18 REVIEW— TROPICAL MEDICINE, ETC. 



Bilharziosis view at length, and states that a first infection with a female sporocyst would give a picture 

 —contiimcd typical of " Hansen's Bilharziosis," i.e. an untouched bladder, but lateral-spined eggs 

 appearing for years in tlie faeces. 



Whatever may bo the truth regarding )S'. mamoni, and I confess that, considering 

 Looss's vast experience and great repute as an helminthologist, his opinion carries most 

 weight, there can be no doubt as to the importance and interest of his paper, which should 

 be carefully studied by all interested in Bilharziosis. 



A useful and well-illustrated paper is that of Sandwith,' who mentions Dight's 

 suggestion to inject large quantities of sulphuretted hydrogen and carbon dioxide gas into 

 the rectum or bladder for the purpose of killing the worms in situ. 



Symmers,- in a paper describing a remarkable case, mentions that he has twice found 

 living worms in the pulmonary blood, and describes a peculiar condition of polypoid 

 outgrowths on the serous coat of the ileum, caecum and colon, extreme polyposis of the large 

 bowel, a fibrosis of the appendix vermiformis, the presence of eggs in the pancreas and 

 lymphatic glands, and the typical liver cirrhosis, although there was only incipient 

 bilharziosis of the urinary bladder. 



Williamson," in a paper on the disease in Cyprus, shows how it was connected with 

 bathing in a certain river, while a suggestive article on Endemic Haematuria in South Africa, 

 by Stock,'' draws attention to the presence of fat in the urine and mentions the "toxin" 

 treatment advocated by Birt. He cites two cases which contracted enteric fever and, as a 

 result, were apparently cured of their bilharziosis, and a case of fatal dysentery in a native 

 where, within two hours of the patient's death, the worms, on being dissected out, were found 

 to be dead. He suggests repeated small doses of Wright's anti-typhoid serum, and mentions 

 two cases under this treatment, of which, however, I can find no further record. 



Letulle' has a paper on intestinal bilharziosis, and mentions the occurrence of the 

 disease due to S. mansoni in the lesser Antilles, particularly in Martinique. He specially 

 points out that it is solely confined to the lower end of the intestinal tract. 



The paper is well illustrated and discusses the morbid histology of the lesions very fully. 



Manson" adopts Sambon's classification, already mentioned, and regards S. mansojii, 

 which has lateral-spined ova, as being probably a West African species which has been 

 introduced into the western hemisphere by the African negro. It was first found by him in 

 a West Indian patient whose urine was free and who had never suffered from haematuria. 

 Sambon^ has recently again dealt with this subject, and points out that he based his 

 differentiation of the two species on diiiferences in the structure of the female genital tract 

 and on the ova, which are distinguished not only by the position of the spine but by its size 

 and shape and by their own anatomical differences. He also considers the peculiar 

 geographical distribution and anatomical habitat of 8. mansoni as proof of its being a new 

 parasite. A concise account is given by Manson of S. japonictim, the trematode found by 

 Katsurada in human stools and in the portal system of cats in Japan, and discovered 

 independently by Catto in a Chinaman's meso-colon in Singapore. Hanson's book is, 

 however, in every practitioner's hands and need not be quoted here. The occurrence of this 

 parasite in the Philippine islands has been noted by WooUey.** He found lesions in the 

 lung, liver and bowel of a Filipino and noted fibrosis of the liver. 



Logan" describes three cases in China and gives rough drawings of the eggs and free 

 embryos as they appear in the faeces. He thinks the fact that the egg is only a little larger 



' Sandwith, Practitioner, October, 1904. 



- Symmers, W. St. C, " Studies in Pathology." Aberdeen, 1906. 



' Williamson, Q. A. (November 9tli, 1907), " A Further Note on Bilharzia (Schistosomum) Disease in Cyprus." 

 Journal of Tropical Medicine, p. 133.3. 



■* Stock, P. G. (Sept. 29th, 1906), " Endemic Hsematuria." Lancet, p. 857, Vol. II. 



= LetuUe, M. (April 15th, 1905), " Intestinal Bilharziosis." Archives dc Parasit6logie, p. 329, Vol. IX. 



« Manson, Six Patrick, " Tropical Diseases." 4th Edition, 1907. 



' Sambon, L. W. (.January 11th, 1908), "The part played by Metazoan Parasites in Tropical Pathology." 

 Lancet, p. 102 ; and (January loth, 1908). Journal of Tropical Medicine and Hijtjiene, p. 27, Vol. XI. 



" Woolley, P. G. (January, 190G), "The Occurrence of Schistosomum Japonicum vel Cattoi in the Philippine 

 Islands." Philippine Journal of Science, p. 83. 



° Logan, O. T. (February 16th, 1906). " Three cases of infection with Schistosomum Japonicum in Chinese 

 subjects." Journal of Tropical Medicine and Uytjicne, p. 294. 



