A. reflexus 93 



the trouble especially in children, where there may be inflammation. 

 In a girl 5 years old, blisters formed over the hand, wrist and forearm. 

 The itching may last 8 days. Chatelin (1882) reports the case of a 

 child that was bitten by reflexus, which had wandered from the pigeon- 

 house into the dwelling. The pigeon-house had not been used for 

 6 years. The bites were followed by pain and oedematous swelling, 

 which persisted for some time. Other persons who were bitten at the 

 same time exhibited no such symptoms. Brandes (1892 d, p. 10) 

 describes the case of a man who was bitten at Aschersleben in 1883, 

 the bite being followed by much swelling. Alt (1892) saw a case 

 which occurred under similar circumstances, where the bite was 

 followed by urticaria factitia and general erythema, which subsided 

 in a few hours. Brandes (1897) also describes this case — that of a man 

 who had been bitten five times in four years. Hauch, who attended 

 him, stated that he woke at night with pain about the wrist, on which 

 he discovered the Argas. Within half an hour an erysipelatoid swelling 

 spread from point of the puncture all over the body, increasing, par- 

 ticularly about the head, until the eyes were hidden by the swollen 

 lids. During this time the patient suffered from shortness of breath, 

 palpitation, dulness, etc. for an hour, when the symptoms began to 

 subside with the appearance of profuse perspiration. The swelling 

 gradually subsided during the following 10 to 15 hours. The patient, 

 who seems to have been particularly susceptible to the bite of the 

 Argas, had previously kept pigeons in his house, but the pigeon-house 

 had been walled up two years before. As Brandes states, this latter 

 proceeding seems to have caused the migration of the parasites into 

 the dwelling. Alt (1892), and two other persons, allowed themselves 

 to be bitten by reflexus obtained from the abandoned pigeon-house. 

 Slight pain, that came and went, followed, but nothing in particular 

 occurred, excepting in one case, where, after four to five days, a painful 

 nodule, the size of a pea, appeared at the seat of the puncture, but this 

 disappeared soon afterwards. Two persons who suffered from urticaria 

 also allowed themselves to be bitten ; one of them remained unaffected, 

 whilst the other developed general erythema after four hours, which 

 subsided again in an hour. Brandes reports a case which was observed 

 in 1884 at Aschersleben, where a man became so oedematous after four 

 to five hours that his clothes had to be cut off. The oedema is said to 

 have lasted three days in this case. The effects here noted seem to 

 depend on a peculiar idiosyncrasy. Brandes believes that a poison is 

 probably elaborated in the salivary glands of Argas. Alt, who injected 



