SUPPLEMENT 651 



was the first to draw attention to grave anaemic conditions induced by 

 Trichocephalus, Morsasca 1 and Becker 2 to progressive grave anaemia 

 (trichocephalus anaemia is accompanied by marked reduction of the 

 number of red blood corpuscles, of the specific gravity and of the 

 haemoglobin, well-marked morphological changes of the red cell, 

 micro-, macro-, and poikilocytosis and nucleated red cells). Sandier, 3 

 in his case of a boy, aged n, who died of anaemia, assumes a tricho- 

 cephalus toxin to be the cause of the disease, and Kahane also reports 

 on anaemic conditions induced by Trichocephalus. Girard, 4 in addition 

 to symptoms in the gastro-iiltestihal tract, calls attention to those 

 arising in the blood anaemia and its sequelae and also to nervous 

 symptoms : cerebral phenomena, headache, giddiness, aphonia, sym- 

 ptoms of meningitis. In a case of Schiller's 5 high fever was present, 

 which probably set in when the Trichocephali present in the gut in 

 great numbers commenced their parasitic activity. Hausmann, 6 in 

 order to explain the adaptability of Trichocephalus, assumes that 

 according to the locus minor-is resistentice, at one time the reflex at 

 another the toxic action is effective, now on one organ, then on 

 another ; anaemia being present in most cases, frequently general 

 and local neuroses and cerebral symptoms of various kinds. 



With regard to the toxic action of Oxyuris there is only the single 

 record of Hartmann, 7 who noticed the disappearance of epileptic 

 fits and psychic disturbances in a girl, aged 13, after the removal of 

 Oxyuris. Nervous disturbances and blood changes can but rarely be 

 attributed to Strongyloides. Silvester 8 and Valdes 9 report on giddi- 

 ness, headache and anuria in cases observed by them ; whether the 

 eosinophilia recorded by Bucklers 10 and Bruns 11 is due to the toxin 

 of Strongyloides must remain an open question. 



Reference has already been made to the possibility that intestinal 

 ciliates (Balantidium coli] can also produce toxins. 



The contents of echinococcus cysts appear to contain a substance 

 only moderately toxic, giving rise to urticaria, in a series of cases 

 where the fluid has escaped into the abdominal cavity (during 

 puncture). D. Muller 12 has collected nine such cases out of the 

 literature, to which may be added six cases of Finsen 13 in which the 





1 Morsasca, abstract in Centralbl. f. innere Med.> 1897. 



' 2 Becker, Deutsch. med. Wochenschr., 1902. 



3 Sandier, ibid. t 1905. 4 Girard, Annal. deflnst. Pasteur, 1901. 



5 Schiller, Beitr. z. klin. Chir., 1902, xxxiv. 



6 Hausmann, St. Peter sb. med. Wochenschr.^ 1900. 

 Hartmann, Naturforschervers., Koln, 1889. 

 Silvester, quoted by Schluter, "Dissert. Kiel," 1905. 



Valdes, quoted by Schluter, op. cit. 10 Bucklers, Munch, med. Wochenschr., 1894. 



Bruns, Munch, med. Wochenschr., 1907. 



Muller, D., "Dissert. Wurzburg," 1885. 13 Finsen, quoted by D. Muller. 



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