Chapter X: Section II: CESTODA (Tapeworms) (2)

“Barrack cooks, unless constantly looked after, are utterly careless as to the washing of chopping blocks, tables, dishes, &c. The dish or pot cover on which the meat is placed when raw is often used without washing for serving the piece up for dinner, and I have myself picked up a _Cysticercus_ from the table on which a cook was preparing food. The dangers too of the parasite being conveyed by the cook’s unwashed hands to the plates in which meals are served, and the common practice of using the same knife for cutting up meat, and afterwards, without washing it, for other culinary purposes, must not be overlooked. With good selection and careful feeding there seems to be every probability that Cysticercus would soon almost or completely disappear from our Commissariat cattle. If they were entirely stall-fed and watered from wells there could scarcely be a possibility of infection after their purchase.

“Perhaps with the trench system of conservancy, which will necessitate the growing up crops, a sufficient quantity of root and other green produce may be obtained from cantonment lands set apart for this purpose, to supply green fodder for the cattle.”

The important question as to whether the presence of cysts detected at the root of the tongue could be made available for the purposes of diagnosis was made the subject of special report through the agency of executive Commissariat officers, and they testified to its practical valuelessness in the following terms:

“_Jullundur._--No appearance of cyst has been found at the root of the tongues of any of the cattle. A medical officer was asked for assistance in making search for the cysts, but he also found none.

“_Rawul Pindee._--It is utterly impossible to discriminate before slaughter, from any outward symptoms, cattle that are cyst infected.

“Every endeavour has been made to discover by close and careful scrutiny before slaughter the cyst-infected cattle, but the result has been in no way satisfactory.

“_Sealkote._--All endeavours to discover any symptoms of the infection by examination of their tongues, while the animals were living, have been unsuccessful.

“_Mooltan._--The mouth and tongue of a large number of living cattle have been examined before slaughter, but in no single instance has the infection been so detected.

“Dr. Ross’s plan of examining the tongues of all animals at time of purchase is not feasible, as they are usually very wild and frightened, and often dangerous to approach.

“_Peshawur._--In probably 99 cases out of 100 it is utterly impossible to discover cyst infection in cattle previous to slaughter by examination of their tongues. In only one instance has it been so discovered, and that was from the animal’s having a number of small lumps over the body which were also apparent on the back part of the tongue. When the tongue is infected the ‘cyst’ lies so far at the very root of it that it cannot be seen in the live animal.”

From Mooltan a specially interesting report was made by Dr Alexander Neill, who says:--

“I have carefully examined the mouth and tongue of a large number of living cattle, and of those slaughtered for issue as rations, and in no single instance did I find such cysts. These cattle were healthy.

“In a case that died, and in which cysts existed, I could discover nothing abnormal in or under the tongue.

“If such ‘cysts’ exist, or if such enlargements of the sublingual glands are found, I argue that they are not a diagnostic sign of what is termed ‘cyst infection,’ or more correctly ‘_Cysticercus bovis_,’ for in the recent outbreak of cattle disease in England, one most prominent symptom of that disease was a bunch of grape-like swelling under the tongue, which in advanced cases suppurated, and to a casual observer would have been called cysts or ‘bags of matter.’

“If such swellings are found in a bullock that is sick, it is merely symptomatic of an inflamed condition of the whole mucous surface of the intestinal canal, and not of any localised disease, such as Cysticercus, the above-mentioned swellings being merely inflamed sublingual glands.

“In the pig the diagnostic sign of swellings of the glands or ‘cyst’ under the tongue is not found in ‘Cysticercus,’ and the disease called ‘measles’ is not ‘Cysticercus,’ but a mere superficial inflammation of the skin and a symptom of fever. ‘_Cysticercus cellulosus_,’ as its name shows, infects the cellular tissue only of the pig, and cannot be discovered in life by any abnormal condition of skin.

“In ‘measles’ these swellings are found, because intestinal mucous membrane sympathises with eruption on the skin and are then merely inflamed glands, not cysts.”

Dr Neill concludes his report by remarking that the larvæ of the beef tapeworm can “only arrive at maturity in the mucous membrane of horned cattle,” and not in the cellular tissue. This is an error on Dr Neill’s part; but in adducing these instructive extracts from the Government Reports my chief object has been to show the prevalence of Cysticercus in the North-West Provinces of the Indian Peninsula. I may say that a large proportion of my tapeworm-infected patients have been officers from the Punjab, and one of these victims told me that when he superintended the serving out of rations to the troops, “he (and those who acted with him) sent the meat away to be burnt, even when they only detected a single cyst in any given carcase.” It is needless to remark that such a waste of valuable food is altogether reprehensible.

