parasitic females. The evacuation was
seen from the next day to 7 days after administration. The maximum count
of evacuated parasitic females observed by TANAKA, SHIROMA et al. (1960) was
7.0 in a smear specimen in an average, the daily counts of this case were 0.5,
3.0, 7.0, 3.0, 1.0 respectively and total evacuation in this period was calculated
as much as 290,000. The output of filariform larvae in sputum was measured
by YOSHINO (1939) in the course of treatment and the count in a case were 176
in a smear specimen before treatment and the daily counts after treatment
were 103, 117, 148, suddenly reduced after 4 days till 9, 55, 1, 1, 0, 0 respectively.
As mentioned above, from the fact that the parasitic females were evacuated
and larvae in stool and also in sputum were reduced by the administration of
gentian violet, no doubt exists on the anthelmintic effect of this medicine.
Nevertheless sometimes eradication was failed applying gentian violet. To
clarify the cause of the failure, SHIROMA (1959) and TANAKA, SHIROMA et al.
(1960) made the comparative studies on the effects of the different types of tablet
and that of the time of administration. Tablets used were three different types
(marking L, M, M ') and administered at different times, 30 minutes before meal,
immediately after meal and 30 minutes after meal. The most effective result
was attained when tal bet M was administered immediately after meal with
success in all 20 cases and the administration of tablet L at 30 minutes after
meal was the least with success of 1 case out of 8. On the contrary, the side
reaction was most severe on tablet M immediately after meal, appearing in 11
cases out of 20 and none on tablet L. In the dissolving test of those three
tablets (according to the 6th supp. of J. P. 1955 and U. S. P. XV) tablet M was
thinnest and the others were thicker. In the report of YOSHINO (1939) who used
gentian violet in the gelatin capsels, the side reactions, inappetency, nausea
and vomiting, appeared in almost half examinees and the drug was considered
to be released from a capsel still in stomach and this early release of medicine
was the cause of successfull results. In consideration from the results of above
experiments, it seems to be difficult to make a such ideal kind of tablet which
releases contents at duodenum, the site of lodgement of S. stercoralis and at the

same time is always compact in stomach to reduce the side reactions. In
practise, the satisfactory results can not be expected unless such thinner coated
tablet may be applied as is definitely dissolved before the beginning of
duodenum even if side reaction of stomach appears.
Gentian violet has been applied to the treatment of S. ransomi of pigs.
NAKAJIMA (1955) administered 1 g daily divided into three times for two days
to 50 young pigs, successfull rate was 90 per cent after 5 to 10 days and pigs
well developed. WATANABE (1956) used 0.6 g daily divided into three times for
two days in 30 pigs, egg diminished in all cases even in animals that discharged
eggs in a concentration more than 1,000,000 E. P. G. and proved its activity.
The drug was administered usually in form of powder or tablets with food but
when pigs could not take any food due to severe strongyloidiasis, mixture in
milk was used or forced administration of the above mixture was tried by
using a pipet. In the experiment of OSHIO & TAKAHASHI (1958), eggs diminished
or enormously reduced in a dosis 0.01 to 0.017 g per kg body weight perdiem
once a week lasting four weeks, or by a single dosis of 0.021 to 0.05 g per kg,
the eggs became negative after 5 days. In the administration of larger volume
than 0.021 g per kg, side reactions, diarrhea, weariness, vomiting, emaciation
and inappetency were much observed.
2. Dithiazanine
SWARZWELDER et ai. (1957, 58) and FRYE et ai. (1957) used dithiazanine and
observed the diminish of larvae in 89 per cent among 18 human strongyloidiasis.
MORISITA, T., KOBAYASHI et ai. (1959) administered 600 mg daily to 5 cases of
heavily infected patient, and larvae became negative within 3 days and also to
26 cases of carriers successful rate was 88 per cent within 13 days. FUKUSHIMA
& TSUKASA (1960) examined 51 cases using dithiazanine, negative by the stool
examination was 91.6 per cent and that by examination of duodenal fluid was
100 per cent. GOTO et ai. (1960) treated with success applying 200 mg three
times a day for 21 days. Stool was examined using the centrifugal concentra­
tion technique and filter paper cultivation technique in the whole course, they
observed the cultivations were always negative during the administering period
and considered dithiazanine had a larvicidal activity.
