CHAPTER LXIV 

 PARAGONIMIASIS 



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

 Morbid anatomy — Symptomatology — Complications- — Diagnosis — Treat- 

 ment—Prophylaxis — References. 



Synonyms. — Parasitic haemoptysis, Pulmonary distomatosis. Endemic 

 haemoptysis. 



Definition. — ^Paragonimiasis is a chronic or subacute general or 

 local infection of man by means of Paragonimus ringeri Cobbold, 

 1880, which produces cystic lesions, containing a thick, opaque, 

 reddish fluid, in which are found at times the parasite or its eggs. 



History. — In 1879 Ringer discovered the parasite of this disease 

 in a patient at Tamsui in Formosa, and it was named Distomum 

 ringeri by Cobbold in 1880. In 1878 Kerbert had discovered similar 

 parasites in the lungs of two Bengal tigers which died in the Zoo- 

 logical Gardens of Amsterdam and Hamburg. Subsequently it 

 was considered that the two parasites were one and the same species, 

 and as Kerbert had named his species Paragonimus westermani 

 in 1878, this name was applied to the human parasite until Ward and 

 Hirsch stated that the spines which cover the cuticle and which 

 are arranged in groups are different in the two species. Thus 

 Paragonimus ringeri has chisel-shaped moderately heavy spines, 

 while P. westermani has lancet-shaped and very slender spines. The 

 human species is, therefore, known by Cobbold's name of P. ringeri. 



In 1880 Baelz found bodies in cases of haemoptysis which he 

 thought were psorosperms, and, therefore, he called the disease 

 ' gregarinosis pulmonum/ but when the bodies were shown to 

 Leuckart he said that they were ova of a distomum. 



In the same year (1880) Manson found the eggs in a case of haemo- 

 ptysis in a Chinaman from Northern Formosa, and later in a Portu- 

 guese with similar symptoms from Tamsui in Northern Formosa. 

 This Portuguese died in Formosa, and Ringer discovered in the 

 lungs during the post-mortem examination a minute fleshy oval 

 body, grey in colour. This specimen was forwarded to Manson, 

 who sent it to Cobbold, who named it Distomum ringeri. 



In 1883 Baelz also found adult specimens in the lungs, and gave 

 them the name Distomum pulmonale. In 1890 Otani and Yamagiwa 

 showed that it could give rise to a general infection and could be 

 found in the brain. In 1902 Musgrave gave a very complete account 



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