Some people, including not a few of the profession, make light of the occurrence of tapeworm, and I have seen many patients who had been told by their usual medical advisers that the presence of the worms was of little consequence. To account for this wide-spread error there is some basis in the fact that by far the majority of infested persons suffer only the trifling inconvenience arising from the passage _per anum_ of the proglottides; moreover, the less civilised the tapeworm-bearers happen to be, the less are they likely to suffer. The recorded experience of Kaschin, before referred to, where 500 hospital patients, in the Baikal district, had tapeworm, although all of them were being treated for other disorders, affords another argument tending to the same conclusion. On the other hand, amongst Europeans only a small percentage of tapeworm-patients suffer severely. But without trenching upon the symptomatology and prognosis of tapeworm disease, I may remark that I have (in my Manual) summarised the whole facts of cysticercal prevalence within the compass of two brief propositions:--1. The prevalence or the rarity of Cysticerci in cattle in any given country must be determined primarily by the habits of the people; for since the beef measle can only result from the ingestion by the ox of the eggs of the _Tænia mediocanellata_, it is clear that the degree of infection of cattle will correspond with the facilities offered by egg-dispersion. 2. It may be affirmed that the frequency of this particular species of tapeworm amongst the people occupying any given area will bear a strict relation to the amount of underdone measly beef consumed by the inhabitants.

Another question, and one of great interest to sanitary science, is that which I have raised in reference to the period that nature requires for the destruction of the Cysticerci, or, in other words, for the performance of a natural cure by calcareous degeneration of the parasites. I have shown that all kinds of tapeworm larvæ (measles, bladder-worms, cœnuri, and so forth) have a natural life-epoch assigned to them, and in one of my experiments on a Dutch heifer or young cow I demonstrated that a period of ten months was more than sufficient to ensure the perfect destruction of the Cysticerci of cattle. Moreover, this law or process of natural cure is not limited to cestode parasites, but affects all other kinds of internal parasites in one or other of their juvenile stages of growth. In the flesh of my experimental animal I estimated that there were not less than 12,000 of these degenerated Cysticerci. This positive contribution to our knowledge of the limits assigned by nature to the epoch of larval activity is not merely one of abstract scientific interest, but it has important practical bearings, inasmuch as it points out in what way an entire herd of cattle (known to be measled by the post-mortem examination of one animal previously selected for the purpose, or for that matter, by the rather barbarous act of excising and examining a fragment of the muscle of a living one) may be freed of its parasitic guests; and it also shows how all risk of propagating tapeworm, apart from the question of subjecting the flesh to a certain temperature, may be effectually prevented. The stockowner has but to remove his animals for six or eight months to localities where no fresh infection can occur, when, at the expiration of the time mentioned, all those Cysticerci that existed in the beasts at the time of the transfer will have perished. The flesh of the animals may then be eaten with impunity, whether well cooked or raw. This is an important teaching deducible from experimental inquiry, and I am rather surprised that it has hitherto escaped the notice of persons who, though they affect to ignore the value of scientific researches, are particularly anxious to parade their practical knowledge, which, unhappily, too often proves a mere cloak for ignorance.

The memoir by Giacomini already quoted (p. 65) affords interesting details respecting a case in which there was a most unusual degree of infection of the human body by Cysticerci. Dr Giacomini instituted a searching comparison between the human measles procured by himself and those of the pig sent to him by Professor Perroncito. In the human Cysticerci he noticed a greater adherence of the capsule to the enclosed measle, and he also observed that while the human measle-heads either displayed thirty-two, or in some few cases thirty-four hooks, in two differently sized circles of fifteen or sixteen each, the pig-measles, on the other hand, carried only twenty-four hooks to the double circle of equal circumference; consequently the hooks appeared to be more crowded together in the human parasite. This fact, Giacomini remarks, does not of itself constitute an essential specific difference, since variations of the kind not unfrequently occur in Cysticerci occupying one and the same host. Even the beef-measle is not necessarily confined to one species of host, since Zenker has succeeded in rearing it in a goat.

Although the substance of the above-recorded conclusions was originally communicated by me, anonymously, to a professional periodical, I have considered this work a suitable medium for a fuller discussion of the subject. Its importance in relation to the public health and the supply of meat-food has not received the attention it deserves.

