18 BULLETIN 1369, U. S. DEPARTMENT OF AGRICULTURE 
some stiffness and pain in the wrist. The pulse and temperature — 
and general physical condition were normal. Three weeks later the 
child exhibited a swelling of a similar nature in the lumbar regton 
on the left side. This lasted only a few days. During the first 
week in December the child was again brought in with a slightly 
edematous area, about the size of the palm of the hand, on the 
left side in the midaxillary region. Two or three days later this 
area showed two small perforations of the skin about an inch 
apart. A similar area next occurred on the lower border of the 
right scapula. Pain was felt in the area and a few hours later 
two punctures appeared. A few days later the child’s father 
saw a larva moving in a hole which appeared on the upper angle 
of the left scapula following a similar clinical experience. Two 
days later a larva was pressed from a puncture which appeared at 
the base of the mastoid process of the left temporal bone. This larva 
was found by the writers to be H. dineatum in the third stage. 
Another interesting case has been brought to the writers’ at- 
tention by R. A. Cooley. Dr. O. E. Patterson, who attended this 
case, and the mother of the infested child have kindly furnished a 
very complete history of the case. This infestation occurred in a 
child of 5 years who lived on a stock farm near Moiese, Mont. From 
late November, 1921, to March 1, 1923, 14 larvee were removed from 
the patient. Seven of these appeared on the head and face, one each 
from the neck, arm, shoulder, and chest, and one each from the 
thigh and from the calf of the leg. The symptoms accompanying 
the appearance of each larva were very similar but most acute 
with those on the face. Several hours (sometimes 24) preceding 
the appearance of each larva there was malaise and pain in the 
stomach, accompanied later with marked fever. These symptoms 
then gave way to retarded heart action, cold limbs, and drowsiness. 
When these symptoms had practically disappeared a local pain 
and swelling occurred in the region where the larva came to the 
surface. The duration of each attack ranged from one and one- 
half to four days. After several larve had been expelled symptoms 
of neuritis began to manifest themselves in stiffness of the legs, 
weakness of the leg muscles, and finally almost complete paralysis 
of the lower extremities, which lasted several weeks, only subsiding 
after practicaly all larve had come to the subdermal region. A 
year later this paralytic condition had not completely disappeared. 
These symptoms suggest that some of the larve may have entered 
the spinal canal and produced lesions there. | 
The writers have examined two of the specimens from this case _ 
and found them to be third-stage larve of H. lineatum. 
Riley (84) has given a rather complete account of the infestation — 
of a child in Pennsylvania. A physician was called to attend this — 
child, which was supposed to be suffering from erysipelas. The — 
child, a boy of 3 or 4 years, was suffering sufficient pain from some- — 
thing working under the skin to prevent his sleeping at night. This _ 
larva had been noticed five months before under the skin near the 24 
sternal end of the right clavicle, and during the intervening time ~ 
it had traveled up and down the chest, in front down one arm to — 
the elbow, and over one side to the back. Prior to the calling of the © 
physician no serious annoyance had been experienced. This larva — 
