5.7 
t 
cestode eggs in the urine, and the fact that tliey were found in but one preparation, 
so that this possibility remains very improbable, notwithstanding the attendant ch} - 
Inria. The second possibility is quite probable, since the eggs of HymeiKjlepis nana 
not only are often difficult to find, but frequently disappear spoutaneoush’ 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. 
Siam, 1892 1 ca.se. 
Case Xo. .s’, s’. — In September, l.St)2, Rascu (1894) was consulted by a native girl, 7 
years 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 pale 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 JTijmenolepis nana, larval nematodes 
Sfrongyloides stercomlis'] and a female Oxyuris verrmcidaris. After treatment with 
male fern, 50 to 80 specimens of ITymenoleph nana were isolated from the stool. 
Tokyo, Japan, 1895 2 ca.se.s. 
Cases Xos. 89 and 90. — Miura & Yamazaki (1897) report two cases 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 Oxyuris, TnchuH.s, and 
llymenolepis, but the patient showed no reflex nervous symptoms which might be 
traced to helminthiasis. When the fever had improved somewhat the boy Avas dosed 
with a decoction of pomegranate, followed by castor oil. Many Oxyuris were 
}>assed, but no Hymenolepis. Two days later, besides the pomegranate decoction 
and oil, male fern was also administered. A large number of Hymenolepis were 
passed, of which over 150 were isolated. After three weeks the eggs again appeared 
in the feces, and 15 more tapeworms Avere passed after doses of male fern and salts. 
Case Xo. 90. — The second case, also obserA'ed in 1895, Avas a foundling, girl, 
aged 5 years, aa Iio had entered the poorhouse the year before. After a AA’hile she 
became thin and anemic, suffered from irregular attacks of remittent feA’er and 
diarrhea. Examination of the thoracic and abdominal organs gave mostly negative 
results; the abdomen ^vas rather sensitiA'e to x)ressure. The eggs of Trichuris, 
O.njuris, Ascaris, Agehylostoma, and Hymenolepis Avere found in the feces. Hookworm 
eggs AA’ere seen only after 60 preparations Avere examined, and those of Hymenolepis 
only after 70 preparations. After treatment Avith pomegranate and male fern, tAvo 
specimens of Hymenolepis nana Avere passed. 
AMEKICA.^ 
Philadelphia, Pa., 1872 1 case. 
Case Xo. 91. — Spooner (1873a, b), on September 3, 1872, presented to the College 
of Physicians of Philadelphia some specimens ( f Hymenolepis nana from the first 
case obserA'ed in America. They were pa.ssed by a young man Avho had symptoms 
of general debility, occasional colicky attacks, diarrhea, severe frontal headache, 
disturbance of Ausion, with slight febrile exacerbations, occurring at irregular inter- 
«See also footnote, p. 7. 