BIBLIOGRAPHY (No. 13).--_Balert, B._, ‘Die Bandwürmer,’ &c. (pamphlet), 1877.--_Bertolus, G._, ‘Diss. sur les metamorph. des cestoïdes,’ Montpellier, 1856.--_Cobbold, T. S._, “On the Production of the so-called ‘Acute Cestode Tuberculosis’ by the Administration of the Proglottides of _Tænia mediocanellata_” (with Mr Simonds), in ‘Proc. of the Royal Society’ for May 4th, 1865; repr. in the ‘Veterinarian’ for 1865, p. 513.--_Idem_, “Experimental Investigations with Cestoid Entozoa,” in ‘Linn. Soc. Journ.,’ vol. ix, p. 170; also for July, 1865, p. 141.--_Idem_, “On Beef, Pork, and Mutton, in relation to Tapeworms,” in ‘Brit. Assoc. Rep.’ for 1865, p. 102, and in ‘Appendix to Treatise on Tapeworms and Threadworms,’ 1st Edit., 1866, p. 73; also in ‘Med. Times and Gaz.’ for Sept. 23rd, 1865, p. 343.--_Idem_, “Remarks on Entozoa,” in ‘Brit. Assoc. Rep.’ for 1865, p. 102; also on “Cystic Entozoa from Veal and Mutton,” in the ‘Path. Soc. Trans.’ for 1866, vol. xvii, p. 462.--_Idem_, “Entozoa found in a Westphalian Ham;” report in ‘Athenæum’ for March 27th, 1869, p. 442; also in ‘Brit. Med. Journ.’ for March 20th, 1869.--_Idem_, “Note on Beef Measles from a Cow,” in ‘Path. Soc. Trans.,’ vol. xvii, p. 463, 1866; also in the ‘Lancet’ for Feb. and August, 1865, p. 249.--_Idem_, ‘Entozoa,’ &c., p. 235 _et seq._, 1864; and in ‘Supp.,’ sections iii, iv, v, 1869.--_Idem_, ‘Tapeworms,’ 3rd Edit. (with 100 cases), 1875, p. 11.--_Idem_, ‘Manual of the Internal Par. of Domesticated Animals,’ chap. iii to vi, 1874.--_Idem_, ‘Worms,’ Lectures i to xi, 1872.--_Idem_, “On the Parasites of our Food-producing Ruminants (Cantor Lectures),” in the ‘Journ. of the Soc. of Arts,’ 1871.--_Idem_, “On the Entozoa of Abyssinia” (Lecture), in ‘Lancet,’ 1867.--_Idem_, “Remarks on Eighty Cases of Tapeworm,” ‘Lancet,’ June, 1874.--_Idem_, “Revised List of Entozoa, with notes and references (the beef tapeworm, No. 15, and the beef measle, No. 25),” in the ‘Veterinarian,’ Dec., 1874, and Feb., 1875.--_Idem_, (anonymously), “Cysticerci, being a review of the writings of Pellizzari, Tommasi, Perroncito, Lewis, Giacomini, &c.,” contributed to the ‘Lond. Med. Record,’ 1874, p. 642 _et seq._; repr. in the ‘Veterinarian,’ Jan., 1875.--_Idem_, “Notice of a Discussion by Paul, Martineau, Créquy, Delioux de Savignac, Trasbot, and others, respecting the Source and Treatment of Tapeworm,” ‘Lond. Med. Rec.,’ July, 1874, p. 472.--_Idem_, “Review of the Writings of Oliver, Fleming, Hewlett, Lewis, and others, on the Cystic Disease of Animals,” ‘Lond. Med. Rec.,’ June, 1873, p. 339.--_Idem_, “Further Experimental Researches with the Eggs of the Beef Tapeworm,” the ‘Veterinarian,’ Aug., 1875.--_Idem_, “Remarks on Perroncito’s Researches,” the ‘Veterinarian,’ Dec., 1877.--_Dardel, A._, “Sulla frequenza della Tenia in Savoia,” ‘Giorn. d’Accad. di Med.,’ 1868.--_Davaine, C._, ‘Traité’ (1. c. Bibl. No. 1), 1860.--_Idem_, “Les Cestoides,” in ‘Dict. Encyclopédique des Sci. Med.,’ 1875.--_Fleming, J._, ‘Indian Med. Gaz.,’ 1869.--_Fock, H. C. A. L._, ‘De Lintworm en het middel om hem mit te drijven,’ Utrecht, 1878.--_Fritsch, G._, “Zur differentiellen Diagnose von _T. solium and T. mediocanellata_,” ‘Berliner Klinische Wochenschrift,’ 1874.--_Gamgee, J._, “Entozoa in Veal and Beef” (Letter on), ‘Lancet,’ 1865.--_Giacomini, C._, ‘Sul _Cyst. cell. hominis_ e sull _Tænia med_, contrib. alla studio dei Cestoidi Parrassiti dell’ Uomo,’ Torino, 1874.--_Heller, A._, “Darmschmarotzer,” in von Ziemssen’s ‘Handbuch der speciellen Pathol. und Therapie,’ s. 598 _et seq._, 1876.--_Hewlett_, ‘Health Officer’s Report,’ Bombay, 1870.--_Krabbe, H._, ‘Beretning om 100 Tilfælde af Bœndellorm hos Menesket iagttagne her i Landet (Aftryk af Ugeskrift for Læger),’ 1869.--_Küchenmeister, F._, ‘Ueber Cestoden im Allgemeinen und die des Menschen insbesondere, hauptsählich mit Berücksichtigung ihrer Entwickelungsgeschichte, geographischen Verbreitung, Prophylaxe und Abtreibung; specieller Theil. Zittau,’ 1853.