638 THE ANIMAL PARASITES OF MAN 



PLATHELMINTHES (Flat Worms) 



BY 



J. W. W. STEPHENS, M.D., B.C., D.P.H. 



FASCIOLIASIS. 

 Fasciola hepatica. 



The symptoms of disease evoked by Fasciola hepatica are rarely 

 observed in our part of the world, whereas Kermogant 1 states them 

 to be of frequent occurrence in Tonkin 2 ; the parasites are there 

 called " Douves." In our experience they are only accidentally 

 found post mortem in a certain number of cases, as no changes are 

 manifested during life which would permit of any conclusion being 

 drawn as to the presence of these parasites. In three cases (Bierner, a 

 Bostroem 4 and Sagarra 5 ) icterus was present ; in a fourth case, recorded 

 by Duffek, 6 the parasites had led to a severe and acute distomiasis of 

 the liver, combined with chronic purulent and ulcerative cholecystitis,, 

 with purulent cholangitis and dilation of the bile-ducts and numerous 

 small abscesses of the liver. The total number of flukes found in 

 these cases amounted to about fifty. The parasites passed from the 

 duodenum into the bile-ducts, and first obstructed the flow of bile 

 and then set up icterus, followed by cholecystitis and cholangitis. 



As regards localization of the liver fluke in the pharynx, see p. 242. 



The treatment must be directed to the principal symptoms ; 

 prophylaxis is especially important in districts where distomiasis is 

 of frequent occurrence. As the embryos live in water, only boiled 

 or filtered water should be drunk. The attempts of Tappeiner 7 to 

 discover an effective remedy against liver-fluke disease (liver rot), so 

 prevalent among sheep, were unsuccessful. 



Fasciolopsis buski. 



This parasite lives in the intestine, not in the liver of man ; it 

 produces bloody stools and typical symptoms high fever and a 

 condition of apathy (Odhner). 8 



1 Kermogant, See. nid. des Hdp. t February 7, 1905. 



2 [The distomiasis of Tonkin is due to Cloiiorchis sinensis and not to /. hepaliia. 

 J. W. W. S.] 



3 Bierner, Schwtiz. ZeitscJ.r.f. Heilk., 1863. 



4 Bostroem, Deutsch. Arch.f. klin. Med., 1883. 



5 Sagarra, quoted by Duffek. 



6 Duffek, Wieu. klin. IVcchenschr., 1902, xxx. 



7 Tappeirer, A/iinch. nicd. Wcchenschr., 1900, 1. 



8 Otlhier, Centialil.f. Bakt., 1902, xxxi. 



