332 old. 



liome and as soon as the patient saw the water lie again became hysterical. 

 Shortly after he reached home a call was received for some one to see him, to 

 which a hospital steward responded; he reported that the boy's heart and 

 respiration showed signs of failure, and that he gave stimulants both by mouth 

 and hypodermic injection, but these had no effect and the boy died at 7.30 p. m., 

 just three and a half hours after he was stung. 



Cask 9. — An American woman was stung on both forearms and hands by a 

 jellyfish. The fingers of one hand became so swollen that a ring caused con- 

 siderable constriction of the tissues. In this case there was severe pain locally; 

 pallor from pain and fright ; the pulse was weak. The patient did not sleep well 

 for several nights because of the pain. Under lead and opium lotion the red 

 welts and swelling began to disappear, but about three days after the sting an 

 eruption resembling lesions of poison oak appeared on both arms and responded 

 to treatment by fluid extract of grindelia robusta. Xo other symptoms were noted 

 in this ease. 



The reason more eases were not seen is probably due to the fact that 

 few if any of the men at the hospital went swimming in 1906, the one 

 case quoted being a man from a shija anchored in the bay. In June, 

 1907, manv of the hospital corps and few patients began to bathe every 

 afternoon off the hospital wharf and it was then that the cases quoted 

 appeared ; a few days later the men stepped going into the water, being 

 deterred by the sufferings of the other men. 



The symptoms, as noted, appeared in from ten minutes to an hour, 

 but usually in from ten to fifteen minutes. In the nine cases quoted, 

 one death occurred (case 8) that of a Filipino boy. I wrote to Dr. 

 Kindleberger about the symptoms I had observed in the other cases here, 

 but lie replied that he noticed none of them in this boy except that he 

 was badly frightened and hysterical. 



Four cases (1, 2, li, and 7), one of whom was a Filipino, had the 

 marked hysterical symptoms, with the incessant cough, restlessness, pain, 

 nausea, etc., and all presented about the same picture. This is the type 

 of case to be recognized as caused by some unknown irritant or poison. 



While some of the symptoms in eases 3, 4, 5, and 9 are like those in 

 the type named, still the marked hysterical condition was not present and 

 the latter is what would impress a physician most on reaching the bedside. 



I have been stung many times by the jellyfish found abundantly in 

 the waters of Chesapeake Bay, Virginia, called there "stinging nettles" 

 and "blood-suckers," but beyond the local erythema and pain no other 

 symptoms were noticed. From this experience, and considering the 

 sufferings of some of the above quoted cases, I can not but believe that 

 there is some absorbable substance present in the secretion of the fish 

 concerned. The irritation of the mucous membrane of the mouth, 

 throat, nose, and eyes, as seen in some cases and not in others, may be 

 explained by the fact that some of the water around the fish which 

 contained the cell secretion came into contact with these areas ; and this 

 might also explain the nausea and vomiting, but the severe general body 



