Bilharziasis 
92 
Dr B. 1893. Not at all. 
1900. If no albuminuria, if symptoms slight, general look healthy, patient, say, 
20 years of age, I should pass the life with a light loading of, say, three years to be taken 
off when the patient is quite better. 
Dr C. 1893. Not at all. 
1906. If symptoms slight, if patient 23 or 24 years old and if applicant has had the 
affection two or three years, I take no notice of it. 
Dr D. 1893. If on examination of urine, ova are detected, add a few years for the protection 
of the Company, though you yourself may not think anything of it. 
1906. If patient of strong physique, temperate and otherwise in good health, pass at 
ordinary rates. 
Dr E. 1893. In case of three or four years’ standing, without serious symptoms and no 
albuminuria. If ova have disappeared, ordinary rates. 
1906. If applicant has been affected a good while and is getting better, I would 
(other circumstances being favourable) pass him as a first-class life. 
( b) When the symptoms are well marked: 
Dr B. 1893. Add three years or more, according to symptoms. 
1906. Would defer the case, but not refuse it. 
Dr C. 1893. Load the life three or four years. If anaemia profound or renal colic, refuse 
the life. 
1906. Might load, because of after trouble from calculi. 
Dr D. 1893. Would be regulated entirely by circumstances. 
1906. Wait for a few months and then re-examine. 
Dr E. 1893. Defer till better or slightly marked. 
1906. In extreme cases, refuse the life. Moderately severe, without anaemia and 
albuminuria slight, I would load the life three to five years. 
TREATMENT. 
The treatment of Bilharziasis in Natal consists in: 
(a) avoiding fresh infection from the bathing-pools, 
(b) destroying the parasites which exist in the portal and mesenteric 
veins. So far we do not know of any effective remedy for this, 
( c ) hastening the exit of the eggs from the bladder, 
( d ) correcting the bacilluria and haematuria, 
( e ) correcting the anaemia, 
(/) treating the renal colic, gravel and cystitis, 
(g) surgical remedies to remove calculus or to relieve retention of urine. 
The consensus of opinion would seem to be that it is best to resort to the 
almost exclusive use of diuretics and urinary antiseptics in uncomplicated 
cases of the disease. The use of hexamine is of undoubted service in many 
cases and may be combined with small doses of Buchu. Where there is 
continuous renal colic, Sodium salicylate and Tr. Hyoscvamus are indicated. 
Amongst the various remedies which are employed in Natal may be 
mentioned: 
(a) Methylene blue, Male fern, Thymol, Santonin and Salol, to destroy 
the parasites in the blood-stream. Injections of Salvarsan have been tried 
without effect, and the mercuric-bichloride treatment of Egypt seems to be 
quite ineffectual in Natal. 
