SUPPLEMENT 639 



PARAGONIMIASIS. 



Paragonimus ringeri. 



The disease produced by the lung fluke is specially endemic in 

 Japan, also in isolated parts of China, Formosa and Korea. The 

 fact that the lung-fluke disease is most frequently found in mountain- 

 ous districts (Katsurada 1 ) is worthy of special attention. The onset 

 of pulmonary paragonimiasis is generally insidious (Looss 2 ) ; generally 

 the only symptom is a slight cough, occurring at first at longer, and 

 later at shorter intervals ; it is accompanied by the expectoration of 

 discoloured sputum, frequently blood-stained. Though now and 

 then severe haemorrhages result, up to the present no case has been 

 established in which they have been the direct cause of death. 



Examination of the thorax frequently fails to reveal anvthinj? 



This section, except for minor corrections, is 

 practically a translation of the original. 



To Binder : face p. 638. 



byinpioms in Tnese tracts. 



The most dangerous locality is in the brain. Otani, 5 Inouye, 6 

 Yamagiva, 7 and recently also Taniguchi, 8 have found post mortem 

 the worms and their ova in tumours of the brain, or, in areas of 

 softening in cases of Jacksonian epilepsy ; in Taniguchi's case the 

 eggs were found in masses in the inflammatory areas of softening. 

 In the nineteen cases of paragonimiasis of the brain collected by 

 Inouye, the following symptoms were observed : general convulsions 

 on eight occasions, unilateral convulsions on six occasions, convul- 

 sions with paralysis on the same side and hemiplegia, five times each ; 



1 Katsurada, Ziegler's Beitr. z. path. Anat., IQOO, xxviii. 



2 Looss, " Handb. d. Tropenkrankh.," von Mense, 1905, i. 



3 Inouye, quoted by Looss. 



4 Scheube, " Die Krankh. d. warm. Lander," 1896. 5 Otani, quoted by Looss. 



6 Inouye, quoted by Looss. 7 Yamagiva, quoted by Looss 



8 Taniguchi, Arch. f. Psych, u. Nervenkrankh., xxxviii. 