--_Idem_, ‘Parasiten’ (1. c. Bibl. No. 1), 1855, Eng. Edit., London, 1857.--_Laboulbéne, A._, “Sur les Tænias,” ‘Mém. de la Soc. Méd. des Hôpit.,’ 1876.--_Idem_, ‘Anat. Pathologique,’ 1879, p. 962.--_Letheby_, “On Diseased Meat,” ‘Med. Times and Gaz.,’ 1867.--_Leuckart, R._, ‘Die Menschl. Par.,’ Bd. i, s. 285 and s. 747, 1864.--_Levi_, “Della freq. della tenia,” &c., ‘Giorn. Veneto di Scienz. Med.,’ 1874.--_Lewis, T. K._, “A Report on the Bladder Worms found in Beef and Pork” (‘App. B. to 8th Ann. Rep. of the Sanit. Commiss. with the Gov. of India’), Calcutta, 1872.--_Masse, E._ et _Pourquier, P._, “Le Tænia inerme et la lardrerie du Bœuf, Nouvelles Expériences,” &c., in ‘Montpellier Med. Journ. Mens. de Méd.,’ p. 220, 1876.--_Mosler_, ‘Helminthogische studien und Beobachtungen,’ Berlin, 1864. _Neill, A._, “Letter, forming the fifth of a series of important articles on Cyst-infected Cattle, and on the prevalence of Cysticercus in Beef,” reported by the Inspector General (I. M. D.), in the ‘Madras Monthly Journ. of Med. Sci.,’ Feb., 1873; repr. in the ‘Veterinarian,’ July, 1873.--_Nitsche, H._, “Untersuchungen ueber den Bau der Tænien,” ‘Sieb. und Köll. Zeitschrift,’ 1873.--_Oliver_, “Rejections of Ration Beef on account of Cystic Disease” (l. c. _supra_), ‘7th Rep. of the Commiss.,’ p. 82, Calcutta, 1871.--_Perroncito E._, “Della panicatura negli animali,” ‘Annali della R. Accad. d’Agricolt. di Torino,’ vol. xv, 1872.--_Idem_, “Sulla morte del _Cyst. cell._ delle carni del majale;” _ibid._, 1872.--_Idem_, “Ueber die Lebenszähigkeit des _Cyst. cell._ und anderer Eingeweidewürmer,” ‘Zeitsch. f. prakt. Veter.-Wissenschaften,’ Bern, 1876.--_Idem_, ‘Della Grandine o Panicatura nell’ Uomo e negli animali,’ Torino, 1877.--_Idem_, “Esperimenti sulla produzione del cisticerco nelli carni del bovini, coll’ amministrazione di anelli della _tænia med._ dell’ uomo,” ‘Lo Studente Vet.,’ Parma, 1876, p. 146.--_Idem_, “Sulla tenacita,” &c., _ibid._, 1877, p. 194.--_Idem_, “Esperimenti sulla prod. del Cyst. della _T. med._ nelle carni dei Vitelli,” ‘Estr. della Annali d. R. Accad. d’Agric. di Torino,’ vol. xx, 1877.--_Idem_, “On the Tenacity of Life of the Helminths, and their corresponding Larval Forms in Man and Animals,” the ‘Veterinarian,’ July, 1877, p. 457.--_Idem_ (with similar title, including notice of experiments), the ‘Veterinarian,’ Dec., 1877; partly from ‘Osservatore Gaz. d. Cliniche di Torino,’ and from ‘Archivvo per le Sci. Med.,’ vol. i, 1877.--_Idem_, “On the Tenacity of Life of the _Cysticercus_ in the flesh of Oxen, and on the rapid development of the corresponding _T. mediocanellata_ in the Human Body,” the ‘Veterinarian,’ Dec., 1877, p. 817.--_Probstmayr_, ‘Jahrb. der Münchener Thierarzneischule,’ 1869.--_Rochard_, “Note sur la fréquence du _Tænia mediocanellata_ en Syrie, et sur la présence du cysticerque qui lui donne naissance, dans la chaire musculaire des bœufs de ce pays,” in ‘Bulletin de l’Acad. de Méd.,’ 1877, tom. vi, p. 998.--_Thudichum, J. W. L._, “On the Parasitic Diseases of Quadrupeds used as Food,” ‘Privy Council Med. Officer’s Rep.’ 1865.--_Sommer, F._, “Ueber den Bau und die Entwickelung der Geschlechtsorgane, von _Tænia mediocanellata_ und _T. solium_,” in ‘Siebold and Köll. Zeitschrift,’ Bd. xxiv, s. 499, 1874.--_St Cyr_, “Deux Experiences,” &c., ‘Journ. de l’Anatomie, de Robin,’ p. 504; and in ‘Lond. Med. Rec.,’ by Higgs, vol. i, 582, 1873.--_Tommasi, T._, ‘Appendice (to Cobbold’s) Parasiti Interni degli Animali Domestice,’ p. 161, Firenze, 1874.--_Van Beneden, P. J._, “Iconographie des Helminthes ou des vers parasites de l’homme” (Vers Cestoïdes, pl. ii), Louvain, 1860.--_Welch, F. H._, “Observations on the Anatomy of _Tænia mediocanellata_,” ‘Quart. Journ. of Microsc. Science,’ vol. xv, 1875.--_Zenker_, in ‘S. B. Soc.,’ Erlang. iv, s. 71.--_Zurn_, ‘Zoopathologische und physiol. Untersuchungen,’ 1872.

