CHAPTER LXXIX 

 INTESTINAL SCHISTOSOMIASIS 



Synonyms — Definition — History — Climatology — ^Etiology — Pathology 

 — Symptomatology — Diagnosis — Prognosis — Treatment — Prophylaxis — 

 References. 



Synonyms. — Intestinal bilharziosis, Rectal bilharziosis, Hepatic bilharziosis, 

 American bilharziosis, Hanson's bilharziosis, Hanson's disease. 



Definition. — Intestinal bilharziosis is infection with Schistosoma 

 mcinsoni Sambon, 1907, the eggs of which invade and irritate the 

 intestines and the liver, and cause inflammation. 



History. — It has long been known that the eggs found in cases of 

 intestinal, rectal, and hepatic bilharziosis are laterally spined, as 

 Bilharz pointed out in 1851; and Sonsino once stated that the two 

 worms must belong to different species, but this statement did not 

 attract attention. In 1903 Manson first suggested, on grounds of 

 dissimilar geographical distribution, that these eggs might belong 

 to a new species of Schistosoma, and in 1907 Sambon showed that a 

 separate species really did exist, calling this S. mansoni, in which 

 he has been supported by Holcomb, Firket, Broden, Grun, and 

 others, though opposed by the great authority, Looss. 



A description of the adult worms has been given by Da Silva 

 and by Flu, confirming the differentiation of the two species. 



The fact of the existence of a separate disease caused by the 

 lateral-spined eggs of 5. mansoni is supported by all authors who 

 have studied the disease in America, where the patient s are said 

 never to have eggs in the urine, and never to suffer from urinary 

 schistosomiasis. It is further supported by the work of Mathis and 

 Baujeau on a case from Gaudeloupe, and by that of Turner in South 

 Africa. Flu, after examining 1,000 eggs from fifteen cases of 

 intestinal schistosomiasis in Paramaribo, never found one with a 

 terminal spine. Reference may also be made to Letulle's paper on 

 ' Bilharziose Intestinale,' published in 1905, to Madden's work in 

 1907, and to Symmer's work in 1902 and 1906, from the latter of 

 which we have taken our two illustrations. Reference must also 

 be made to the admirable exposition of the disease by Mathis, Noc, 

 and Leger in 1913. In 1914 and 1915 Leiper thoroughly estabhshed 

 the species S. mansoni, and worked out its life-history. He has 

 traced the life-cycle of the parasite through the snails to its adult 

 condition in rabbits, guinea-pigs, and man. Lutz has published 

 his extended researches into the disease and its parasite as seen 



1864 



