78 



suppuration, accompanied by gangrene, followed, finally leaving the 

 arm in a state of permanent contraction in the flexed [)osition, as the 

 result of cicatricial action. Happily', in the present case, the extraction 

 of the larvie has not been followed by any excessive inflammatory re- 

 action, owing, perhaps, to the general good health enjoyed by the 

 patient at the time of the operation. 



Since this case has come under my observation I have been informed 

 that similar instances of larval deposits in the skin have not been rare 

 in the hospital, at least since the Panama Canal and other enterprises 

 have increased the trafiic between this port and the Central American 

 Republics. I have been informed, in fact, that on one occasion quite a 

 number of returning laborers or immigrants were admitted in various 

 wards of the Charity Hospital suffering with these parasitic larva?. 

 But of these cases no report has been presented thus far, and to my 

 knowledge at least no attempt has been made to discover the parent- 

 age of the larvae or even to determine their proper entomological char- 

 acters. The specimens removed from my patient are the first that I 

 have seen, and I believe are the first that have been preserved for ex- 

 amination and, certainly, for the inspection of this association. At any 

 rate these larvse are certainly not familiar to our parasitic pathology, 

 for our texts, and even those that devote special attention to parasitology 

 (Cobbold, Leuckart, Davaine), are almost barren of all information in re- 

 gard to them; so that it is necessary to appeal to the si)ecial entomologists 

 to obtain some clear notions as to their exact taxonomic characteristics. 



In view of our prospects of increased relations with Spanish America, 

 and of the probability of a future importation of similar specimens, I 

 have thought it a matter of some interest to this society to inquire into 

 the natural histor^^ of these hypodermatic parasites, in order that we 

 may at least possess ourselves of some clear ideas respecting them, so 

 that they may prove more familiar acquaintances when we are again 

 confronted by them. 



The three specimens that are now under the microscope before you 

 are mounted in a glycerine cell, a i)reparation which was kindly made 

 at my request by the gentlemen in charge of the pathological department 

 of the hospital. The larva) ar^ smaller than thej' appeared in life, as 

 they have contracted slightly. The largest of these measures about 4 

 or 5""" in its long diameter and is about li'""' in breadtli. To the naked 

 eye they present an elongated i)yriform or clavate appearance, the 

 broad, thick and rounded portion corresponding to the head and trunk, 

 which were tho parts furthest from the surface of the skin ; tlie long, 

 tapering or caudal extremity jwinted upwards, so that in squeezing the 

 larva out of its lodgment the tail end appeared first. As the caudal 

 extremity i)resented itself a dark red dot was visible at the very ex- 

 tremity. This corres[)onded to the dark anal extremity containing the 

 stigmata for respiratory ])uri)oses, and is characteristic of, though not 

 l)eculiar to, the Dermatob'ui larva'. 



