GENERAL ARTICLES.

REFERENCES.

De Does, J. K. F., 19°7: Een Syngamus·soort bij het rund op Java. Geneeskundig Tijdschrift voor Nederlandsch-lndie, Deel XLVII., p. 263.

Gedoelst, L., 1924: Un Syngame Parasite de I'Hippopotame. Annales de Parasitologie, Humaine et Compart!e, Tome 11., p. 307.

Lane, c., 1923: Some Strongylata. Parasitology, Vol. XV., p. 348. Leiper, R. '1'., 1913: Observations on Certain Helminths of Man. Trans.

Soc. Trop. Med. and Hyg., Vol. VI., p. 265. Railliet, M. A., 1899: Syngame laryngien du Breuf. Compt. Rend. Soc.

Biol., LI., p. 174. Railliet, M. A., 19°2: Sur quelques Sc1erostomiens parasites des Rum­

inants et des Porcins. Compt~ Rend. Soc. Biol., LIV., p. 107. Railliet, A., and Henry, A., 1913: Sur les CEsophagostomiens des Rum­

inants. BuH. Soc. Path. Exot., p. 509. Sheather, A. 1., and Shilston, A. W., 1920: Syngamus laryngeus in Cattle

and Buffaloes in India. Agric. Res. Inst., Pusa, BuB. No. 92. Von Linstow, 0., 1899: Nematoden aus der Berliner Zoologischen Sam­

mlung. Mitt. Zool. Mus. Berlin, 1., 2, pp. 3-28.

SOME PARASITIC INFECTIONS OF COMPARATIVE INTEREST.

By the Same.

THROUGH the kindness of Major R. E. Wright, I.M.S., Super­intendent, Government Ophthalmie Hospital, Madras, the writer has had the opportunity of examining material from four human patients, who were unfortunate enough to be the subjeet of para­sitic infestation in uneommon, and so more than usually interesting, sites. The details of eaeh ease have been sllpplied entirely by Major Wright, and the writer is responsible only for the diagnosis of the parasite.

Case No. 1.-The patient was admitted to hospital on aceount of a small sub-conjunctival swelling near the inner eanthus of the right eye. The eyst, which was removed, was cylindrieal, semi­opaque, full of fluid, and measured about 2 cm. by lern. It showed a: denser opacity at one point with a somewhat ovoid eminenee on the inner side, and an examination of this scolex established the fact that the eyst was a Cysticercus ce/lulostE. Thi~ ease has beeil reported by Major Wright (1923) in the" Indian Medieal Gazette."

Case No. 2.-A boy, aged thirteen, was admitted to hospital, having lost his vision about a month previously, after severe headache on and off for five months. The patient had vomiting, giddiness, and a bad headaehe for the last month, with shivering attacks and fever. There was adefinite history of sudden loss of vision. There was no alburnen or sugar in the urine, and the tension was normal in each eye. There were no parasites in the btood. The patient comphiined of bad pain in the nape of the neck. He could recognise objects by feel, and his senses other than

GENERAL ARTICLES.

visual seemed active. His reflexes were normal and he responded to questions clearly.

The patient died twenty days after admission to hospital, and the post-mortem examination was held by Dr Tirumurti, Professor of Pathology, Madras Medical College, who kindly supplied the following notes:-

The. brain was extensively involved with multiple cysts, varying in size from that of a pea to a cherry, and contained greenish­yellow pus. No bacteria were {ound in the pus. There was injection and inflammation of the meninges, evidently due to irritation set up by the parasites. There were large numbers of cysts in the white as weIl as in the grey matter of the cerebrum and cerebellum, but they were more in the grey matter. An adult specimen of Tcenia solt'um was removed from the intestines at the post-mortem. The cysts proved to be Cysticercus cellulosce. In one specimen examined in detail twenty-four hooks were present, but their measurements were smaller than usual.

