SUPPLEMENT 645 



demonstrate that this parasite under certain circumstances can pro- 

 duce a severe, progressive and sometimes fatal anaemia, which can be 

 cured, generally in a surprisingly short time, by expulsion of the 

 worm. Among the various hypotheses which have been advanced 

 as to the mode of origin of bothriocephalus anaemia, the greatest 

 importance has been attached to the assumption already mentioned 

 by Reyher, but definitely expressed by von Shapiro, 1 to the effect that 

 Bothriocephalus latus produces a poison which is absorbed by the 

 intestine and exercises a deleterious influence on the composition of 

 the blood, especially on the erythrocytes, perhaps also on the blood- 

 forming organs. This assumption is supported by no slight number 

 of clinical and experimental investigations. Podwissotsky 2 observed 

 severe blood changes in a child, aged 4^, affected with B. latus. In 

 the case reported by Pariser 3 the severe anaemia in a girl dis- 

 appeared fairly soon after expulsion of the worm. In that reported 

 by Schaumann 4 high fever accompanied the bothriocephalus anaemia ; 

 he also proved the haemolytic properties of the broad tapeworm. 

 The case reported by F. Miiller 5 -was one of severe anaemia. Also, in 

 the first of the cases described by Kurimoto 6 of Diplogonoporns 

 grandis there were present the same symptoms of anaemia as in the 

 case of B. latus. Meyer 7 observed severe anaemia in two youths 

 caused by B. latus. Rosenquist 8 has discussed the proteid metabolism 

 in anaemia. The presence of B. latus produces in the majority of 

 cases an increased proteid consumption, to which the blood change 

 generally corresponds toxic anaemia ; in a further communication 

 he reports on twenty cases of bothriocephalus anaemia, nineteen of 

 which were cured by expulsion of the worms, while one case proved 

 fatal, and he again emphasizes the toxic properties of the intestinal 

 parasites. In the case reported by Bendix, 9 that of a girl, aged 4^, 

 the anaemia was moderate, whilst in the case of Zinn 10 (a woman, 

 aged 30) the anaemia was so excessive that the patient succumbed 

 five days after expulsion of six bothriocephalus heads. Isaac and 

 van den Velden 11 have established that in the serum of patients who 

 suffer from anaemia due to B. latus, parasitic products are dissolved,. 



1 von Shapiro, Zeilschr.f. klin. Med., 1888. 



2 Podwissotsky, Jahrb. f. Kinder krankh., 1889. 

 8 Pariser, Deutsch. med. Wochenschr., 1892. 



4 Schaumann, Berlin, 1894, and Deittsch. med. Wochenschr., 1898. 



5 Muller, Charite-Annal. , xiv. 



G Kurimoto, Zeitschr. f. klin. Med., xl, an<l Kongr. f. inn. Med., Karlsbad, 1899. 



7 Meyer, Mount Sinai Hosp. Reports, 1903 and 1904, iv. 



H Rosenquist, Vereinf. inner e Med. in Berlin, May 6, 1901 ; and Zeitschr. f. klin. Med. xlix. 



' Bendix, Deittsch. Aerzte Zeitg., 1904, i. 



Zinn, Deutsch. med. Wochenschr., 1903. 



11 Isaac and van den Velden, Deutsch. med. Wochenschr., 19 j xxvii. 