_Tænia solium_, Linneus.--This cestode was formerly known as the common tapeworm, but in England it is of far less frequent occurrence than the beef tapeworm. In contradistinction it is best to speak of it as the pork tapeworm. Though only one specimen is usually present, the bearer may entertain several worms of this species at one and the same time. The parasite has been known to science from the earliest times, though possibly not earlier than the measles, or Cysticerci, from which it originates. Hippocrates, Pliny, and Aristotle describe the full-grown worm; and, in regard to the larvæ, some have gone so far as to express their belief that the prohibition of swine’s flesh as food amongst the Jews and other Oriental people, was dictated by sanitary considerations. Weinland has suggested that the Mosaic commandment not to eat pork may have originated in an old popular notion “of the fact that tapeworm sometimes comes from this food.” Weinland’s hypothesis is probably correct, for if one supposes Moses to have been supernaturally informed that pork would produce tapeworm disease, one naturally asks why veal and beef should not also have been prohibited, seeing that these meats also frequently harbour tapeworm larvæ.

A perfect pork tapeworm presents itself to the eye of the observer as a long, soft, white, jointed strobile, which, when alive, elongates and contracts itself with facility. Though commonly spoken of as a single creature, it is a compound of many individuals. These are variously called “cucurbitini,” “zooids,” “proglottides,” “segments,” “links,” or “joints.” When fully grown the segments are capable of detaching themselves and of enjoying a free and independent existence. Very annoying it is to the human bearer to be continually reminded of his unwelcome “guests” as they seek to quit his interior.

The head of _Tænia solium_ is seldom seen in anatomical museums, although the evacuation of pork tapeworms is not of rare occurrence. Placed under the microscope, the head displays a quantity of dark, almost black, pigment granules, which are abundant at the base of the rostellum and in the neighbourhood of the hook-fangs. They are equally present and abundant in the pork measle proper, and in measles derived from the human subject. The cephalic hooks of this cestode are comparatively large, those of the greater circle individually measuring 1/156″, whilst the smaller hooks have a length of about 1/220″.

The male reproductive organ consists of a number of small vesicles or sacs, in which filiform spermatozoa have been detected, these latter, when ripe, being conducted by a _vas deferens_ into a seminal pouch, from which a canal passes laterally into the penis; the latter organ, in its retracted condition, being lodged within a flask-shaped sheath or cirrhus-pouch. The female organs are somewhat more complicated. They consist of two masses of vitelligene glands occupying a limited space, a small ovarium, a centrally-placed and largely-developed branched uterus, canals of outlet leading from all these organs, and enlargements of the main passages to form internal seminal reservoirs; also, a vaginal canal, which is widened at its termination to form a receptaculum for the curved penis.

In addition to the above-named structures, the entire series of joints from the head downwards are traversed by a set of vascular canals, which are doubled in the region of the head. These form the so-called aquiferous system. There are two main channels, one passing down on either side of the worm, both being connected by transverse vessels, which occur singly at one end of every joint.

The eggs in their mature condition are globular, and contain a six-hooked embryo. They present an average diameter of 1/694 of an inch, the shell itself measuring about 1/4000″ in thickness. In 1856 I observed that many of the eggs, whilst still within the uterine branches, displayed an outer envelope, very delicate in structure and totally dissimilar from the egg-shell proper. This has since been more accurately described by Weinland, Van Beneden, and Leuckart. The outer membrane, according to the last-named authority, constitutes the primitive yolk-membrane, within which a part of the yolk-contents separates to form the true egg and embryo by a process of daughter-cell formation. The remaining part of the yolk forms a granular mass, being probably concerned in the formation of the true chitinous shell. The true shell displays a series of radiating and circular lines; the former, however, are more conspicuous than the latter, being due, according to Leuckart, to the presence of a series of fine rod-like chitinous elements, which are formed on the external surface of the original true shell-membrane. The enclosed embryo is furnished with six boring spines, arranged in three pairs, its granular body being invested by an extremely delicate skin-membrane, which is separated from the inner surface of the shell by a clear transparent fluid. The embryo measures 1/1250″ in diameter.

The scolex or higher larval stage of growth forms the well-known pork measle or _Cysticercus_ (_telæ_) _cellulosæ_ of authors. The smallest measles found by Leuckart measured 1/25″ in length. They were obtained from the brain, liver, and intermuscular substance of a pig fed with proglottides about thirty days previously. Only those specimens, however, occurring in the liver at this early period displayed an outer membrane proper to the worm itself, the others being simply invested with capsules formed out of the connective tissues of the host. Many measle-masses in the same host were much larger, presenting an average diameter of 1/6″. The smallest already displayed a smooth, transparent, homogeneous, outer, cuticular membrane, overlying a double, finely-granular corium, the latter being traversed by a branched system of aquiferous vessels. These vessels proceed from a central spot, which marks the position of the so-called head-cone, or _receptaculum capitis_. It is, in fact, the first well-marked indication of that flask-shaped capsule within which the head, neck, and body of the Cysticercus is formed, and which Goeze long ago very aptly compared to a lantern. As growth proceeds, a central granular mass forms the true foundation of the head, its upper or stalk-like extension becoming the future neck and body. Further changes result in the evolution of the internal water-vascular system, the calcareous corpuscles, the marginal transverse foldings of the body, the four suckers, the rostellum, and, in particular, the double coronet of hooks. All these metamorphoses were minutely followed and described by Leuckart, who found the development of the larva to be completed within the space of ten weeks.