TANAKA, SHIROMA & AMANO (1960) examined application of this medicine
similar to gentian violet. By the administration of dithiazanine, the larvae
were reduced and the parasitic females were evacuated as by that of gentian
violet and the drug was clarified to be satisfactory anthelminthics. As in the
tests, failure was experienced in certain occasions, comparative study was
made on the improved method of application of different types of tablets.
Tablets used had three types (marking L, EA, EB) and coating of tablet was
627

628
thinnest in L and thickest in EB at the dissolving test for enteric coating. The
course of treatment was divided in four types, i) reduction of larvae and
evacuation of parasitic females, ii) reduction of larvae only, iii) transient
reduction of larvae and increase after cease of administration, iv) no alteration
of larval output. When the course of i and ii was successful, the effective
cases/ examined numbers in different tablets and in different daily dosis were
2/4 in L 300 mg, 0/2 in L 600 mg, 1/4 in EA 300 mg, 7/9 in EA 600 mg, and 1/3 in
EB 600 mg. From the result, application of EA tablet 600 mg daily was most
satisfactory and larvae became negative in 6 cases. Side reaction appeared in
the one third of the patients and nausea or vomiting presented the more, when
the thinner coated tablet was used. As pointed out by KOBAYASHI (1959) the
medicine has larvicidal activity, the larvae came to be killed in 80 to 90 per
cent in staines stool at 4 hours after evacuation and in all after 10 hours. So
the detection of larvae from the stool of the patient being treated with dithiazanine
is difficult because dead larva has to be often detected and should be
made with much care even if either the technique of detection might be used.
The exact existance of larvae should be known by the detection on the several
days after the cease of the administration. Similar to gentian violet, it seems
to be difficult to make such a kind of tablet with dithiazanine as keeping
satisfactory anthelmintic effect and simultaneously showing less side reaction
on stomach.
3. The other chemicals
NAGOE (1954) and NAGOE & YONEZAWA (1954) observed disapperance of larva
in a case using carbarsone and symptomatical recovery in other cases. SHIROMA
(1959) also proved symptomatical effect on the severe cases and for the recovery
of the alimentary tract, succeeding administration of gentian violet could be
readily accomplished.
SOTOLONGO (1950) used diethylcarbamazine to three cases with success.
TANAKA (1957 d, 58) administered it to 8 cases in a dosis 4.8 to 11.5 mg per kg
body weight daily for two weeks and the larvae was 14.6 in a smear specimen
in an average at the beginning, 4.8 after a week and 7.2 after 2 weeks. The
reduction was lesser than in gentian violet in control group, in which larvae
were 14.3 at beginning and 0.9 after a week. On the other hand, the medicine
dramatically eased such symptoms as abdominal pain, diarrhea, inappetency
and bloody mucous discharge. The medicine also recovered symptoms of ali­
mentary tract on the other 6 cases. FUJITA & TAKAHASHI (1953) administered
diethylcarbamazine in a dosis 30 mg per kg body weight for three days to 81
pigs, younger than 4 months old and harbouring S. ransomi, and development
of body weight was larger than untreated control group though the egg output

was not reduced comparing with controls.
GRAHAM (1960) administered pyrvinium pamoate to Macaca mulatta to prevent
S. fiilleborni and reported successfull result. METZEL (1963) observed the
parasitic femal evacuated into the stool by the administration of pyrvinium
chloride in a child case. The application of pyrvinium chemicals to man was
also reported by BROWN & STERMAN (1958), MEIRA, NETO & CAMPOS (1961),
MEZZOTTI (1959) and WAGNER (1963). Recently TANAKA (1964) applied the suspension
of pyrvinium pamoate in a dosis 5 mg base per 1 kg body weight once
daily for 5 days in two heavily parasitized patients, the larvae suddenly disap­
peared within 5 days and complete recovery followed after 2 months. The drug
showed little side reaction and the anthelmintic activity will be much expected
in the further studies.
