220 
Plerocercoides prolifer Ijima 
superintended my work and allowed me to use his numerous specimens 
prepared from Case I. The opportunity of studying the parasite and 
all information about the patient in Case II were given by the latter 
two gentlemen. My thanks are also due to Mr Inoue who gave me 
valuable information about the worms and the patient in Case III. 
The second case in Japan. 
An enormous number of the cestode larvae were obtained from 
a patient who died of a parasitic disease in the Imperial University 
of Tokyo Hospital, on 13. xii. 1907. 
The patient and his symptoms. The patient, a monk, 36 years old, 
Bunkai Shibasaki by name, had settled recently in a temple in Tokyo. 
I am unable to give a detailed account of his life before his coming 
to the hospital. His statements show that some six years previously 
he had suffered from a disease the cause of which neither himself nor 
his family understood. This was the origin of his fatal illness. About 
a year previous to his coming to the hospital, he accidentally scraped 
a worm out of his neck region. In the year 1907 the disease became 
serious and produced in him an unusual state of mind, probably 
because his brain was attacked by the worm. 
He came to the University Hospital 13. xi. 1907. He appeared 
thin and anaemic. One glance at him showed the presence of the 
worms under the skin as indicated by the presence of vermicular or knob¬ 
like swellings of the integument. On close examination these cutaneous 
swellings were found in every part of the body, i.e. upon the face, 
trunk, and both upper and lower extremities. When I visited the 
patient on 11. xii. 1907, I found the swellings more plentifully on the 
breast and the abdomen than in any other parts. According to the 
information given by Mr Usui, who attended the patient and observed 
him carefully, the number of cutaneous swellings in the various parts of 
the body varied periodically. This observation shows that the worms 
were moving about in the underlying tissues. There was nothing 
remarkable about the symptoms from their pathological aspect; 
they differed entirely, however, from those observed in Case I. In 
Case I, the patient’s skin itched at the spots under which the worm 
capsules were present, as mentioned by Prof. Ijima, bnt in Case II 
the patient did not complain of itching; it should be noted, however, 
that the patient’s sensibility may have been lowered because of the 
worms attacking the brain. I shall not, however, dwell on the 
symptoms since they lie outside my province. 
