Tp8 FLAT WORMS. 



LUNG FLUKES. 



Paragonimus westermani. In certain parts of Japan and For- 

 mosa it is estimated that as many as 10% of the inhabitants may harbor 

 this parasite. 



It is also common in China, and recently many cases have been 

 reported in the Philippines. Dr. Stiles states that around Cincinnati 

 there is quite a heavy infection among the hogs, so that it may be that 

 certain cases diagnosed in man as pulmonary tuberculosis may be due 

 to this disease. 



It is popularly known as endemic haemoptysis on account of the 

 accompanying symptoms of chronic cough and expectoration of a 

 rusty-brown sputum. After violent exertion, and at times without 

 manifest reason, attacks of haemoptysis of varying degrees of severity 

 come on. The characteristic ova are constant in the sputum and 

 establish the diagnosis. The fluke itself is a little more than 1/3 of an 

 inch long and is almost round on transverse section. It is rather flesh- 

 like in appearance. The flukes are usually found in tunnels in the 

 lungs, the walls of which are of thickened connective tissue. There 

 may be also cysts formed from the breaking down of adjacent tunnel 

 walls. In addition to lung infection with this fluke, brain, liver and 

 intestinal infections may be found. Musgrave was the first one to call 

 attention to the frequency of general infection with this parasite 

 (paragonomiasis) in the Philippines. He found it in 1 7 cases in one year. 

 The life history, beyond the stage of miracidium, is unknown. As 

 stated previously, Manson suggests that the miracidium may enter 

 directly by the skin. 



BLOOD FLUKES. 



Schistosomun haematobium. Flukes of the circulatory system. 

 These flukes are of great importance in Egypt, Japan and the West 

 Indies. The disease is named bilharziasis after Bilharz who first as- 

 sociated the parasite and the disease. It seems probable that there are 

 at least three human species, differentiated principally by the character 

 of the egg. In the blood-fluke disease of Egypt, S. haematobium, the 

 parasite chiefly infects the bladder and the egg has a terminal spine. 



