swollen thigh and the itching of the skin in parts where a pimplelike hardening 
made its appearance; scratching with the nails, in order to allay the itching, 
had led to breaking the skin, from which a soft whitish mass, together with 
some fluid, could be pressed out. A number of resulting recent scars, especially 
.^on the breasts, were visible. 
In preparations, made of skin taken from the left thigh, Ijima became con- 
vinced of the presence in the connective tissue of numerous encapsuled worms, 
the cestode nature of which was recognized from the calcareous corpuscles. 
On each of two subsequent occasions, July 9 and 24, 1904, a very large piece 
of skin, with the underlying connective tissue, was excised from the left thigh, 
in order to relieve the patient of the superfluous tissue. Altogether several 
pounds in weight were removed during the patient's stay at the hospital. 
When freshly excised the subcutaneous tissues presented an unusual appear- 
ance. At places several centimeters thick they were moderately rich in pan- 
niculus adiposus and extraordinarily rich in lymph ; the latter swelled the con- 
nective tissue between the panniculi, giving it a slimy or gelatinous appearance 
and consistency ; the slimy character seemed more manifest in the deeper parts ; 
lymph exuded copiously from the cut surfaces; numerous capsules, with the 
contained worm, wei*e observable as whitish objects, isolated or in clusters, in 
- all parts of the tissues. The thickness of tissues between the surface and the 
underlying tissue measures 30 to 60 mm., notwithstanding the fact that the 
hardening process has contracted the subcutaneous connective tissue, through 
loss of the lymph, into dense fibrous bundles, so that it no longer bears a resem- 
blance to what it was in the fresh state. The corinm in the same piece may be 
said to be 3 to 6 mm. thick; it seems to be on the whole considerably thicker 
than in the normal state. — Abstracted from Ijima, 1905, pp. 1-21. 
Further medical details are not given by Ijima, but he states that 
Professor Kondo will publish a report of clinical and pathological 
observations. I have not as yet learned of the publication of the 
report in question. ^ 
From the foregoing abstracts the suspicion immediately arises that 
in Florida we have a skin infection, hitherto unrecognized for the 
American continent, and similar to, perhaps identical with, an infec- 
tion recognized only on one former occasion, namely, in Japan. 
It is interesting to note the following comparison in the cases, with- 
out laying too much stress upon these points at present : 
Both cases occurred near the eastern shore of the continents in 
question (Old World, between 35° and 36° X., and Xew World, be- 
tween 27° and 28° X.) ; both patients lived in or near cities or towns 
located directly on the water, very near larger bodies of water (Pacific 
Ocean and Gulf of Mexico) ; both patients, though of different sex, 
were adult (23 }Tars, male; 31 years, female) when the infection was 
first noticed ; both patients belonged to the poorer class of society : one 
had a professedly fish diet, the other lives in a country where a fish 
diet is very common; both infections are of long standing (in one 
case over three years, in the other case about twenty-five years) ; in 
both cases the number of individual worms present was very great; 
both observers (Ijima for Japan and Gates for Florida) independ- 
ently call attention to the acnelike lesion resulting from the infec- 
