640 OCCURRENCE AND MEDICAL IMPORTANCE. 



In Algiers the Echinococcus seems somewhat widely distributed 

 both among the aborgines and Europeans. It is also frequent in 

 Egypt, but in America, so far as we know, it is rare. In Europe we 

 know of the occurrence of the Echinococcus in almost every country. 

 It is found, for example, in Italy, France, England, and especially in 

 Germany, from which the accounts are so numerous, and -so numeri- 

 cally exact, that they alone furnish us with tolerably satisfactory 

 statistics. In the literature of other countries we search almost in 

 vain for any numerical statements. We can indeed hardly learn 

 anything more than that, in 200 post mortem examinations made 

 by Leudet in 1855 in the hospitals of Rouen, he found Echinococcus 

 six times. I do not know what foundation there is for the statement 

 of Cobbold, that in England there are every year about 400 Echino- 

 coccus patients. 1 



In his reports on the clinical institutes and hospitals of Germany, 

 Neisser 2 gives the number of cases as 153, and as this number was 

 found in about 500,000 persons who had been examined, the per- 

 centage may be estimated at 0*03. If we only take into account the 

 results of the post mortem examinations (ninety-five cases out of 13,882), 

 we shall of course obtain a much larger proportion (nearly 07 per cent.), 

 and if we add to this the 1812 autopsies, with two cases of Echino- 

 coccus, not mentioned by Neisser, in the Erlangen Clinical Hospital, 

 and also the 2002, with seven cases, in Dresden, 3 the number is raised 

 to nearly 0'6 per cent. Obviously it is principally the reports coming 

 from the north and middle of Germany (Rostock, Berlin, Gottingen, 

 Dresden, Breslau) that affect the result, with their ninety-four cases 

 of Echinococcus in 12,800 autopsies, while observations made in Prague, 

 Vienna, and Zurich (six cases in 2916 examinations, thus about 0*02 

 per cent.) make hardly any difference. 



The Echinococci are thus considerably more frequent in the middle 

 and north of Germany than in the south, and the number of patients 

 even appears to increase as we go northwards. Yet we find from the 

 foregoing reports that among 261 post mortem examinations made in 

 Rostock 4 there were no fewer than twelve cases of Echinococcus, thus 

 giving a per-centage of 4'59, which is larger than in Iceland. On 



1 Journ. Linn. Soc. Land., vol. ix., p. 292, 1867. 

 8 Loc. cit., p. 36. 



3 Miiller, "Statistik, &c.," p. 14. 



4 [It has recently been most unexpectedly shown that the Echinococcus is truly endemic 

 in Mecklenburg, especially its northern and eastern districts, as also in the neighbouring 

 districts of Pornmerania. The disease seems to be most widely distributed in Rostock, 

 where there is one patient in every 1414 inhabitants : the whole country shows one patient 

 in every 18,800 inhabitants. See "Beitrage Mecklenburger Aertze zur Lehre von der 

 Echinococcuskrankheit " herausgegeben von Madelung : Stuttgart, 1885. R. L.] 