As regards the injurious effects of this parasite upon man, it may be said to act prejudicially in three separate ways. I have remarked in my ‘Entozoa,’ that this parasite may cause disease and death both by its action in the larval and adult states. It may likewise injure us by rendering the flesh of swine unwholesome.

When one or more sexually-mature tapeworms have developed themselves within the human intestine, they are apt to give rise to a variety of unpleasant symptoms, more or less marked according to the habit or irritability of the patient. According to Davaine (p. 103 of his ‘Traité’) the principal features are “vertigo, noises in the ears, impairment of sight, itching of the nose and anus, salivation, dyspepsia and loss of appetite, colic, pains over the epigastrium and in different parts of the abdomen, palpitation, syncope, the sensation of weight in the abdomen, pains and lassitude in the limbs, and emaciation.” In ordinary cases there is always more or less anxiety and restlessness; but in severe cases the sympathetic symptoms are very strongly marked, showing themselves in hysterical fits, chorea, epilepsy, and epileptiform seizures, attended by more or less alarming convulsions.

Amongst some of the more interesting and remarkable cases recorded in our English journals, I may instance that of Mr Hutchings, where a complete cure followed the evacuation of the worm which had produced convulsions. Mr Tuffnell records a case where irritability of the bladder and stricture of the urethra were entirely dependent on tapeworm, as proved by the subsequent recovery. At a meeting of the Pathological Society, in 1853, Dr Winslow mentioned his experience of three or four cases of mania arising from tapeworm; whilst on the same occasion Drs Ryan and Davey each recorded a similar instance. A case has also been previously published by Mr W. Wood. At a meeting of the London Medical Society, held on the 10th of April, 1837, Dr Theophilus Thomson (during an interesting discussion on this subject) stated the facts of a case where the presence of tapeworm had given rise to a tumultuous action of the heart, this symptom entirely disappearing after evacuation of the worm. Our journals likewise (anonymously) record a considerable number of cases from foreign sources. Thus, in the ‘London Medical Gazette’ for 1840, there is the case of a lady, aged thirty-seven, who had convulsions attended with a complete loss of consciousness, the separate fits lasting an hour at a time. The passage of the worms effected a complete cure. In the same journal for 1838, there is also the case of a younger lady (aged twenty-seven) suffering from epilepsy, in whom a complete cure had been similarly brought about; here, however, in addition to a single specimen of the _Tænia solium_, there were two lumbrici present. This journal also gives Ettmüller’s case, where eighteen tapeworms were the cause of hysteria; and likewise the case published by Steinbeck, where the symptoms presented an altogether peculiar character. More precise references to some of the above cases will be found in the ‘Bibliography’ below; and I may also refer to my published lectures on Helminthology and especially to my separate work on Tapeworms, where particulars of one hundred cases are briefly recorded. These were all average cases occurring to me whilst in private practice. Davaine’s book also abounds with remarkable cases.

Whilst the adult worm is capable of producing serious and even fatal mischief to the bearer, the larvæ or measles much more frequently prove fatal. The Cysticerci may develop themselves in almost any situation in the human body, but they occur most commonly in the subcutaneous, areolar, and intermuscular connective tissue; next, most commonly in the brain and eye, and lastly, in the substance of the heart and other viscera of the trunk.

In my ‘Entozoa’ I have stated that probably not less than one hundred cases have been observed where death had resulted from Cysticerci in the brain. Griesinger alone collected between fifty and sixty such cases. Mental disturbance occasioned by the presence of measles in the brain may occur with or without epilepsy. When Griesinger states that “the epilepsy from Cysticercus is in all respects like cerebral epilepsy and the psychical disturbances have nothing characteristic about them,” he tacitly admits the impossibility of correct diagnosis during life.

Since the publication of Griesinger’s well-known memoir on Cysticerci of the brain, many similar cases have appeared, and amongst the more recent of these is one by Dr Frédet in which the victim was a young man twenty-two years of age. Though apparently in good health he fell dead in the street; the fatal result being due to the presence of a Cysticercus within the _pons Varolii_.

Many other cases of earlier date are especially noteworthy. Thus Mr Toynbee recorded a case where an hydatid (which I take to have been the _Cysticercus cellulosæ_) situated in the middle cerebral fossa beneath the _dura mater_, but in this instance death ensued from other causes. Mr Ottley gives the case of a woman aged forty, where an undoubted Cysticercus in the brain gave rise to distressing fits, convulsions, and death. Then, again, there was Dr Burton’s workhouse patient, only twenty years of age, who was found dead in bed, but who at the time of admission merely complained of pain in the head. After death, four hydatids (_Cysticerci_) were found in the _tuber ancillare_ at the summit of the spinal marrow. M. Bouvier’s similar case is also reported in our periodicals. Of instances where Cysticerci occupied the cavity of the eye, we have one or two cases by Mackenzie of Glasgow, one by Mr Rose of Swaffham, and others by Windsor, Logan, and Estlin. Amongst the more peculiar cases, I may mention that described by Dr Greenhalgh in the ‘Lancet’ (1848), where the Cysticercus was lodged within the substance of the lip. Five similar cases are likewise recorded by Heller of Stuttgard. Then there is Dupuytren’s case of a Cysticercus ensconced within the great peroneus muscle; and also Fournier’s, where several of these scolices were said to have been found in a boil. The so-called _Trachelocampylus_, discovered by Frédault in the human brain, was neither more nor less than a common _Cysticercus cellulosæ_.

