52 
fectly well, but after that began exhibiting evidences of a perverte<il appetite, and 
would eat mud. plaster, 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 depraveil 
appetite, ami where she could be watched more closely, she was cure<l of the habit. 
Her physical condition did not improve, however, and she continued to be subjeet 
to fatigue, cardiac palpitations, and dyspnea. Her appetite was. if anything, greater 
than normal, and she suffered from frequent indigestion. 
On examination the patient appeare<l 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 
digestion was difficult, with frequent acid eructations. The patient often complained 
of transient pains in the b<xly and limbs. The cervic-al glands were slightly enlafge<l 
and the voice was rather hoarse. Fecal examinations showecl neither eggs of Affchy- 
lo.stoma nor of Ojiyuris. Occasional eggs of Tnchurl< and some of Ascoris, and one or 
two per slide of Hi/menolepis nana were found. Treatment with santonin and <.-astor 
oil expelltMl several 0:njurls. 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. Ocvuris and more than 100 H. n>ina were passe«l. while in 
the last two only Oiyuris were expelle<i. 
Notwithstanding the apparent success of the treatment the patient Ixc-ame no 
Ixtter. Eggs of Hymenolepis were no longer present in the feces, but Asorri^ and 
Trlcltnri^ eggs were still to be found. Treatment was again instituted, and Oxytfri.^ 
and Asraris were passed, but neither Hymenolepis nor Trkhuris. 
Several months later, in November, 1891, Soxsixo 1895a ) again examined the 
feces of this patient, and found the eggs of Hymenokpis more numerous than before. 
Electuaries of male fern and calomel were administered twi«.-e and vomitwl each 
time. The second time some of the dose undoubteilly took effei-t. as about 
H. niiioi in fragments were expelled. A third dose a few days later exjx*lleil about 
15 H. nano, and a large number of Oxyurk. 
In January, 1894, the feces were free iroxn Hymenokpl-^ eggs, but containeil those of 
Asearh, Trlclinrls, and Agchylostorna, After two treatments with santonin and thymol 
a couple of Agchylosioma were expelled. 
Finally, in. 5Iay, 1895, the feces were free from eggs of parasites, exeept a few of 
Trlrhnrls. and the patient was in a state of comparative health, considering her 
scrofulous constitution. 
Case Xo. — The fourth case .Soxsixo, 1895a , first observed inOctoljer. 1892, was 
a lx>y, 23 months old, from a family of brickmakers of the same locality as that of 
the first and third ca.ses. Seven meml>ers of the family had ha<l uncinariasis. The 
child’s feces contained lai-ge numljers of Hymenokpis eggs, but none of any other 
}>arasite. Entil the age of 8 months, mother s milk had been his only fool, and up 
to that time he remained jxrfectly well. He then !_>egan to eat other fixKl also, and 
likewise to suffer from lientenc diarrhea, with frecpient vomiting and motor disor- 
«lers. such as shivering, biting the lips, gritting the teeth, strabi.smus, and an almost 
continuous automatic lateral movement of the head of the nature of a clonic par- 
tial spasm spa.smus nutans), referable to a lesion or functional disorder of the spinal 
accessory nerve. The boy was weaned entirely and his symptoms gradually l>ecame 
woi'se. 
When seen by Sousino the patient exhibited the motor disorders noted alxjve. 
complaine<l also of pains in the abdomen and head; his nose itched very often, ami 
he was suffering from an intense intestinal catarrh. The abiomen was fiatulent, but 
not sensitive to pressur^. There was some fever, and the patient was inclined to 
l)e drowsy. 
On October 27, after treatment with male fern susi)ende<i in mucilage, and cak>- 
