PATHOLOGY OF BLADDER-WORMS IN THE EYE AND BRAIN. 559 



since in such cases the pressure of the tumour must act on the nerve, 

 causing pain, and impairing vision, if not producing blindness. 



Among the different cases of intra-ocular Cysticerci, those are 

 certainly least serious in which the parasite occurs in the anterior 

 chamber of the eye. Not only can it be easily extracted, but its 

 presence seems to do little more harm than slightly impair vision, and 

 produce a more or less distinct irritation of the iris. 



A Cysticercus in the fund us of the eye 1 has disastrous consequences, 

 especially in the subretinal tissue, for by the separation of the retina 

 and induced irido-choroiditis sight is in course of time almost wholly 

 lost. The trouble begins by a slight diminution in the power of 

 vision, but this is succeeded by a limitation or interruption in the 

 field of vision, which afterwards becomes a marked defect. After the 

 lapse of some months or even more, inflammation sets in, which spreads 

 to the front of the eye, especially to the iris, and passes through several 

 slow periodically aggravated stages, until finally a " phthisis bulbi " 

 results. More rarely an acute irido-cyclitis is the issue, and this may 

 culminate in panophthalmitis. A most violent ciliary neurosis is 

 associated with these processes, and persists perhaps for several years. 

 As a rule, the danger of sympathetic inflammation has before this 

 necessitated enucleation. When the Cysticercus passes early into the 

 vitreous humour the prognosis is somewhat less serious, especially if 

 the worm be en capsuled, as v. Graefe once observed. In such cases 

 the eye sometimes retains its outer form and a slight power of vision. 

 Usually, however, the retina undergoes separation, and here, too, a 

 gradual irido-choroiditis sets in, which usually ends as above described, 

 but sometimes acquires a more glaucoma tous character. 



Important and interesting as are bladder-worms in the eye, they 

 are still more so in the brain, where they almost always cause serious 

 trouble. Among the cases collected by Kiichenmeister 2 there were 

 only sixteen which were not accompanied by pathological symptoms 

 during life. In six cases the troubles were slight, such as headache, 

 fatigue, lethargy, and giddiness ; twenty-four were cases of epilepsy 

 (eleven of which were characterised by psychical disorders) ; six were 

 cases of cramp, and forty-two of paralysis, of which seven were associated 

 with psychical disorders and ten with apoplexy, while twenty-three 

 were mental disturbances of varying intensity, and occurring partly 

 alone and partly combined with more or less radical nervous diseases. 



We are indebted to Griesinger for an excellent discussion of these 

 pathological states, though this has been subsequently somewhat 

 modified by Kiichenmeister. 3 The former refers the phenomena te 



1 See the reports of Leber and v. Wecker. 2 Loc. cit. 



3 Archivf. HeUkunde, p. 207, 1862. 