It is worthy of remark, as Griesinger has also observed, that in cases where the Cysticerci have taken up their temporary residence in the brain, they are usually found, post mortem, in the grey cortical or peripheral substance of the cerebrum. The particulars of such a case are given in my ‘Entozoa’ where the victim suffered from epileptic fits due to the presence of numerous Cysticerci (fig. 24). The patient was under Mr Hulke’s care.

As regards infection by the adult worm it is not alone sufficient that we avoid underdone _meat_, as brought to the dinner-table, but we must be especially careful to have our sausages well cooked. Under ordinary circumstances, we are safe for the following reasons:--No respectable butcher will knowingly supply us with pork or with sausages which are measled. Even in the case of underdone meats, in whatever way prepared, it is usually only a small portion which is unaffected by cooking. As we have seen a temperature of 140° Fahr. is sufficient to kill the Cysticerci.

The successful rearing of pork measles by experimentation with the eggs of _T. solium_ has been accomplished by many helminthologists, amongst whom may be particularised Van Beneden, Leuckart, Küchenmeister, Haubner, Gerlach, and Baillet. The converse experiment of rearing the adult worm from the Cysticercus was first successfully undertaken by Küchenmeister on a condemned criminal; Leuckart, Humbert, and others having repeated this method with more or less success.

The dangers arising from infection by swallowing the larval worms or six-hooked embryos are not easily avoided. Our flesh, like pork, thus becomes measled, although certainly not to the spawn-like extent so often seen in the lower animals. A single measle is sufficient to prove fatal; and this humiliating contingency, moreover, is one which we can never be absolutely certain of avoiding. We become the “host” or bearer of the measle by swallowing the fully-developed eggs of the _Tænia solium_. This we may do directly by handling fresh tapeworms, whose eggs, being concealed under our nails or in our clothing, may subsequently be swallowed, and develop within us accordingly. Even a thorough washing of the hands will not ensure absolute security. In like manner, those who partake of choice salads, prepared from the stores of the market-gardener, run a certain amount of risk. The vegetables may have been manured with night-soil containing myriads of tapeworm eggs, or they may have been watered with fluid filth into which the eggs were accidentally cast. In such cases, one or more tapeworm ova will be transferred to the digestive organs, unless the vegetables have been very carefully cleansed. In the same way, one perceives how fallen fruits, all sorts of edible plants, as well as pond, canal, and even river water procured from the neighbourhood of human habitations, are liable to harbour embryos capable of gaining entrance to the human body. One individual suffering from tapeworm may infect a whole neighbourhood by rendering the swine measly, these animals, in their turn, spreading the disease far and wide. As already remarked, measles sometimes occur in great numbers in different parts of the body. Among the more remarkable cases of the multiple Cysticerci are those recorded by Delore (1864) and Giacomini (1874). In M. Delore’s case, about 2000 were obtained post mortem. Of these, 111 occurred in connection with the nervous centres, eighty-four being in the cerebrum, twenty-two in the membranes of the brain, four in the cerebellum, and one within the substance of the medulla oblongata. Dr Knox published a less notable instance in the ‘Lancet’ (1838); and in the year 1857, Dr Hodges, of Boston, U.S., published a case where the cysts, which in size he compared to rice grains and coffee beans, were felt subcutaneously. The coexistence of Tænia and Cysticerci in the same individual has also recently been observed in France (‘Lond. Med. Rec.,’ 1875). Besides these, several remarkable instances have lately been reported by Davy, Tartivel, and others.

To the literature already quoted in connection with the beef tapeworm the following may be added:

