546 OCCURRENCE AND RESULTS OF CYSTICERCUS CELLULOSE. 



This latter does, indeed, occur very abundantly among bladder- 

 worm patients. Kiichenmeister is even of the opinion that the above- 

 mentioned preponderance of male patients is due to greater possibility 

 of self-infection. In support of his position he refers 1 to the male 

 clothing, which makes the removal of spontaneously liberated pro- 

 glottides difficult, and also to outdoor work, which frequently compels 

 a man to ease himself in the open air under circumstances which make 

 defiling of the hands very easy. 



On the other hand, there are investigators, and among them such 

 a prominent scholar as Virchow, who would refer but few cases to 

 self-infection, and are even inclined to question its existence. They 

 refer to the results of statistics, according to which the occurrence of 

 a Tcenia solium has been but seldom proved in a bladder- worm 

 patient, so that the cases of their associated occurrence are probably 

 accidental, and do not admit of any conclusion being drawn as to the 

 origin of the Cysticerd. 



Graefe is their chief witness, who, 2 out of eighty cases of Cysti- 

 cercus, found only five or six in which he could prove the presence of 

 a Tcenia, while in a great number of cases the persons who shared the 

 same room with the patient suffered from tape-worm. Dressel's 

 testimony is still more emphatic ; for in the cases compiled by him 

 from clinical reports, there was not one of a tape -worm and bladder- 

 worm co-existent, though he acknowledges that, not knowing the 

 history of the patients in question, he could not say that the patients 

 had not formerly suffered from tape-worm. But this last question is 

 a most decisive one ; for while the bladder-worms persist after they 

 have once been developed, the tape-worm often lives for a com- 

 paratively short time in the intestine of its host. 



For this reason we may assume that cases of co-existence of tape- 

 worm and bladder-worm represent but a small fraction of those cases 

 in which the bladder- worm hosts have been also tape- worm hosts. 

 The twenty to twenty-one cases of such co-existence, which Lewin a 

 has earned our thanks by collecting from the scattered and hardly 

 accessible reports, are by no means of such little weight as one might 

 at first sight suppose. And this, too, must be remembered, that they 

 all refer to recent decades, at a time when the relations between 



1 Loc. cit., second edition, p, 108. a Loc. cit. 



3 Loc. cit., p. 651. Kuchenmeister erroneously reports the number only at eleven. 

 Two other cases have been since discovered by Miiller, a third by Heller (Ziemssen's 

 44 Handbuch," Bd. iii., p. 331 ; Eng. transl., p. 599), and a fourth by v. Wecker (v. Graefe 

 u. Samisch, 44 Handbuch d. ges. Augenheilkunde," Bd. iv., p. 713). Boyron ("Etude 

 sur la ladrerie chez rhomme," Paris, 1876) also reports cases of two bladder-worm patients 

 also infected with tape- worm (Observ. i. and iv.), so that the total number of cases is about 

 twenty-seven. 



