fectly well, but after that began exhibiting evidences of a perverted appetite, and 
would eat mud. pla.^ter, charcoal, and even feces of animals. Her health suffered 
and she grew pale. At about the age of 6, consequent upon a change of habitation 
to a spot where she no longer had so many opportunities of satisfying her deprave<l 
appetite, and where she could be watched more closely, she was cured of the liabit. 
Her physical condition did not improve, however, and she continued to l^e subject 
to fatigue, cardiac palpitations, and dyspnea. Her appetite was, if anything, greater 
than normal, and she suttered from frequent indigestion. 
On examination the patient appeared somewhat cachectic, due rather to the waxy 
appearance of the skin than to any actual emaciation. The lungs, heart, liver, 
spleen, and kidneys were normal; the abdomen was not painful on palpation, but 
•ligestion was difficult, with frequent acid eructations. The patient often complained 
of transient pains in the body and limbs. The cervical glands were slightly enlarged 
and the voice was rather hoarse. Fecal exammations showed neither eggs of Agclnj- 
lo.?toma nor of 0.v>/uris. Occasional eggs of Tnchurh and some of Hacerf.s-, and one or 
tM'o per slide of Rymenolepis nano, were found. Treatment with santonin and castor 
oil expelled several O.vguris. The next morning after this treatment extract of male 
fern and calomel were administered. In the first three of the five stools which 
followed during the day, Oryurh and more than UK) H. no,, a were passe<l, while in 
the last two only Oxyuris Avere expelled. 
Notwithstanding the apparent success of the treatment the patient became no 
lietter. Fggs of Hyrnenolepis were no longer present in the feces, but Ascaris and 
Tricharis eggs were still to be found. Treatment was again instituted, and Oxy>n-'i.< 
and Ascaris were passed, but neither Hyrnenolepis nor Trichuris. 
Several months later, in November. 1891, Soxsixo (1895a) again examined the 
feces of this patient, and found the eggs of Hymenolxpis more numerous than before. 
Electuaries of male fern and calomel were administered twice and vomited each 
time. The second time some of the dose undoubtedly took effect, as about 2o0 
H. nana in fragments were expelled. A third do.^e a few days later expelled about 
15 H. nana, and a large number of O.ryuris. 
In January, 1894, the feces were free from Hymenolejfis eggs, but contained those of 
Ascaris. Tricharis, and AgchyJoslorna. After two treatments with santonin and thymol 
a couple of male Agchylostomn Avere expelled. 
Finally, in 51ay, 1895, the feces AA'ere free from eggs of parasites, except a fe\A’ of 
Trirhuris, and the patient A\as in a state of comparatiA-e health, considering her 
scrofulous constitution. 
Case Xo. 49 . — The fourth case t, Soxsixo, 1895a i, first obser\'ed in October, 1892, Avas 
a boy, 23 months old, from a family of l>rickmakers of the same locality as that of 
the first and third cases. Seven meml)ers of the family had had uncinariasis. The 
child’s feces contained large numl)ers of Hymenoleihs eggs, but none of any other 
parasite. Until the age of 8 months, mother's milk had been his only food, and up 
to that time he remained perfectly Avell. He then began to eat other food also, and 
likeAvise to suffer from lienteric diarrhea, AA'ith frequent vomiting and motor disor- 
ders, such as shivering, biting the lips, gritting the teeth, strabismus, and an almost 
continuous automatic lateral movement of the head of the nature of a clonic par- 
tial spasm (spasmus nutans), referable to a lesion or functional disorder of the spinal 
accessory iierA’e. The lx)y Avas weaned entirely an<l his symptoms gradually became 
Avoi*se. 
When .'^een by Sonsino the patient exhibite<l the motor disorders noted alHjve, 
complained also of pains in the abdomen and head; his nose itched A'ery often. an<l 
he AA'as suffering from an intense intestinal catarrh. The abdomen AA as fiatulent, but 
not sensitiAC to pressure. There AA'as some fever, and the patient Avas inclined to 
be droAAsy. 
On October 27, after treatment A\ ith male fern suspended in mucilage, and calo- 
