560 OCCURRENCE AND RESULTS OF CYSTICERCUS CELLULOSiE. 



two groups, those caused by the wandering of the embryos, and 

 those determined by their permanent residence. The symptoms of 

 the first group are more or less inflammatory (headache, giddiness, &c.), 

 with the subsequent phenomena resulting from irritation and com- 

 pression of the brain. The patients are then usually induced to seek 

 medical advice. As a rule they also complain of attacks of cramp 

 and of mental disorder, of which the former are in all probability due to 

 the movements of the parasites, contraction of the caudal bladder, and 

 protrusion of the head. The diagnosis is not of course always equally 

 certain ; such symptoms might appear without the presence of bladder- 

 worms. Specially dangerous are those attacks of more or less epileptic 

 cramp (without aura), which sometimes occur in later life without 

 obvious cause, and which either appear of a semi-acute character, or 

 rapidly succeed one another, increasing in number and intensity till a 

 very serious cerebral disease results. The mental disorders which 

 sometimes appear along with the epilepsy, or sometimes persist by 

 themselves, are generally of the nature of melancholia or mania. 

 Griesinger asserted that paralysis was a very rare consequence of 

 Cysticercus, but this is contradicted by Kiichenmeister's generalisations. 

 These paralytic consequences are indeed very varied ; they appear often 

 only after 9, long time ; they may be widely diffused or restricted to 

 particular parts ; but these differences are of secondary importance, 

 being determined by the number and position of the worms, or by 

 the nature of the affected nervous tissue. "We know further that 

 Cysticerci in the brain are of fatal significance, not merely because of 

 their presence, but also because they soften the surrounding nervous 

 substance and lead to haemorrhage, and to other diseases, such as 

 meningitis, hydrocephalus, apoplexy, &c., which again induce other 

 disorders, often of very great extent. 



Where paralysis, even of slight character, occurs, the position of 

 the Cysticerci is almost always deep down ; when they ar^ superficial, 

 other serious disorders ensue. In fact, in the latter case, paralysis 

 results only when the Cysticerci form round about them apoplectic 

 areas, or when by their position (say at the base of the hemispheres) 

 and size they are capable of exerting pressure even on the deeper 

 central portions. According to Kiichenmeister, on whose authority 

 these statements are mostly made, epilepsy has been observed almost 

 only in those cases where both hemispheres or ventricles, or when 

 unpaired organs, especially the pons and medulla, were infected. 

 The Cysticerci on the surface of the brain do not per se cause mental 

 diseases, except in cases of hereditary predisposition thereto, but these 

 seem to result especially when the cerebral ganglia, ventricles, and 

 choroid plexuses are attacked either by themselves or along with 

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