71 
The presence or absence of symptoms'' has been noted in more or 
less detail in d9 out of the 101 ^ cases. 
Of the d9 cases, 3 (Nos. 54, 57, 89) showed no symptoms whatever 
which could be traced to H. nana. It is only very remote!}' possible 
that there was any connection between the presence of II. nana in 
cases 1 and 3 and the diseases mentioned in these two instances, viz, 
meningitis and anemia, fatal in both cases. In 9 other cases (Nos. 10, 
11, 13, 14, 15, 35, 53, 86, 101) the symptoms were only slight. In case 
35, although thousands of II. nana were present, there were no symp- 
toms of any kind exhibited, with the exception of occasional slight 
abdominal pains. Although several hundred specimens, besides 
numerous Oxyurls were passed after successive treatments in case No. 
53, the patient was healthy in every respect and showed no symptoms 
except an itching of the nose. In 4 cases (Nos. 6. 47, 97) the 
severity of the symptoms is not defined (in Nos. 82 and 97, however, 
they were probably slight). The symptoms in the 31 cases remaining 
are more or less severe. Only 17 of them, however (Nos. 7, 8, 32, 33, 
34, 36, 37, 38, 39, 41, 42, 43, 44, 49, 81, 94, 95), are marked by symp- 
toms in which the influence of Ilyrnenolepis nana can be definitely 
traced, either by the disappearance or improvement of the symptoms 
after the expulsion of II. nana in those cases in which there seemed 
to be no other parasites present, or, if present, few in number com- 
pared with II. nana: or by the correspondence between the reappear- 
ance of Ilyrnenoleyns eggs in the feces after treatment, and the 
recurrence of symptoms. 
In 13 (Nos. 7, 8, 32, 33, 34, 37, 38, 39, 42, 43, 49, 94, 95) of these 17 
cases, some disorder of the digestive system was noted. The relative 
frequency of symptoms referable to the digestive system is as follows: 
Bulimia or increased appetite, 3 cases (Nos. 7, 8, 39). 
Perversion of appetite, 1 case (No. 95). 
Gastric dyspepsia and difficult digestion, 1 case (No. 38). 
Functional gastro-intestinal disorders, 1 case (No. 37). 
Frequent vomiting, 1 case (No. 49). 
Abdominal pain or paresthesia, 11 cases (Nos. 7, 8, 33, 34, 37, 38, 
39, 42, 43, 49, 94). In one of these cases (No. 38) there was a sensa- 
tion of crawling in the abdomen, and heat in the epigastrium; in 
another (No. 43) pain, and crawling and gnawing sensations; in another 
case (No. 42) pain and a sense of pressure; it was noted in one case 
« This is leaving out of consideration the symptoms in cases Xos. 51 and 52, not 
available to me on account of the Russian text in which they were recorded, and 
also the symptoms which may have been mentioned by Yenuti (1895) in connection 
with his 23 cases, but his paper, unfortunately, is not at present accessible. 
^ The list of symptoms was compiled before the discovery of cases 102 to 106, which 
are therefore not included in the discussion. The ward records of these five cases 
showed, however, no symptoms which could be traced to the presence of the 
parasites. 
