GENERAL STJMMABY AND CKITICISM. 19 



It appears from these experiments that male fern as administered 

 is not efficacious against thysanosomiasis. While the negative find- 

 ings of the former experience are inconclusive, the findings in this 

 case are fairly conclusive. The failure of the medicine to exert any 

 effect on four infected sheep indicates that male fern is not a remedy 

 which could be recommended in thysanosomiasis. 



GENERAL SUMMARY AND CRITICISM. 



It appears from the foregoing that anthelmintics have been 

 claimed to be efficacious in 8 cases of human somatic ta?niasis (male 

 fern) ; inefficacious in 8 cases of somatic tseniasis in the lower ani- 

 mals (male fern) ; inefficacious in at least 6 cases of intestinal and 

 extraintestinal thysanosomiasis (carbon bisulphid and male fern) ; 

 efficacious in over 14 cases of hepatic distomatiasis (carbon bisul- 

 phid and male fern) ; efficacious in 8 cases of venal distomatiasis 

 (salvarsan) ; inefficacious in 5 cases of venal distomatiasis (salvar- 

 san) ; and efficacious or inefficacious, according to various authors, in 

 an indefinite number of cases of venal distomatiasis (male fern). 



While the figures in the above paragraph are preponderantly in 

 favor of the efficacy of anthelmintics against somatic helminthiasis, 

 it should be borne in mind that there is much more likelihood of cases 

 being published where the administration of a medicine is followed 

 by apparent cure of disease than where it is followed by evident 

 failure to cure. Further objections to the figures as they stand are 

 based on a critical examination of the cases. This criticism may be 

 summarized as follows: 



Ziirn's experiments are entirely indefinite and lacking in detailed 

 statement. In Feletti's cases one patient died in spite of treatment 

 and there was no autopsy, and in the other cases the possibility of 

 spontaneous degeneration of the cysticerci, a not uncommon thing, 

 is not excluded. De Renzi's cases, as we have already stated, have 

 been criticized by Hall (1909) as open to suspicion of error as 

 regards diagnosis and the connection between the disease, the treat- 

 ment, and the cure. Dianoux's case is open to much the same criti- 

 cism as those of De Renzi. Granting that the diagnosis was correct 

 (as it apparently was in this case), the possibility of spontaneous 

 degeneration of the parasites is not excluded, and it is not safe to 

 conclude that their disappearance was due to the treatment. At least 

 one of Hall's cases was not at all conclusive. None of the cases deal- 

 ing with distomatiasis specifically eliminate the possibility of the 

 natural death and spontaneous evacuation of the flukes, the usual 

 ending of the yearly life cycle, although the use of check animals^ 

 where such checks were used, probably meets this objection. Per- 

 roncito's cases show that on the basis of fecal examination the flukes 

 apparently were not killed in two cases out of three. Floris and 



