HISTORICAL REVIEW. 15 



etc., of vast numbers of eggs, the parasite itself in the blood vessels 

 having practically no direct pathological significance. By the time 

 the patient goes to a physician for treatment for hematuria the 

 worms producing the eggs which cause this are probably dead or 

 near their end. Looss looks upon the cures reported by Joannides 

 as resulting from an artificial retention of the eggs in the tissues, 

 causing thereby a suppression of the symptoms but not a cure of the 

 disease. For the purpose of this article a consideration of the 

 question whether anthelmintics are effective against metazoan para- 

 sites located elsewhere than in the digestive tract the question as to 

 whether the killing of the fluke is desirable or not, or as to whether 

 the bilharzia disease is, strictly speaking, one due to flukes or to 

 fluke eggs, is not material. Looss does not attack Joannides's con- 

 clusions that the embryos in the fluke eggs and possibly the adult 

 flukes, also, are killed by salvarsan. 



Conor (1911) has tried salvarsan in one case of bilharziasis and 

 found it inefficacious. Eggs containing living miracidia were found 

 in the patient's urine every day but one for a month after the 

 treatment. 



Fiilleborn and "Werner (1912) have also tried salvarsan in a case 

 of bilharziasis. with the same negative result. 



Day and Richards (1912) have criticized Joannides's findings, and 

 report three cases in which salvarsan was administered with no effect 

 on the passage of living ova or, in two cases examined, on the 

 eosinophilia. 



A summary of the foregoing papers on the treatment of hepatic 

 distomatiasis shows the following: 



The administration of anthelmintics has been declared effective by 

 Grassi and Calandruccio as a result of experiments (number not 

 given) followed by fecal examination and post-mortem (male fern) ; 

 by Perroncito after three experiment cases followed by fecal ex- 

 amination and post-mortem (male fern) ; by Floris after experiments 

 (number not given) in which no autopsies or subsequent fecal ex- 

 aminations showing absence of eggs are noted (carbon bisulphid) ; 

 by Alessandrini after two experiment cases followed by autopsy 

 (male fern) ; by Borini after experiments (number not given) in 

 which no autopsies or subsequent fecal examinations showing absence 

 of eggs are noted (male fern and thymol) ; and by Railliet, Moussu, 

 and Henry after nine experiment cases, four other animals being 

 used as checks, followed by autopsy (male fern). This is a total of 

 14 detailed experiments and 2 other sets of tests with the number of 

 animals not given. Romagnoli's treatment is omitted from con- 

 sideration in this summary, as no claim has been made that it affects 

 parasites already established in the host. 



In the case of venal distomatiasis, male fern has been commended 

 as being- efficacious, with no data found by us on casual examination 



