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Bilharziosis in South Africa 
It is generally accepted that the ova, and not the worms, cause the 
pathological changes. 
Mesenteric Glands. 
These glands in a patient with intestinal Bilharziosis are slightly 
enlarged : they are of a very dark colour and of hard consistence. I 
have frequently found terminal spined ova when examining scrapings 
taken from them. 
Lungs. 
Of the few lungs I have examined I have only found the ova on one 
occasion (terminal spined ova) in a boy who died from acute pulmonary 
tuberculosis. The tuberculosis was evidently secondary to the Bilharzial 
infection. It is reasonable to suppose that a Bilharzial infection of the 
lungs would render the patient more susceptible to infection with 
Bacillus tuberculosis. It is interesting to note that Cobbold suggests 
the peculiar susceptibility of the South African native to pneumonia may 
be the result of Bilharzia. 
Treatment. 
I have only heard of three native remedies, but doubtless many 
others exist: (1) A decoction made from the roots of a Cassia, 
growing in Equatorial East Africa, which Dr O’Sullivan Beare obtained 
from the natives of those parts. This plant has since been named 
Cassia beareana; an extract made from the roots has been used with 
marked success in the treatment of Blackwater fever (see O’Sullivan, 
Lancet of Feb. 1st, 1902, and Bostock, Transvaal Med. Journ. of July, 
1907). (2) While among the kraals in the Inhambane District, I was 
informed by natives that they used a medicine, consisting of a decoction 
of the leaves of a tree called Umrangala Umgubo (spelt phonetically). 
The use of this plant for bladder troubles would appear very widespread, 
as a Mozambique boy told me that a decoction of the roots of the same 
plant was used in his country by persons passing blood in their urine. 
Among the Mozambiques, he informed me, the plant is known by the 
name of Reba Reba: I regret to say that I have not been able to get 
this plant identified. (3) A demulcent drink made from the beard of 
mealie cobs has a great reputation for the treatment of the disease 
among some natives. 
