TREMATODA 27 



very little knowledge of the parasites which take up their abode 

 in the viscera of savages. This ignorance results partly from 

 the fact that these untutored races,, as proved by the statements 

 of Kaschin and others, actually, in the matter of severe sym- 

 ptoms, suffer much less from the presence of intestinal worms 

 than their civilised fellow-men do. The subject is worthy of 

 further attention, but no one, so far as I am aware, has cared 

 to institute the necessary inquiries in a methodical way. I 

 strongly suspect that several of the human parasites which we 

 now consider to be rare would be found to be abundant if by 

 means of post-mortem examinations and other methods of in- 

 vestigation we could be made acquainted with the facts of hel- 

 minthism as they occur amongst the raw-flesh Bnd fish-eating 

 savage tribes. Of course any person, notwithstanding the 

 utmost care and cleanliness, as in the cases before us, may 

 contract a noxious parasite; nevertheless, speaking generally, 

 it may be said that the measure of internal parasitism affecting- 

 any given class of people' hears a strict relation to the degree 

 of barbarism shown by such persons in their choice of food and 

 drink, and in their manner of eating and drinking. This 

 statement, if true, is not destitute of sanitary importance ; 

 moreover, it applies not alone to ourselves, but also to all the 

 domesticated animals that serve our wants. Cleanliness is just 

 as necessary for their welfare as for our own. 



In the spring of 1878 my patients returned from China. 

 They had experienced fresh attacks from the parasite ; more- 

 over, one of their children, a little girl, was also victimised by 

 the same species of fluke. Thus, in one family I have en- 

 countered three cases of fluke-helminthiasis due to Distoma 

 crassum ! One of the worms passed by the little girl per anum 

 is now in my possession. It not only shows the upper testis 

 perfectly, but also the many times transversely folded, simple, 

 uterine rosette which is certainly not branched. There are 

 also traces of an organ which I take to be the cirrhus-pouch ; 

 but I have never seen the penis protruded externally. 



For the purposes of diagnosis I subjoin the following cha- 

 racters. The Distoma crassum is a large, flat helminth vary- 

 ing from an inch and a half to two and a half inches in length, 

 and having an average breadth of five eighths of an inch ; it is 

 especially also characterised by its uniform and considerable 

 thickness, combined with the presence of a double alimentary 

 canal which is not branched ; the body is pointed in front, and 



