146 LECTURES. 



in the month of May, 1870 ; and I first saw her on 

 the 22nd of July of that year. She was suffering 

 from haematuria, the first indications of the disease 

 having been noticed about a twelvemonth previously. 

 Though by nature a remarkably strong and healthy 

 child her strength had gradually declined; the 

 prostration, however, being more marked during the 

 warmer months. She complained but little; yet 

 her parents and nurse observed that she frequently 

 showed that she suffered pain during or at the close 

 of the act of micturition. She had been treated 

 for urinary parasites by the family physician ; and 

 the true nature of the helminthiasis appears to 

 have been fully determined by Dr. J. Vacy Lyle. 

 In a letter to Dr. Harley, recently published, Dr. 

 Lyle refers to this case. According to the statements 

 of her parents, the child had passed three vermiform 

 entozoa from the bladder; moreover, she also suf- 

 fered from the common roundworm, the exhibition 

 of santonin powders under Dr. Lyle's advice bring- 

 ing away altogether about one dozen lumbrici. The 

 powders were supplemented by enemata and cold 

 bathing ; tonics and diuretics being likewise ordered 

 from time to time. In addition to the symptoms 

 above mentioned I have to notice that she was pale 

 and anaemic, the skin and muscles were lax and 

 ilabby, the sclerotics and conjunctivas almost blood- 

 less, the tongue white but clean, the skin moist, 

 the pulse irregular, very feeble, and varying from 