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31. HATORI , J . (1898): On the larvae of Stl'ongyloides stercomlis. Tolzyo Igaldwi Zasshi,
12 (16), 735-748. (in Japanese)
32. HAYASHI, S., M. SASA, R. SHIRASA KA, A. TAKA DA, S. OTANI, K. F UKAYA, Y. SUGIMOTO
& Y. YOSHITAKE (1958) : Studies on an outbreak of urinary nematodiasis due to Rhabditis
sp. Kiseichugallu Zasshi, 7 (6), 641-645. (in Japanese) (with English summary)
33. IMAI, T. & G. KOGA (1949): Diarrhea. Rinshyo to Kenllyu, 26 (12), 802- 804. (in
Japanese)
34. IMAlZUMI, K. (1911): A case of Anguillula intestinalis. Iji Shimbun, (826), 433- 434.
(in Japanese)
35. INATOMI, S., D . SAKUMOTO, K . ITANO & H. TANAKA (1963): Studies on the submicro·
scopic structure of body surface of larval nematodes. Kiseichugalm Zasshi, 12 (1), 16-39.
(in Japanese with English summary)

36. ITO, S. (1932): Supplemental studies on parasitic females, eggs and larvae of Strongyloides
stercomlis. Keio Igaku, 12 (11), 2147-2164. (in Japanese)
37. IWAYA, S. (1912): A case of Anguillula intestinalis. Kenyokai Zasshi, 104. (in
Japanese)
38. (1914): On Anguillula stercoralis. Tokyo Iji Shinshi, (1870), 1082- 1092,
(1872), 1196- 1198, (1873), 1239- 1247. (in Japanese)
39. JONES, C. A. (1950): Clinical studies in human strongyloidiasis 1. Semeiology. Gastroenterology,
16, 743- 756.
40. KAGOSHIMA MEDICAL ASSOCIATION (1954): Symposium on the endemic diseases in the
south Kyushu. Kagoshima Igaku Zasshi, 27 (5, 6), 116- 120. (in Japanese)
41. KATO, S. (1921): Demonstration of Stl'ongyloides ste1'Coralis. Nippon Nailw Gakkai
Zasshi, 9 (8). (in Japanese)
42 . KATO, T. (1955) : The epidemiology of helminthiasis in Aichi Prefecture (Report
1). Kiseichugaku Zasshi, 4 (1), 44- 49. (in Japanese with English summary)
43. KATSUKI, s. (1951): Strongyloidiasis. Igaku, 11 (3), 184. (in Japanese)
44. KAWAI, T. (1935): On the resistance of infective (filaria from) larvae of Strongyloides
stercoralis against chemicals. Taiwan Igakkai Zasshi, 34 (12), 2051- 2062. (in Japanese)
45. KAWAJI, K., H. KITAMURA, T. HASHIGUCHI, R . HAMADA & M. OYAMA (1956): An
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46. KAWAMOTO, T. (1961): Studies on Strongyloides and strongyloidiasis (S-5). Susceptibilities
to infective larvae of Strongyloides mtti SANDGROUND 1925 and S. stercoralis
(BA VA Y, 1876) STILES et HASSALL, 1902. Kagoshima Daigaku Igaku Zasshi, 12 (6), 3169-
3183. (in Japanese with English summary)
47. KAWASAKI, H. (1924): An autopsy of strongyloidiasis stercomlis with assumptive cause
of ulcer in colon. Nagasa/li Igakkai Zasshi, 2 (4), 453-470. (in Japanese)
48. Kl]IMA, T. (1955): A case of strongyloidiasis. Kagoshima Igaku Zasshi, 28 (1, 2), 43.
(in Japanese)
49. KIMATA, N. (1903): Curious vomit, Anguillula intestinalis, found in a patient. Chuo
Igakkai Zasshi, 54 (1). (in Japanese)
50. KISHIDA, T. & M. HONMA (1952): A case of strongyloidiasis with gross intestinal
bleeding. Tokyo Iji Shinshi, 69 (7), 424. (in Japanese)
51. KOBAYASHI, M. & K. TAKIKAWA (1959): Studies on the secretion and excretion systems
of Strongyloides mtti. Kiseichugaku Zasshi, 8 (3), 411. (in Japanese)
52. KOGA, G. (1949): A severe case of strongyloidiasis. Kyushu Igakkaishi, 15. (in Japanese)
53. (1955): Occurrence of Taenia solium in Tokunoshima Island. Kiseichugaku
Zasshi, 4 (2), 144. (in Japanese)
54. KOMIYA, Y. (1959): Parasitic infections and medicine. Yakkyoku, 10 (1), 109- 116. (in
Japanese)
55. KOSUGE, 1. (1924): Histologische Untersuchungen tiber das Eindringen von St1'Ongyloides
stercoralis in die Haut von Versuchstieren. Arch. Schiff. Trop. Hyg., 28 .
