REVIEW TROPICAL MEDICINE, ETC. 17 



sulphide is a cumulative poison and that, as the quantity in the rings is considerable, a Beverages — 

 rubber free from such poisonous ingredient should be used. coaiUued 



A serious indictment of both tea and coffee is put forward by Fernet'* who calls them 

 " satellites of alcoholism," and describes caffeism and theism in acute and chronic forms. 

 Coffee is especially libelled, because its abuse has recently increased in France. It is said 

 to depress the mental power, and chronic coffee intoxication leads, it is asserted, to impotence 

 and sterility, while the children of coffee drinkers are ill-formed, ill-nourished, abnormally 

 excitable and often suffer from arrests of development. The quantity sufficient to produce 

 such dire results is uncertain, but three or four small cups daily may be enough to cause 

 chronic intoxication. 



These remarkable statements certainly do not find confirmation in the Sudan, where 

 coffee is largely drunk both by Europeans and natives, though be it noted, it is very excellent 

 coffee, prepared directly and carefully from the bean. Indeed, as the British Medical 

 Journal- remarks: "There can be little doubt that Dr. Fernet's article is somewhat tinged 

 by exaggeration, though it is well to bear in mind that some of these ill effects may be 

 encountered in practice from personal idiosyncrasy or excessive use of tea and coffee." 



Bilharziosis. The most recent work on this subject will be found incorporated in 

 Madden's^ monograph which, dealing as it does with the disease from an Egyptian 

 standpoint, is of special interest to us in the Sudan. The author supports Looss's theory as 

 to the direct entry of the miracidium by way of the skin, and he rejects Sambon's supposition 

 that there are two species of Schistosomum, one characterised by terminal-spined, the other 

 by lateral-spiued, ova. He also mentions an interstitial nephritis due to the disease, and 

 deals with its effects on the female generative organs. 



Looss'' in a recent paper severely criticises Sambon's views, and regards the evidence 

 adduced by the latter as wholly inadequate to prove the existence of Schistosomum mansoni. 

 He points out that no distinctive anatomical character of (S. mansoni has been 

 demonstrated, and, as regards the egg, states that proof of its belonging to a definite 

 species must consist in showing that one form of egg is constantly connected with a certain 

 anatomical structure, and the other form as constantly connected with another anatomical 

 structure of the adults. " Until this is done," he says, " I am afraid that S. mansoni will 

 find little approval with zoologists in spite of Dr. Sambon's contention that to zoologists the 

 character of the ovum should sufBce for the determination of a new species." 



Looss goes on to say that the position of the spine depends on the relative position of 

 the egg during the process of its formation in the ootypes, and points out that long ago 

 Bilharz found that in Egypt the eggs of S. haimatohium and ti. mansoni may occur in 

 one and the same individual female. Moreover, he would lay no stress on the point if a 

 lateral-spined egg happened to be found in the urine. To him it would appear as an 

 accidental exception, due to accidental reasons, to the rule that the urine contains terminal- 

 spined eggs only. One important statement made is, that the lateral-spined eggs do not 

 come from the rectal lesions. They are probably abnormal eggs, for Looss has found that 

 very generally Trematodes, as they approach sexual maturity, form such ova. At the same 

 time, he does not pretend that immaturity is the sole cause of the lateral spine. Indeed, an 

 immature female may quite possibly produce a terminal-spined egg. 



Taking up the question of geographical distribution, Looss apparently shows that 

 Sambon's position is untenable, and mentions that in LetuUe's case, where the bladder was 

 entirely free from infection, both forms of egg were found. 



One cannot follow Looss throughout his whole argument, but one statement must be 

 noted. His experiments to find an intermediate host in various species of mollusc have 

 invariably failed, and he has been forced to the conviction that "Ifaw himself acts as 

 intermediary host." If this be true, then the spread of iS'. heematobium is not limited by 

 the natural geographical distribution of a special intermediary host. He now believes, and 

 he adduces some proof in favour of the idea, that the miracidia enter through the skin and 

 that a few of them reach the liver and there form sporocysts. He proceeds to discuss this 



' Fernet, Scmaine Midicale, No. 31, 1906. 



^ British Medical Journal, p. 652, Vol. II. (September 15th, 1906), " Our Breakfast Beverages." 



' Madden, P. C, " Bilharziosis," Cassell & Co., 1907. 



^ Looss, A. (July 1st, 1908), "What is Schistosomum Mansoni?" Annals of Tropical Medicine and 

 Parasitoluijij, Series T.M., Vol. II., No. 3. 



• Article not consulted in the original. 



