174 
original neatness. The statements, mostly based on clinical obsc 
vations during tlie daily routine work, seem contradictor)’, vi 
nowhere is there a sharp line of demarcation left. I, forone, caniw 
see any trace of a ‘peculiar geographical distribution’ of (he t»i: 
shapes of the egg which are said to lx* distinctive of the alleged t»o 
species—admitting even that the statistics are all equally reliable, ie. 
made with special regard to the question at issue. But, be that as 
it may; tliere is certainly no doubt about the evidence supplied by 
the case of Letulle. This was, according to Dr. Sambon'sowd 
words, a case of ' Manson’s Hilharziosis,' and, so far as I can judge 
one absolutely typical both as regards the origin (Martinique) and the 
clinical and pathological aspects. Nevertheless, a careful study d 
the lesions revealed the presence in them of both forms of 
After Sambon, it would thus have been a ‘ combined ’ infection widi 
Sc/i. via 7 isoni and Sch. hamatobium ; an infection, however, in whki 
Sch. hcematobium did not produce its own lesions, but those d 
'Sch. mansoni.’ It remains for Dr. Sambon to show the way out 
of this labyrinth. For me there is no difficulty, for I say that both 
forms of eggs belong to the same species, and that the app^r^ 
differences between vesical and rectal Bilharziosis are not due to J 
difference in the species of the parasite, but to reasons which 1"“^ 
be looked for elsewhere; we shall see later what they may be- 
I were to make a ‘ prophecy ’ I would say that in almost all eas® 
of ‘ Manson’s Bilharziosis,’ if they are so thoroughly examined as 
Martinique case was by Letulle, the eggs of Sch. 
w 1 11 be found among the eggs of ‘ Sch. mansoni: (I have 
emphasized the word ‘almost’; we shall see later that there ^ 
certain conditions under which the lateral-spined ought to be 
9 e a one). I especially recommend for examination the li'^ 
IS a pity that it was not studied in Letulle's case; but I 
easdy comprehend that there was for Letulle no visible reason tu 
Jook for ova there. 
.ccLr "r K by 
rdffl ‘“Observers with those know., from Egypt, the<^ 
th^ ^PP--nt irregularity 
rne Jocalisation of th 
c lesions. In order to 
nry case complete I will try to show that the bmiorsueb 
in 
as 
1 