56. (1924): Wie weit wirken dem Eindringen von Strongyloides larven und anderen
parasitischen Nematoden in das Gewebe spezifische Reize? Ibid., 28.
57. (1924): Studies on the invasion of larvae of Strongyloides and other nematodes
into the tissue. Jikken Igaku Zasshi, 8 (12), 1105-1111. (in Japanese)
58. KREIS, H. A. (1932): Studies on the genus Strongyloides (Nematodes). Am. Jour. Hyg.,
16, 450-491.
59. KUROKAWA, H. (1950): Observation of intestinal parasites at Kanda Clinic and a consideration
to the hook worm disease. Nippon Kiseichu Gakkai Kiji, 19, 41. (in Japanese)
60. KUSUI, K. & S. USHYUKU (1934): Uber einen Fall von Anguillulose mit interessantem
Rontgenbild des Dtinndarmes. Nagasaki Igakkai Zasshi, 12 (9), 1175- 1186. (in Japanese
with German summary)
61. LEICHTENSTERN, O. (1899): Zur Lebensgeschichte der Anguillula intestinalis. Cent.
631

comparative studies on the effect of several kinds of anthelmintics. Nippon Kiseichtt
Gakkai Kiji, 20, 64-65. (in Japanese)
85. MORI, K. & S. KURODA (1948): A case of strongyloidiasis. Yo/wha ma Igaktt, 1 (1), 13-
14. (in Japanese)
86. MORISITA, T ., M. KOBAYASHI, Y. KUNII & K. T AKIKAWA (1959): Development of
St1'ongyloides with relationship to Rhabditis. Nippon Iji Shinpo, (1817), 45-48. (in
Japanese)
87 . , Y. Y AMA KAWA & M. MORI (1959): Treatment of strongyloidiasis
with dithiazanine. Gifu Ika Daigaku Kiyo, 7 (4), 1245- 1247. (in Japanese)
88. NAGAo, M. (1918): On Anguillula viviPam found in a horse in Japan. Jikken Iga/zu
Zasshi, 2 (2) . (in Japanese)
89 . NAGASAWA, D. (1902): On Anguillula intestinalis. Tokyo Iji Shinshi, (1268), 1167-1175.
(in Japanese)
90. NAGOE, T . (1954 a) : An endemic disease on Tanegashima Island. Chiryo Yakuho, (514),
11 . (in Japanese)
9l. (1954 b): Strongyloidiasis and its treatment. Kagoshima Igaku Zasshi, 27
(3, 4), 65- 68. (in Japanese with English summary)
92. & T. YONEZAWA (1954) : Strongyloidiasis and its treatment on Tanegashima
Island. Ibid., 27 (3, 4), 75. (in Japanese)
93 . NAITO, H. (1928): A case of so-called Cochin-China diarrhea. Naigai Chi/'Yo, 3 (5) . (in
Japanese)
94 . NAKAJIMA, T. (1955): Malnutrition of young pigs due to S trongyloides mnsomi and
curative effect of " Hinetol ". Jui Chikusan Shimpo, (157), 430- 433. (in Japanese)
95 . NISHIGORI, M . (1925) : Life cycle and external development of Strongyloides stercomlis.
(Ab) T aiwan Igakkai Zasshi, (248). (in Japanese)
96. (1926): The development of St1'ongyloides stercomlis. Nippon BYQ1'i Gakkai
Kaishi, 16 , 27l-274. (in Japnese)
97 . (1927): The factors which influence the external development of Strongyloides
ste1'Comlis and on autoinfection with this parasite.(Ab) Taiwan Igakkai Zasshi, (27l), Ibid.,
(272). (in Japanese)
98. (1928): Ibid., Ibid., (276), 291-311 ; (277), 397-43l. (in Japanese with English
summary)
99_ NISHIMURA, H. (1943): Helminths of alimentary tract of house rats in Fukuoka City.
Fukuoka Ika Daigaku Zasshi, 36 (8), 726- 74l. (in Japanese)
100. ODAWARA, T. (1954): Cases of strongyloidiasis. Kagoshima Igaku Zasshi, 27 (3, 4),
64-65. (in Japanese)
10l. OHIRA, T . (1913): On Strongyloides stercomlis especially on the pathogenicity. Tokyo
Igakkai Zasshi, 27 (20), 1601-1646 . (in Japanese)
102. (1914 a): False identification and its cause at the cultivation of hook worms
and Strongyloides, in addition of studies on the free living nematodes. T okyo Iji Shinshi,
(1887), 1929- 1936. (1888), 1977- 1983. (1889), 2031- 2038. (in Japanese)
103. (1914 b): Criticism to the report of Dr. IWAYA on StTongyloides steTcomlis.
