TENAL BISTOMATOSIS. 
A enal distomatosis is known as bilharziosis, or Egyptian hematuria. 
It is caused by flukes of the genus Schistosoma. As a matter of fact, 
the flukes themselves seem to be comparatively harmless; it is their 
sharp-pointed eggs which do the 
injury. At least three (import- 
ed) cases have been diagnosed in 
the United States, and the dis- 
ease is said to exist in Cuba and 
Porto Rico. 
Clinical diagnosis. — ]\lake 
microscopic (low power) exami- 
nation of fresh urine and feces 
to find the characteristic eggs 
or embryos; examine particu- 
larly the flocculi and clots found 
in the urine. In doubtful cases, 
have patient micturate and ex- 
amine the last few drops forced 
out by straining. 
Symptoms. — If ova are con- 
fined chiefl}" to urogenital s}"s- 
tem : Hematuria, pains in lumbar 
region, left iliac fossa, thigh, or 
vulva, either spontaneous or at 
micturition; cystitis, vesical cal- 
culus, urinaiy fistulie, vaginal 
tumors, nephritis. If ova are 
confined chiefly to rectum : 
Bloody stools, diarrhea, prolaps 
of rectum, papilliform growth 
which msiy require surgical in- 
terference. 
Treatment. — Favorable re- 
sults are claimed from repeated doses of male fern; some authors 
consider specific treatment futile; practicalh^ treatment is the same as 
for chronic cystitis; occasional^ surgical interference for polypoid 
growths. 
Fig. 84. — Male and female specimens of the Human 
Blood Fluke {Schistosoma hsemaldbium) , enlarged. 
X 12. (After Looss, 1896, pi. 11, fig. 107.) 
14167— No. 17-04- 
