40 TROPICAL MEDICINE AND HYGIENE 



Severe attacks of pain referred to the pubic region are 

 said by Turner to sometimes occur without any increase 

 in vesical symptoms. In some of his cases there was 

 hydronephrosis. 



The eggs are shown by Turner to be frequently present 

 in the lungs, and he believes that this may account for 

 some of the cases of haemoptysis and render the patients 

 more susceptible to tuberculosis and pneumonia. They 

 are destroyed by treatment with acids, and therefore in 

 the ordinary process of examining for acid-fast organ- 

 isms would escape detection. 



S. hcematobium is prevalent in Egypt, in Central and 

 East Africa, and throughout the greater part of South 

 Africa. It occurs in places on the West Coast, but is 

 less common than on the East Coast. It also occurs in 

 Arabia, in some of the islands near Africa, and in a few 

 places in the West Indies. 



Army Statistics. After the Transvaal War many of the 

 soldiers suffered from the disease, and carried it with 

 them to England, India, and other places. 



Persistence of Infection. The disease may persist for 

 years after the patients have left an area where it is 

 endemic. As a rule the symptoms gradually become 

 less severe ; failing this, the patient pays less attention to 

 the less important symptoms. Hsematuna may persist 

 after the ova cease to be passed and there is the 

 possibility of general fibrotic changes in the kidneys. 



With this worm, as with many others, more careful 

 investigation has shown that the prominent local sym- 

 ptoms are not the only ill-effects of the parasite. An 

 irregular fever with vague discomfort in various parts of 

 the body is common in the early stages. Turner, in 

 South Africa, has shown that the eggs may be widely 

 distributed, and are quite common in the lungs. They 

 may also be found in the liver and elsewhere. 



Diagnosis. This is readily made by examining the 

 mucus discharged per rectum or by the urethra, as the 

 large eggs with a sharp spine containing the fully 