Case No. 3.-A male, aged twenty-five, came to hospital with a proptosed eye and panophthalmitis. The proptosis was said to be of four months' duration. An orbital cyst was carefully removed at the same time as the eye. The cyst was about the size of an average walnut anel was situated between the muscle cone of the penosteum and the inferior temporal quadrant of the orbit. Its milky fluid contents contained neither daughter cysts, scolices, nor hooklets, but from the laminated structure of its wall it appeared to be a sterile hydatid, the cystic form of Echz'nococcus granulosus (Tcenia echinococcus).

Case No. 4.-A woman was brought to hospital suffering from a small inflammatory cyst in the anterior chatriber of the eye. It filled the pupil and abutted against the cornea. When the in­flammatory cyst was removed and placed in saline a small parasitic cyst about 5 mm. by 3 mm. escaped. Unfortunately this was fixed in such a way that no complete picture of the scolex could be obtained, but sections of it enable one to say definitely that it contained four suckers and typical tcenia hooks, so that it was almost certainly another example of Cystzcercus cellulosce.

Dzscussz'on.-According to Fantharn, Stephens, and Theobald (1916), the occurrence of Cystz'cercus cellulosce has been known in man since 1558. They state that there is hardlyan organ in man in which cysticerci have not been observed at some time: they are most frequently found in the brain, and next in frequency in the eye. During the last decades, however, these cases have become lcss common. In the sixties 2 per cent. of post-mortems in Berlin showed cysticerci, but the number fell gradually to 0'16 per cent. in 1903. The first recorded case of Cystzcercus cellulosce in the eye of a man in India was that published by Elliot and Ingram in the "Indian Medical Gazette" for June 1911, and in the same number of that journal Dr Tirumurthi records another ca se of multiple Cysticercus cellulosce of the human brain and other viscera. Major Wright states that cysts of the sub-conjunctival tissues are not

GENERAL ARTICLES.

cO'mmonly met with in the out-patient department of the Madras Ophthalmie Hospital, certainly not more than three to six tim es a year, but he considers that if such cysts were always investi­gated with care Cysticercus celluloscc might be detected more frequently. It is interesting to dweil for a moment on the method of infection of human beings, wh ich must be through the introduction into the stomach of food, water, or dirt contaminated with the oncospheres of Tamia solium from the patient himself or some other carrier, or, as suggested by Fantham, Stephens, and Theobald (1916), a process of internal auto-infection may take place. They suggest that in the act of vomition, possibly during anthelminthic treatment, mature proglottids near the stomach are drawn into it, and the oncospheres or segments there retained are then in the same position as if they had been introduced through the mouth.

The literature concerning hydatid disease appears to contain very little mention of this as affecting the human eye or orbit. Even in Heller's (1913) exhaustive treatise on echinococcus disease, no mention of these sites can be found, Major Wright, however, states that his hospital contains, in addition to the case recorded in these notes, the records of two undoubted hydatids of the orbit occurring in 19z2 and 1923'; while Elliot and Ingram, in the " Indian Medical Gazette" for 1910, published three cases of hydatid cyst, one situated in the orbit and two in the sub-conjunctival tissues of human patients.

REFERENCES.

Fantham, H. B., Stephens, J. W. W., and Theobald, F. V., 1916: Tbe Animal Parasites of Man.

Heller, E. B., 1923: A Treatise on Echinococcus Disease. International Clinics, Vol IV., Series 33.

Wright, R. E., 1923: Cysticercus of tbe Sub-conjunctival Tissues. Tbe Indian Medical Gazette, Vol. LVIII., No. 5.

TREATMENT OF ACUTE THEILERIA FEVER) BY INOCULATION WITH BLOOD.

(EGYPTIAN "IMMUNE"

By S. J. GILBERT, M.R.C.V.S., Senior Veterinary Officer, Government of Palestine.

CASES of acute Theileria appear in Palestine from time to time in cattle imported from Europe. U p to the present time such cases wh ich have come under observation and in which large numbers of parasites have appeared in thc blood have been invariably fatal.

In August 1924 two young Jersey bulls were ,imported from England to J affa for experimental purposes. On 3rd Fcbruary