57 
cestode eggs in the urine, and the fa.et that they were found in but one preparation, 
so that this possibility remains very improbable, notwithstanding the attendant chy- 
hiria. The second possibility is quite probable, since the eggs of Hijmenolepis nana 
uot only are often difficult to find, but frequently disappear spontaneously from the feces 
and later recur again, so that even a large number of examinations might fail to dis- 
close the presence of the parasite. Even the most extreme care in technique is 
insufficient to entirely exclude the last-named possibility. 
The authenticity of this case is therefore extremely doubtful. 
ASIA. 
Siam, 1892, 1 case. 
Case Xo. 88 . — lu Septeml)er, 1892, R.vsch (1894) was consulted by a native girl, 7 
5 'ears of age. The patient had suffered for a long time with sleeplessness. There was 
no organic trouble. She was constipated, so that cathartics were frequently neces- 
sary. Vomiting was of common occurrence, especially in the morning, which was 
not due to overeating, as she had but little appetite. The stools were usually mixed 
with copious quantities of mucus. Temperature, pulse, heart, lungs, abdomen were 
normal. The patient appeared somewhat i>ale and anemic, and blue rings were 
often present under the eyes. Her general physical condition was fairly good. An 
examination of her feces showed the eggs of Hiimenolepis rama, larval nematodes 
['? Strong i/loides ste.rcoralis'] and a female Oxguris verrmcularis. After treatment with 
male fern, 50 to 80 specimens of Hijmenolep'n< nana were isolated from the stool. 
Tokyo, Japan, 1895 2 case.s. 
('ases Xos. 89 and 90. — Miura & Yamazaki (1897) report two eases from .Japan. 
The first case was that of a l)oy of 5 years, who had been received in 1893 at the 
poorhouse with his mother. In June, 1895, he became ill of a fever, with enlarge- 
ment of the liver and spleen. The feces contained eggs of O.vyuris, Trichuris, and 
irgmenolepis, but the patient showed no reflex nervous symptoms which might be 
traced to helminthiasis. When the fever had improved somewhat the boy was dosed 
with a decoction of pomegranate, followed by castor oil. Many O.ninrls were 
])assed, but no Ilginenolejns. Two days later, besides the pomegranate decoction 
and oil, male fern was also administered. A large number of ITgmmolepis were 
]^assed, of which over 150 were isolated. After three weeks the eggs again appeared 
in the feces, and 15 more tapeworms were passed after doses of male fern and salts. 
Case Xa. 90 . — The second case, also observed in 1895, was a foundling, girl, 
aged 5 years, who had entered the poorhouse the year before. After a while she 
became thin and anemic, suffered from irregular attacks of remittent fever and 
diarrhea. Examination of the thoracic and abdominal organs gave mostly negative 
results; the abdomen was rather sensitive to pressure. The eggs of Trichuris, 
O.ryuris, Ascaris, Agchylostoma, and Hyrnenolepis were found in the feces. Hookworm 
eggs were seen only after 60 preparations were examined, and those of Hymenolepis 
only after 70 preparations. After treatment with pomegranate and male fern, two 
specimens of Hyrnenolepisi nana were passed. 
AMERICA.® 
Philadelphia, Pa., 1872 1 case. 
Case Xo. 91. — Spooxer (1873a, b), on September 3, 1872, presented to the College 
of Physicians of Philadelphia some specimens cf Hymenolepis nana from the first 
case observed in America. They were passed by a young man who had symptoms 
of general debility, occasional colicky attacks, diarrhea, severe frontal headache, 
disturbance of vision, with slight febrile exacerbations, occurring at irregular inter- 
«See also footnote, p. 7. 
