45 
111 July, 1<SS6, nearly two years later, there was a recurrence of the nervous 
syinptoins. Eggs of J[;fmeito/epls nnna were found in the feces. Up till October the 
child suffered with severe cerebral troubles and epileptiform attacks. The eggs were 
still abundant in the feces. Extract of male fern was prescribed. Although the 
worms were not found in the stools after the treatment, the eggs disappeared from 
the feces, and the attacks ceased. In the latter part of December (Comixi, 1887a, 
p. 61) the attacks again recurred more severe than before, and the eggs likewise ha<l 
reappeared in the feces. Comixi (1888a) is rather doubtful as to the etiological 
importance of ILpnenolepIs in this case, in which there was already an apparent 
congenital predisposition to nervous disease. 
Case Xo. 37. — A second case was observed Deceml)er, 1886, by Co.mixi (1887 a, d, 
1888a) at the hospital in Varese. 
The patient, a little girl of 3 years, with a tuberculous mother, had suffered for two 
years with a continual dyspnea, without fever or cough, but often accompanied by 
pains in the alidomen, and functional gastro-intestinal disorders. Eggs of Hymen- 
olepis urma were numerous in the feces (7 to 8 in every preparation). Eggs of Ascaris 
were also present. 
After anthelminthic treatment the dyspnea became gradually better and disappeared 
entirely in a few days. A year later the child was in excellent physical condition, 
and the feces were free from eggs of HymenolepC. 
Pavia, Italy, 1886-1889 6 case.s. 
These 6 cases were observed in very complete detail by 8 exx.\ (1889) at the 
clinic of Professor Orsi, who also published a short paper (Orsi, 1889) in regard to 
them. 
Case Xo. (8ex.\a’s Case 1). — Epileptiform convul.'^ions with intestinal helmin- 
thiasis. 
Female, 15 years of age, domestic. Always weak and of a delicate constitution, 
she had suffered for three years from convulsive clonic attacks, with foaming at the 
mouth and complete loss of consciousness. These attacks were at first fleeting and 
occurred only at long intervals, but as time went on became more frequent and 
insistent, ei^pecially at night. There were present also gastric dyspepsia and trouble- 
some abdominal paresthesia, with a sense of constriction in the fauces. Anthelmin- 
tics had'been tried with no apparent result. She had also had at one time a convulsive 
cough which lasted a year, a suppurating keratitis of the right eye, and frequent 
inflammation of the cervical glands. Her father and brother Avere both healthy, 
but the former, a day laborer, was somewhat giA^en to drunkenness. Neither nerv- 
ous maladies nor pellagra Avas known in the family; a paternal uncle had died of 
consumption. 
The patient entered the clinic the last of November, 1886. The convulsive attacks 
continued, occurring almost every night, and rarely in the daytime. Some nights 
the attacks Avere very transitory and passed almost unperceived by tlie nurse. The 
girl Avas someAvhat melancholy, taciturn, and preferred solitude. She was, howeA'er, 
of good intelligence, and careful physical examination revealed no morbid organic 
conditions of importance. Examination of the feces shoAved numerous eggs of eel- 
AA'orms {Ascaris himbricoides), a very iev,' of liookAvorms {Agchylostoma duodenaIe), i\ 
feAv of AvhipAVorms ( Trichuris tricMiira), and of Hymenolepis nana. SeA’eral eelworms 
Avere passed after the administration of santonin, but no tapeAA'orms Avere seen, nor 
Avere any of the latter perceived in the stools after treatment Avith ethereal extract of 
male fern. Some tapeAvorms, hoAvever, Avere undoubtedly expelled, since the eggs 
Avereno longer to be found in the feces. The patient improA'ed, and left the hospital 
the latter part of December. 
Amelioration lasted only a few months; the conAuilsions came on again, and the 
patient returned to the hospital in April, 1888. As before, she suffered Avith epilepti- 
