76 
general population. Thus it has happened that a comparatively .large 
number of cases have presented themselves in which severe symptoms 
were associated with the occurrence of Hi/menolepis nano, while prob- 
ably a very large number of cases have never been noticed because 
there have been no symptoms. A case of T^nia saginafa or T. soUum. 
on the other hand, is very likely to come under observation: the aver- 
age individual, when he has once obsm’ved the passage of worms from 
his intestme. usually does not delay, whether there are any other 
unpleasant symptoms or not. to seek relief from the presence of his 
unwelcome guests: the case consecpiently stands a very good chance 
of being placed somewhere on record. Another point might be noticed 
in this connection. Hynienoleph nano, is more especially a parasite of 
children: the larger tapeworms are more common among adults. It 
is rather to be expected that children would, in general, experience i 
more severe effects from parasitic infection than adults: for example, j 
nearly half of Coblx)ld‘s cases (as noted above), which exhibited severe j 
nervous symptoms, were children, while the great majority of all his 
cases were adults: an indiscriminate comparison of statistics, therefore, 
without taking into account the cpiestion of age of affected individuals, 
is not likely to give a true idea of the relative nocuity of the different 
parasites. 
The symptomatology of helminthiasis with HyrnenoJejjU nano may 
be summed up as follows: 
The effects of helminthiasis with II. nano, are no more severe than ;i 
may occur from infection with other tapeworms, nor. if it is consid- j 
ered that many cases of the former are probably overlooked, are 
serious .symptoms more common. Although the effects are usually so ^ 
slight, even when the parasite is present in considerable numbers. ,1 
that the symptoms are only very mild or absent entirely, it occasion- ^ 
ally happens, as with the larger tapeworms, that severe symptoms | 
(persistent diarrhea, epileptiform attacks, etc.) are exhibited. The | 
most frequent symptoms determined by the presence of II. nano, are ’ 
abdominal pain, which may or may not be associated with diarrhea: 
convulsions of various sorts, frequently epileptiform: headache and 
strabismus. Nasal or anal pruritus, common in cases of infection with 
other tapeworms, is rarely seen with II. nano. In many cases in 
which a neuropathic condition is already present, infection with 
Hyrnenolejris nano, is likely to result in an aggravation of the morbose 
phenomena and. in general, a predisposition to nervous disease seems 
to be the important factor in the appearance of nervous symptoms. 
DIAGNOSIS. 
In speaking of the diagnosis of helminthiasis. Blanchard (lS91a. 
p. 100) remarks as follows: | 
The persistence of digestive troubles and the diversity and irregularity of other 1 
symptoms are very suggestive of helminthiasis. The diagnosis is rendered more • 
