54 
were passed. An hour or two after the last dose the child became very restless, and 
cried on account of pain in the abdomen. The abdomen was hard and tense, but 
not swollen; the legs were doubled up. Severe and repeated vomiting occurred. 
The first and second vomit! had the characteristic odor of male fern. The abdominal 
pains ceased in the afternoon, but the vomiting continued until late in the night. 
On the 13th day eggs again appeared in the feces. On the 20th day there were 
1,500 eggs in 1 cc. of feces. In June thymol was tried, but no worms were passed, 
and the eggs continued present in the same number. Three days later 8 grams of 
male fern in 3 doses, which were well borne, were administered, and 70 worms were 
passed. On the 14th day eggs again appeared. 
Numerous Oxyuris were expelled at each treatment. Charcot-Robin crystals were 
not present in the feces. 
Naples, Italy, 1892-1896 ... ^4 cases. 
Out of 73 children, aged from 1 month to 12 years, examined in the pediatric 
hospital at Naples, Cima (1893a, 1896a, 1896b) reports 34 cases of helminthiasis, 4 of 
which were infections with Hymenolepis nana. 
Case Xo. 55 (Cima’s Case 33). — Boy, aged 8 years, from the city, showed a slight 
trace of rachitis. Feces contained eggs of H. nana. During a single day’s stay at 
the hospital he gave no signs of disturbances which could be traced to the action of 
parasites. 
Case Xo. 55 (Cima’s Case 56). — Boy, 7 years, from the city, chronic intestinal 
catarrh. He was brought to the hospital on two occasions. According to his father, 
the boy had suffered for two years with a bloody diarrhea, and had grown thin and 
pale. “Feces showed elements common to those of anemic patients,” and eggs of 
Hymenolepis nana were observed in every j^reparation. Rectal injections of boric 
and tannic acids were prescribed, with what effect is not known as the patient was 
not seen again. 
Case Xo. 57 (Cima’s Case 65). — Girl, 10 years, from the city, with nervous disturb- 
ances. Fifteen days before entering the hospital the patient began to experience 
difficulty in walking, and in four or five days the trouble became so pronounced 
that she was not able to leave her bed; at night she complained of pains in the 
shoulders, loins, and legs. The pains diminished after a few days but an uncertainty 
in the gait remained, together with a sensation of formication and itching of the 
trunk, especially in the mammarv region. No disturbances in the movements of the 
hands or arms were observed. The gait resembled that of ataxic or choreic subjects. 
The left leg dragged a little also. When the eyes were closed, the gait became more 
incoordinated, she often tottered, and would fall if not supported. There were no 
pains in the spine or legs, the general sensibility and special senses were intact; 
patellar reflexes were a little exaggerated; electrical tests showed nothing abnormal. 
The symptoms could not be assigned to any known clinical type, and rest and a 
hygienic diet were prescribed. In a day or two the symptoms ameliorated, 
the left leg was no longer dragged; blindfolded, she still walked badly, with a 
tendency to turn to the right. On the fourth day she was able to walk more freely 
with the eyes covered, and in a few days more the gait became entirely normal. 
During her stay at the hospital the girl passed about 75 grams of feces, 3 to 4 times 
per day. Since every microscopic preparation of less than 1 mg. of feces contained 
2 or 3 eggs of Hymenolepis nana, an enormous number of parasites must necessarily 
have been present. Some Tric/utri.s eggs were also present. No special anthelmintic 
treatment was attempted. Cima thought it very likely that the nervous disturb- 
ances were to be attributed to the excitation of the intestinal sympathetic plexus 
from the irritation set up by the heads of the parasites embedded in the mucosa. 
Case Xo. 57 (Cima’s Case 67). — Boy, 3 years, from the city, abdominal tubercu- 
losis. This case was a typical one of abdominal tuberculosis, from which death 
