Gr. H. F. Nuttall 
387 
12 years, all infested on the hairy scalp. The father was probably 
infested (Grindon, 1893)^. 
(b) Adults: 
Man, aged 27, previously treated successfully for pubic infestation; 
the lice afterwards appeared on his eyelashes. 
Man, aged 18, with lice on the eyelashes, head, and in axillae. (These 
two cases are described by Brault, 1906, p. 707.) 
Woman, with normal hair, bore lice on the eyelashes, forehead and 
occiput, with maculae at the back of the neck. The active stages were 
found clinging very closely to the lashes of the upper lids only, the 
lashes being heavily charged with nits. With the exception of one nit 
found in the pubic region no lice or nits could be found elsewhere, but 
maculae were discovered on the abdomen (Fischer, 1910, pp. 115-118). 
Furthermore, Railliet (1895, p. 828) cites Denny as having found 
crab-lice in the ears; an observation which appears to be unique as far 
as I can judge from the literature. Further instances of infestation of 
the head and eye-lashes by Phthirus will be found by reference to the 
following authors: Hooper, 1853, p. 354; Hilgenberg, 1854, p. 154; 
Stelwagon, 1881, p. 301; Hansell, 1883, p. 119; Ring, 1885, p. 647; 
Rosenmayer, 1886, p. 145; Schweinitz, 1888-9, p. 353; Jullien, 1891; 
SchAvenk, 1891, p. 381; Schweinitz and Randall, 1891-2, p. 137; Burdin, 
1892-3; Guyard, 1893-4; Marzocchi, 1908, p. 150 and 1910, p. 150. 
(See Bibliography.) 
Infrequency of head infestation. 
Crab-lice occur very rarely on the head (scalp and eyelashes) in 
adults. Fischer (1910, pp. 115-118) cites Jullien (1892) as having ob¬ 
served it but once in 50,000 cases of phthiriasis in adults. The eyelashes 
are more commonly infested in children and infants and in one-fifth of 
the cases the insects also occur on the eyebrows. It is not so easy to 
discern the active stages upon the eyelids and they may be oA’erlooked; 
a clue to the presence of Phthirus in this situation is afforded by the 
nits on the lashes making these appear dusty. Harkness (cited by 
Fischer) believes that the lice spread from the body to the head, and 
Blaschko is stated to have seen this occur. Pinkus (1915, p. 239), in a 
six years’ practice among Berlin prostitutes, but once observed crab-lice 
on the scalp hair at the back of the neck; only tAAm nits were found, 
the lice disappearing after two days. 
1 The cases cited, beginning Trouessart and ending with Grindon, are abstracted 
from Waldeyer (1900, pp. 494-9), and Dubreuilh and Beille (1895, p. 133). 
