43 
Milan, Italy, 1879 1 case. 
Case No. 5. — Gkassi (1879h, j). 156) reports a case from the Milan Hospital of a girl 
41 years old, suffering from severe nervous troubles with epileptiform attacks, the 
symptoms resembling those of a basilar cerebral tumor. The child was also troubled 
by an intermittent diarrhea. In her feces, besides the eggs of H.sc«?’rs, Trichuris, and 
Oxyuris, were some cestode eggs determined several years later (Gkassi, 1886a, b) 
as belonging to Hymenolepis nana. Kousso and kamala were administered with 
negative results. 
Belgrade, Servia, I885-. 1 case. 
Case No. 6. — Blanchard (1886e) reported the next case of Hymenolepis in Europe. 
A 7-year-old girl of poor parents came under the care of Doctor Holez of Belgrade, 
suffering from digestive troubles. Tapeworm was suspected and male fern adminis- 
tered. A Tsenia solium, some Oxyuris vermicularis, and 50 Hymenolepis nana were 
passed. The treatment was repeated four or five times, about 50 examples of H. 
nana being passed each time, so that altogether about 250 were expelled. This Dase 
was also reported by Leuckakt (1886a, pp. 995-997). 
Lombardy and Sicily, Italy, 1886 2 cases. 
Cases Nos. 7 and 8. — In 1886 two cases of Hymenolepis nana were observed at Milan 
by Gkassi (1886a, b, 1887d.) Two young Sicilians, one of whom seems to have been 
a medical student from near Catania, Sicily (Calandruccio, 1890a, p. 124), both of 
robust constitution, were affected with severe nervous troubles, indolence, epileptic- 
attacks without loss of consciousness, weakening of the mental faculties, melancholia, 
and bulimia, which resisted all treatment, the symiDtoms generally resembling those 
exhibited by the little Milanese girl in 1879 (see case Xo. 5). Upon the discovery 
of cestode eggs in the feces male fern was administered, after ineffective trials with 
kousso and kamala, and each patient expelled several thousand specimens of Hymen- 
olepis nana. Following this treatment all the morbid symptoms disapj^eared. 
Cusago, near Milan, Italy, 1886 1 case. 
Case No. 9 . — This case was reported by Visconti & Segre (1886.) On October 9, 
1886, a peasant, aged 17, in a state of extreme prostration, with severe dyspnea, 
entered the hospital at Milan from Cusago. Toward evening the dyspnea increased, 
and when the patient was seen the next morning he was unconscious, respiration 
stertorous, lips blue, extremities cold, and pulse thready. Death supervened shortly. 
Upon inquiry it was found that for three years the patient had suffered from 
an habitual diarrhea, passing several yellowish stools a day. He complained con- 
stantly of colicky pains in the abdomen, which often became very severe. His 
appetite however, remained good, and was not perverted. He had had malaria, 
from which recovery was complete. He suffered from frequent headaches of short 
duration; always felt cold; the last two months of his life had a slight fever even- 
ings, upon which quinine had no effect; his respiration was noisy, and light attacks 
of dyspnea were of occasional occurrence. Three days before entering the hospital 
he was seized with a violent attack of dyspnea, and repeated attacks of clonic con- 
vulsions, almost epileptic in character, each lasting for some time and followed by 
evacuations from the bowel. 
The autopsy revealed 4 specimens of Aychylostoma duodenale in the duodenum, and 
6 Ascaris lumhricoides and about 400 Hymenolepis nana in the ileum. The tape- 
worms, not adherent, were scattered through the ileum from its beginning to about 
20 cm. from the ileo-cecal valve. (For pathology of this case see p. 68. ) 
Lombardy, Italy, 1886-1887 . 3 cases. 
Catania, Sicily, 1886-1889 23 cases. 
Italy, 1890-1891 several cases. 