Ibid. , (1874), 1305- 1307. (in Japanese)
104. (1914 c): Criticism to the second report of Dr. IWA YA on St1-ongyloides steTcQ1-alis.
Ibid., (1876), 1409- 1410. (in Japanese)
105. (1914 d): A species of S tTongyloides in a monkey. Fukuoka Ika Daigalzu
Zasshi, 8 (1), 90-96. (in Japanese)
106. (1918): Problem whether human Strongyloides' is infective on the other
animals, in addition of autoinfection. Tokyo Iji Shinshi, (2096), 2003-2009. (in Japanese)
107. (1919): Studies on St1-ongyloides ste1-comlis. Tolzyo Igalzkai Zasshi, 33 (11),
601- 633. (in Japanese)
108. (1921) : Histological studies on human case of Strongyloides stercQ1-alis, on
633

634
experimental animal infections and on autoinfection of this nematode. Kanpo, (2681).
(in Japanese)
109. ONODERA, N. (1922): Human strongyloidiasis and diabetes. Fukuoka Ika Daigaku Zasshi,
15 (3), 151- 155. (in Japanese)
110. OSADA, M. (1952): Strongyloides stercoralis infections in three families in Tochigi Prefecture.
Igaku to Seibutsugaku, 22 (4), 146- 149. (in Japanese)
111. OSHIO, Y. (1956): Studies on the larval migration of Strongyloides ransomi at percutaneous
infection. Nogyo Gijutsu Kenkyujyo Hokoku G., (12), 181-186. (in Japanese with
English summary)
112. & 1. FURUTA (1954): Studies on the infection of Sf1'ongyloides l"ansomi.
Nippon juishikai Zasshi, 7, 259-261. (in Japanese)
113. (1955 a): Studies on hyaluronidase in parasitic nematodes. Nogyo
Gijutsu Kenkyujyo Hokoku G., 11, 47- 56. (in Japanese with English summary)
114. (1955 b): Histological studies on the hide at the percutaneous
infection of Strongyloides ransomi. Ibid., 11, 57- 66. (in Japanese with English summary)
115. & A. TAKAHASHI (1958): Treatment and prevention of Strongyloides ransomi.
Ibid., 14, 137- 143. (in Japanese with English summary)
116. ROMAN, E. (1956): Specificite parasitaire de Strongyloides ratti du surmulot. Effets
de la cortisone sur l'infestation d'autres rongeure par ce Nematode. Ann. de Parasit.,
31 (5, 6), 552- 571.
117. SAITO, S., N. YONEDA, M. MIURA & 1. OMURA (1959): On strongyloidiasis. Chil'YO, 41
(5), 627- 632. (in Japanese)
118. SANDGROUND, J. H. (1925): Speciation and specificity in the nematoda genus Strongyloides.
jour. Parasit., 12 (2), 59-80.
119. (1926) : Some biological studies of the lifecycle in the genus Strongyloides .
Arch. Schif. Trop. Hyg., 30 (9), 528-533.
120. SASA, M., S. HAYASHI, H. TANAKA, K. SATO, A. MIURA, M. WAKASUGI, R. SHIRASAKA,
A. TAKATA, K. TOKURIKI, E. NAKAMURA & M. NAGANO (1957): Comparative studies
on parasitic infections among coal miners in Kyushu and Hokkaido. Koshu Eisei, 21
(11), 1- 9. (in Japanese)
121. & R. SHIRASAKA (1958): Application of test· tube
cultivation method on the survey of hookworms and related human nematode infection.
japan. jour. Exp. Med., 28 (3), 129- 137.
