126 Beport of the Bilharzia Mission in Egijpt^ 1915 



without normal content. If Bilharz met with a female similar to this one 

 at the commencement of his investigations, he might well have concluded 

 that the worm contained both types of e^g. 



When these sketches were made, I thought they might give support to 

 the view put forward by Ward that the termiiial-spined type of worm pro- 

 duced at first abnormal eggs with a sort of lateral spine ; not identical 

 with the lateral-spined egg of the New World. 



On this interpretation the female was actually in Looss' " transition 



period," but the formation of standard terminal-spined eggs had not been 



reached. I now believe that the female was one just commencing to lay ; 



that ovulation had not fully set in ; and that after producing one or two 



complete eggs a number of casts of the ootype in egg-shell were thrown 



off. I have since met with similar abnormal lateral-spined eggs in the 



material obtained by maceration of the liver of annuals experimentally 



infected with S. mansoni in Egypt. 



^ ^j- , Among South African tribes there is a widespread 



^r. ^^^^^r.rr.r^L bellcf that the cause of ha3maturia there, which we know 



to be bilharzia, enters the body through the orifice of the 



penis during bathing. 



To prevent this certain races, such as Zulus, wear a basket-like pro- 

 tection. Pfister [323] has shown that a similar belief and a like form of 

 protection prevailed among the ancient Egyptians. Its mode of use is to 

 this day figured on the walls of some of the ancient temples of Egypt. 



The belief, so far as I am aware, is no longer current among the native 

 populace in Egypt. It has however spread in South Africa among the 

 white population although the protective measures do not seem to be in 

 vogue with them. The matter is of interest here because, as I am told, 

 troops proceeding to Egypt were mstructed that they could avoid bilharzia 

 infection while bathing in the canals there, if they took the precaution of 

 wearing the European equivalent of this ancient speciality. 



During the field work in Egypt certain observations seemed to afford 

 a rational basis for this ancient belief. Often one found small and very 

 agile leeches on the nets and collecting gear. These were indeed a great 

 pest, for unless they were carefully excluded from the aquaria they rapidly 

 destroyed the molluscs. Now I have heard of one or two cases where such 

 a small leech entered the penis during bathing, and, lodging in the urethra, 

 gave rise to profuse bleeding. This I believe is the probable origin of the 

 association of a penile ingress with bilharzial hoematuria and in so far as 

 these penile sheaths have proved efficacious this is probably due to the 

 exclusion of leeches. 



In this report it has been shown that infection through the mouth is 

 readily induced experimentally. As the acidity of the stomach destroys 

 the cercariai, it has since been argued that such experiments are of little 

 practical significance, giving merely an extension of the area of skin infec- 

 tion. I am personally inclined to attach much more importance to this 



