658 OCCURKENCE AND RESULTS OF CYSTICERCUS CELLULOSjE. 



The worms inhabiting the cutis may be felt through the skin as 

 moveable tumours about the size of a pea, but cause hardly any 

 discomfort. They come and go almost unnoticed, unless it be that 

 owing to their position on the nates or on the back, or in some other 

 situation where they are exposed to considerable external pressure, 

 their capsular wall becomes inflamed, and results in the formation of 

 an abscess.^ A spontaneous inflammation caused by the bladder- 

 worms alone is as yet unknown, though in a few cases the infected 

 muscular tissue has exhibited a somewhat reddened appearance. As 

 regards discharge of function, a decrease of muscular strength is the 

 most that has ever been observed. 



Those cases, however, in which the bladder-worms inhabit the 

 heart seem more serious. But on superficial positions the worms seem 

 hardly capable of occasioning any marked disturbance; but it is 

 different when they lie under the endocardium, or are fixed as stalked 

 bladders to the valves. In such cases we find to a varying extent 

 symptoms of endocarditis, and such phenomena as valvular insuffi- 

 ciency and stenosis, besides palpitation, impeded respiration, and 

 syncope. Without further proof, such as of course primarily, the 

 direct demonstration of bladder-worms under the skin or in the eye, 

 the true nature of these troubles could hardly be determined with any 

 certainty. This is true also of the visceral Cysticerci, which excite 

 symptoms that have hardly any special or distinctive pathological 

 character, and that vary according to the position of the worms. 

 In the respiratory organs they occasion asthma, and sometimes even 

 inflammatory conditions; in the walls of the intestine they cause 

 peritonitis, &c. 



The disturbances of functions and the pathological changes induced 

 by the bladder-worms of the eye are still more serious. This is true at 

 least of those which have taken up their abode within the eye, for in the 

 outer parts, and when easily accessible, the Cysticercus is not peculiarly 

 dangerous. The slight inflammations of the connective tissue which 

 may have been excited by the worm cease when it is removed. In 

 the orbit the Cysticercus has been as yet certainly observed only in 

 the anterior division — outside the muscular funnel.^ The eyeball is 

 displaced by the growing tumour, and the conjunctiva is red and 

 sensitive. The thickness of the capsular wall and the occasional 

 formation of pus may be referred to an inflammatory reaction on the 

 part of the surrounding connective tissue. When the worm is lodged 

 in the depth of the orbit, the disturbances become still more serious, 



' Perls mentions a case in which thirty bladder- worms were extracted from an abscess. 

 "Pathol. Anat.," Bd. i., p. 80. 



^ See Berlin in "Handbuoh d. ges. Augenheilk.," Bd. vi., p. 689. 



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