122. , H. TANAKA, Y. ABE, A. SUGIURA, H. UCHIYAMA, K. IZUMI & 1. TAKIKIKU
(1958): Epidemiological studies on the human parasites at Amami-Oshima Island (1)
Distributions of the main intestinal helminthic infections detected by direct smear,
floatation and test-tube cultivation methods of fecal specimens. Kiseichugaku Zasshi, 7
(4), 357- 362. (in Japanese with English summary)
123. , S. HAYASHI, H. TANAKA, A. SUGIURA, Y. ABE, H. UCHIYAMA. K. IZUMI &
1. TAKIKIKU (1958): Ibid. (2) Familial distributions of the parasites and correlations
between infections of different parasites. Ibid., 7 (5), 449-453. (in Japanese with English
summary)
124. , K. TERUYA, K. IKEMIYA, S. KUNIYOSHI, S. SHIROMA & S. KIN]O (1958):
On the parasitic infections at farming villages on Okinawa. Nippon Ishikai Zasshi, 39
(9), 601-604. (in Japanese)
125. SATO, H. (1956): Strongyloidiasis. Nippon Iji Shinpo, (1673), 111. (in Japanese)
126. , H. FUKUSHIMA, E. IBUSUKI, S. TSUKASA & T. NONAKA (1958): On parasitic
helminths, especially on hookworms and Strongyloides stercoralis in Amami Oshima.
Kagoshima Daigaku Igaku Zasshi, 10 (4), 1140- 1147. (in Japanese with English summary)
127. , H. TOYAMA, T. NONAKA, H. TERUYA, M . KUNI YOSHI & M.
SHIROMA (1958): A study on parasitic helminth and filariasis bancrofti in Okinawa.
Ibid., 10 (4), 1148- 1160. (in Japanese)

636
mental stage of Strongyloides ratti SANDGROUND and statistical observations of the adult
worms on the parasitizing parts in the specific host. Kagoshima Daigallu Igalltt Zasshi,
12 (4), 1632- 1647. (in Japanese with English summary)
149. TAKAHASHI , M. (1942): A case of strongyloidiasis stercoralis with ascites. j icchi IIw
to Rinshyo , 19 (5), 402- 406. (in Japanese)
150. TAKEDA, S. & S. T. RI (1924 a): A case of strongyloidiasis stercora lis. Chosen Igaldwi
Zasshi, 47 . (in Japanese)
151. (1924 b): A case of strongyloidiasis stercoralis. Ibid., 50, 352-
355. (in Japanese)
152. TAKEGAWA, T., H. SUGANUMA & M. EN DO (1958): Studies on parasites in Joban area
especially among coal miners. Yollohama Igallu, 9 (3), 301-306. (in Japanese)
153. TAKEUCHI , H. (1905): Experimental studies on Anguillula intestinalis as a causative
agent of chronic idiopathic diarrhea. Taiwan Igallllai Zasshi, 3D, 260. (in Japanese)
154. TANABE, K. (1938 a): External development of larvae of St1'ongyloides ratti and inter·
nal development in norvegic and albino rats. (Ab) Nippon Kiseichu Galllwi Kiji, 10, 37.
(in Japanese)
155. (1938 b): Development of the larvae of Strongyloides ratti in the proper host.
Keio Igallu, 18 (6), 785- 794. (in Japanese with English summary)
156. (1938 c): Development of St1'ongyloides ratti in the albino rats. Ibid., 18 (7),
867-877. (in Japanese with English summary)
157. (1938 d): On influence of environmental conditions upon the development of
Strongyloides ratti. Ibid., 18 (9), 987-999. (in Japanese with English summary)
158. (1938 e): Supplemental studies on the determination of both types of external
development of Strongyloides 1·atti. Ibid., 18 (10), 1139-1143. (in Japanese)
159. (1939): On eosinophilia in the intestinal wall of the rat infected with
Strongyloides 1'atti. Ibid., 19 (2), 2l3-229. (in Japanese with English summary)
160. & H. TAKEISHI (1936): A survey of helminths in the digestive system of
the rat. Ibid., 16 (11), 1767- 1785. (in Japanese with English summary)
161. TANAKA, H. (1957 a): Studies on St1"ongyloides stercoralis. Kiseichugallu Zasshi, 6 (3,
4), 293. (in Japanese)
162. (1957 b): Studies on strongyloidiasis. 1) Epidemiological observations in
Amami·Oshima Island. juntendo Igallu Zasshi, 3 (I), 22-30. (in Japanese with English
summary)
163. (1957 c): Ibid. 2) Cultivation methods and morphological observations of
Strongyloides in the free· living phase. Ibid., 3 (2), 91- 100. (in Japanese with English
summary)
164. (1957 d): Ibid. 3) Clinical studies of experimental and natural infections.
