1590 



KATAYAMA DISEASE 



temperature, hatched out, the shell being broken. The newly-born 

 miracidia swim about vigorously and enter a snail, said at the time 

 to be a species of LimncBus, in which after twelve days redise appear 

 in the liver. They further found that mice placed in the same vessel 

 with these snails for three hours a day develop 5. japonicum in 

 their livers. 



Also in 1913 Katsurada found that the worms reached maturity 

 in two weeks and produced eggs in three weeks, and that the method 

 of infection of the vertebrate was by the skin, as could be demon- 

 strated by producing the disease in cats and dogs (Katsurada), 

 in cattle (Fujinami), in man (Mat sura in himself). 



In 1914 White gave an account of a case of the disease, as seen 

 on H.M.S. Cadmus, under the term urticarial fever. The patient 

 suffered from fever about 102° to 103° F. in the evening and normal 

 in the morning, pains in the lumbar and epigastric regions, pulse- 

 rate 90, with a temperature of 103° F., slight reduction of the red 

 corpuscles, 4,800,000 per c.mm., and 50 per cent, to 70 per cent, 

 of eosinophiles, and loss of weight associated with the appearance 

 of urticarial eruptions in various parts of the body. 



In the same year Tanning noted that it was not uncommon for a 

 fair proportion of the crews of gunboats patrolling the Yangtze 

 River to become infected after wading through the water-covered 

 paddy fields in search of snipe. 



Miyairi's work induced Teiper and Atkinson, in 1914, to proceed 

 to Shanghai and later to Katayama in Japan to investigate the 

 parasite. Their results were published in 1915. At Katayama 

 they found a small brown snail, with eight spirals and an operculum, 

 known at that time as Katayama nosophora, which had an ex:tra- 

 ordinary attraction for the miracidia, its small head and foot 

 becoming festooned with white specks (the miracidia), which 

 appeared to irritate the snail. Tater the liver was found to be full 

 of cercariae with bifid tails, which infected laboratory-bred mice by 

 passing through the skin, male and female adult worms being found 

 in the portal vessels one month after infection. 



In 1916 Koiki drew attention to the fact that in forty-two cases 

 found near Shushin, in Japan, all but three were farmers, and most 

 had had an itchy eruption on the legs about a year before. In the 

 same year Mann reported upon the disease, and said that salvarsan 

 was beneficial in the second stage; and Narabayashi studied the 

 life-history of the parasite {vide p. 592) and pointed out the re- 

 lationship between it and the skin disease called kabure. 



Climatology. — It occurs in Japan, China, and the Philippine 

 Islands: in the first in the provinces of Bingo, Yamanashi, Hiro- 

 shima, and Saga ; in the second it is reported up to date from Hunan, 

 Honan, Hupeh, Kiangsi, and Anhwei provinces, and from Fukien. 

 In Wuhu 8 per cent, of all male cases entering the General Hospital 

 show either latent, active, or overwhelming infection. In China 

 only the low-lying lands appear to be infected; no cases from the 

 hills or mountains are known. 