Ibid. , 3 (3), 155- 162. (in Japanese with English summary)
165. (1958): Experimental and epidemiological studies on strongyloidiasis of
Amami·Oshima Island. japan jour. Exp. Med. 28 (3), 159- 182.
166. (1964): Studies on the treatment of human strongyloidiasis with pyrvinium
pamoate suspension. Chi/'Yo Yalluho, (631). (in Japanese)
167. & R . AMANO (1959): The course of the evacuated numbers of eggs of
Strongyloides ratti. (Ab) Kiseichugallu Zasshi, 8 (3), 412. (in Japanese)
168. & (1960): Studies on Strongyloides 1'atti with a special reference
to the screening test for Strongyloides anthelmintics. Bull. Tollyo Med. Dent. Univ.,
7 (2), 193-230.
169. , K. S UGIYAMA & Y. SHIROMA (1959): Detection of St1"Ongyioides
ratti from house rats by fecal examination. Ochanomizu IgallU Zasshi, 7 (I), 195-200.
(in Japanese with English summary)
170. , N. KUMADA, K. FUKUMINE, H. KAWAMITSU, H. TOKUMINE & C. IJYU (1959):
Examination of nematode infections on Miyako Island, Ryukyu. Koshyu Eisei, 23 (8),

523- 527. (in Japanese)
171 . , Y. SHIROMA & R. AMANO (1960): Application of dithiazanine iodide to the
treatment of human strongyloidiasis. Kiseichugaku Zasshi, 9 (4), 415. (in Japanese)
172. , N. KUMADA, K. FUKUMINE & H. KAWAMITSU (1960) : An effica·
cious application of gential violet to the treatment of strongyloidiasis. Bull. TollYo Med.
Dent. Univ., 7 (1), 137- 150.
173. , H. TOKURIKI , R. SHIRASAKA & S. HAYASHI (1958): On Strongyloides
ste1'coralis with special refference to its detection. Naika no Ryoiki, 6 (5), 335- 340. (in
Japanese)
174. TANI, M. & H. UZAWA (1954): An autopsy case of heavy infection of Strongyloides
accompanied with liver cirrhosis. Saisei, (315), 46. (in Japanese)
175. TASHIRO, 1. (1912 a): Studies on Strongyloides stercoralis in Japan. Saikingaku Zasshi,
(198), 273-287. (in Japanese)
176. (1912 b): Studies on StTongyloides stercoralis in Japan with special refference
to its infection in dogs. Ibid., (204), 805-811. (in Japanese)
177. TERASHI, K. (1953): Strongyloidiasis. Kagoshima Igalm Zasshi, 26 (11. 12), 282- 283 . (in
Japanese)
178. & Y. NAKAM URA (1954): Strongyloidiasis in the Isa Gun area. Ibid., 27 (7. 8),
179. (in Japanese)
179. TOMITA , S. (1937): External development of Genus Sf1'ongyloides, GRASSI. Taiwan
Igakkai Zasshi, 36 (12), 2825- 2826 . (in Japanese)
180. (1938): On the resistance of the filariform larvae of St"ongyloides papillosus
to various agents. Ibid., 37 (7), 1104- 1111. (in Japanese)
181. (1939): On the species of Strongyloides harbouring in Formosan pig and
monkey. Ibid., 38 (11), 1613- 1624. (in Japanese)
182. (1940 a): On the difference of infectivity of S. papillosus and S. jiilleborni
upon dogs and monkeys. Ib id., 39 (10), 1649- 1650. (in Japanese)
183. (1940 b): Experiment on the susceptibility of men to infection by Strongy.
loides jiilleborni and by Strongyloides papillosus. Ibid., 39 (11), 1884- 1885. (in Japanese)
184. (1941 a): Cutaneous reaction at the innoculated area, clinical and hematolo·
gical courses at human experimental infection of Strongyloides papillosus and St1'ongy,
loides jiilleb01·ni. Ib id., 40 (1), 149- 150. (in Japanese)
185 . (1941 b): Ibid. Ibid., 40 (3), 427-443. (in Japanese)
186. (1941 c): On the host specificity of Strongyloides jiilleb01'ni and Strongyloides
papillosus. Ibid., 40 (11), 2147- 2157. (in Japanese)
187. TSUKASA, S. & T . HASHIGUCHI (1959): Ecological and histochemical studies on St,·ongy·
loides stenoralis. (Ab) Kiseichugaku Zasshi, 8 (3), 410. (i n Japanese)
188. TSUNODA, S. (1934): On the parasitic disease of Strongyloides ste1'coralis. Tokyo Iji
Shinshi, (2894), 2059-2063. (in Japanese)
189. UCHIZONO, Y. (1954) : Strongyloidiasis. Kagoshima Igaku Zasshi, 27 (3, 4), 75. (in
Japanese)
190. UENO, M. (1948): A case of StTongyloides steno1'alis. Kagoshima Igaku Zasshi, 21 (7).
(in Japanese)
191. UMEKI, O. (1951): A case of strongyloidiasis with appearance of larvae in pleural and
peritoneal effusion. (Ab) Nippon Naika Gakkai Zasshi, 40 (7), 392. (in Japanese)
192. WATANABE, S. (1956): Internal parasitic diseases of pigs and their control. Chikusan
no Kenkyu, 10 (1), 217- 220. (in Japanese)
193. YAMADA, M. (1907): A case of Rhabdonema strongyloides in Japan. Iji Shinbun, 73 1.
(in Japanese)
194. YAMAGUCHI, T . (1958): Histochemical studies on parasitic helminths. 3) Histochemical
studies on larvae of Ancylostoma duodenale and Strongyloides ratti. Kiseichugaku
Zasshi, 7 (1), 29-36. (in Japanese with English summary)
637

638
195. YAMAGUTI, S. (1925) : Ueber die durch Larven von Ascaris lumbl'icoides und Strongyloides
stercoralis an Gehirn und Nieren verursachten Vedinderungen. Arch. Sch-i/. Trop.
Hyg., 29 (10), 589-604.
196. YOKOGAWA, S. (1913): On the pathogenicity of Strongyloides stercoralis. Taiwan
Igakkai Zasshi, (127) . (in Japanese)
197. (1914): The second report on the pathogenicity of Strongyloides stercoralis.
Nippon Shokakibyo Gakkai Zasshi, 13 (1). (in Japanese)
198. (1929): The autoinfection and the principle of the treatment of St1'Ongyloides
sterc01'alis. Chil'Yo oyobi Shoho, 10 (107), 123-126. (in Japanese)
199. & T. OISO (1925 a): Studies on the life cycle of hookworms and Strongyloides
stercomlis. Pts. 1- 3. Tokyo Iii Shinshi, (2418), 971- 977; (2425), 1336- 1340; (2439), 2022-
2028. (in Japanese)
200. & (1926 a): Studies on the life cycle of hookworms and Stl'ongyloides
stel'coralis. Ibid., (2456), 327-337. (in Japanese)
201. & (1925 b, 1926 b): Ibid. Taiwan Igakkai Zasshi, (241), (246),
(248), (250). (in Japanese)
202. YOSHIDA, H., R. TAKADA & S. ITO (1931): Clinical and pathological observations in a
case of Strongyloides ste1'Coralis. Gunidan Zasshi, (213), 464. (in Japanese)
203. (1932): Ibid. Kaigun Gunikai Kaishi, 21 (2), 132.
(in Japanese)
204. YOSHIDA, J. (1940): A case of Stl'ongyloides ste1'Comlis. Kumamoto Igakkai Zasshi, 16
(1), 174. (in Japanese)
205. YOSHIDA, S. (1918): On the course of internal migration in the peroral larval infections
of hookworms and Stl'ongyloides stercoralis. Tokyo Iii Shinshi, (2088), 1639-1644. (in
Japanese)
206. YOSHINAGA, K. (1950): A case of Strongyloides ste1'Comlis with perforated peritonitis.
Rinshyo to Kenkyu, 27 (9), 631- 633. (in Japanese)
207. (1950): Ibid. Nippon Byori Gakkai Zasshi, 39, Editio generalis, 265-266. (in
Japanese)
208. YOSHINO, K. (1932): Clinical observations of 25 cases of strongyloidiasis in Yaeyama
Islands, Okinawa, Japan. Taiwan Igakkai Zasshi, 31 (9), 1067- 1080; 31 (10), 1124- 1138.
(in Japanese with English summary)
209. (1939) : An application of gentian violet to the treatment of Strongyloides
stel'coralis. Tokyo Iii Shinshi, (3124), 566-569. (in Japanese)