BIBLIOGRAPHY (No. 14).--_Aran_, in ‘Archives Gén. de Médecine,’ 1841.--_Baillet_, “Helminthes,” art. in ‘Bouley and Reynal’s Dict. Vétérin.,’ tom. viii, 1869.--_Bécoulet_ and _Giraud_, “On Cysticercus in the Brain,” ‘Bullet. de la Soc. Méd. de Gand,’ 1872; and in ‘Lond. Med. Rec.,’ Feb., 1873.--_Birkett, J._, Cases, ‘Guy’s Hosp. Rep.,’ 1860.--_Bouchut_, “Cyst. in the Brain,” ‘Gaz. des Hôp.,’ 1857, and ‘Journ. für Kinderkrankheit.,’ 1859.--_Bouvier_, ‘Bullet. de l’Acad.,’ 1840.--_Burton_, in ‘Med. Times and Gaz.’ (supposed hydatids), 1862.--_Cobbold_, “On Measly Meat and Measles in Man,” the ‘Veterinarian,’ 1876.--_Czermack_, “Cysticerci causing Insanity,” Corresp.--Blatt, 1838.--_Dalton, J. C._, “Cyst in the Scrotum,” ‘New York Journ. of Med.,’ 1857.--_Davaine_ (see his ‘Traité’ for many additional references; p. 676).--_Davy, R._, “Cysticerci in the Muscles,” ‘Rep. of Lond. Med. Soc.,’ ‘Lancet’ for Nov., 1876.--_Estling_, “Cases of Cysticercus,” ‘Lond. Med. Gaz.,’ 1838-39.--_Frédet_, “Cysticercus in the _pons Varolii_,” in the ‘Lancet’ for June 23rd, 1877 (p. 925), from ‘Giornale Veneto de Scienze.’--_Fournier_, ‘Journ. des Connois. Med. Chir.,’ 1840.--_Griesinger_, “On Cysticerci of the Brain,” from ‘Med. Jahrb.’ in ‘Med.-Chir. Review,’ 1863.--_Harley, J._, “Cyst. in the Brain,” ‘Lancet,’ 1867.--_Hodges, R. M._, “Specimens of _Cyst. cell._, felt as small tumours just beneath the skin, varying in size from that of a grain of rice to that of a coffee bean,” ‘Rep. of Boston Soc. for Med. Improvement,’ in ‘Brit. Med. and Surg. Journ.,’ 1857.--_Hogg, J._, “Obs. on Cysticercus,” in his ‘Manual of Ophth. Surgery,’ 3rd edit., 1863.--_Holler, A._, “_Cyst. cell_., im Gehirne einer Geisteskranken,” ‘Allgem. Wiener Med. Zeitung,’ 1878.--_Logan, R._, “Probable Cases of _Cyst. cell_.,” removed by Robertson, ‘Ed. Med. and Surg. Journ.,’ 1833.--_Mackenzie, W._, “Cyst in the Eye,” ‘Lancet,’ 1848, ‘Lond. Med. Gaz.,’ 1839.--_Mazotti, L._, “Caso di numerosi cisticerchi del cervello e delle meningi,” ‘Rivista Clin. di Bologna,’ 1876.--_Mégnin, P._, “La Ladrerie du porc et le _Tænia solium_,” ‘La France Médicale,’ 1876.--_Putz, H._, “Ueber die Lebenszähigkeit des _Cysticercus cellulosæ_,” &c., ‘Zeitsch. f. pr. Vet.-Wissenschaften,’ 1876.--_Rainey, G._, “On the Structure, &c., of _Cyst. cell._,” ‘Phil. Trans.,’ 1857.--_Rizzetti, G._, “Rendiconto Statistico dell’ufficio d’igiene di Torino per l’Anno 1873.”--_Rudall, J. T._, “Cyst. in the Brain,” ‘Australian Med. Journ.,’ 1859.--_Tartivel, De A._, “Cysticerques multiples dans le tissu cellulaire sous-cutané et dans certain viscères,” ‘Rec. de Méd. Vet.,’ 1876.--_Von Gräfe, A._, in ‘Arch. für Ophthal.,’ 1857.--_Wells, S._, Bourman’s Case, ‘Ophth. Hosp. Rep.,’ 1860.--_Windsor, J._, “Cyst. in the Eye,” ‘Brit. Med. Journ.,’ 1861.

_Tænia tenella_, Cobbold.--I have long been acquainted with the fact that there is a comparatively small human tapeworm which cannot be referred to either of the foregoing species. In the absence of experimental proof, I incline to the belief that the worm in question owes its existence to measly mutton. The sheep harbours an armed Cysticercus (_C. ovis_), which I regard as the scolex of _Tænia tenella_. The specific name (_tenella_) was originally applied by Pruner to a cestode six feet in length, which he found associated with a larger tapeworm. This latter he called _Tænia lata_. Whilst Diesing has pronounced Pruner’s _Tænia lata_ to have been a _T. mediocanellata_, I, on the other hand, consider Pruner’s _T. tenella_ to have been a _T. solium_. Mr J. C. Mayrhofer has suggested its identity with _Bothriocephalus tropicus_. When, some years back, I applied the term _T. tenella_ to a new tapeworm (of which I possess several strobiles) I was quite unaware than any similar nomenclature had been adopted by Pruner. From the few facts supplied by Pruner and Diesing, I cannot suppose that our cestodes are identical. Unfortunately my specimens are imperfect, wanting the so-called head. It is not possible to estimate the length of the worm accurately, but the perfect strobile must measure several feet.

On one slide I have mounted nine mature proglottides of a worm which I procured on the 15th Dec., 1875. The segments measure, on the average, exactly 1/10″ in length, and only 1/20″ in breadth. The uterine rosettes are all full of eggs, and their branches so crowded together that I am unable to ascertain their average number. The segments are perfectly uniform in character, their reproductive papillæ alternating irregularly at the margin.

In the autumn of 1872 I caused a lamb to be fed with the proglottides of a tapeworm which I referred to this species. The animal was slaughtered on the 22nd of January, 1873, when the result was stated to have been negative. As I had no opportunity of examining the carcase, I cannot feel quite sure that there actually were no Cysticerci present. On several occasions I have detected measles in the flesh of animals, when none were supposed to be present by those who either assisted me or were professional on-lookers. Assuming my _Tænia tenella_ to be derived from the sheep’s Cysticercus, I think it fitting to describe the mutton measle in this place. Even if _T. tenella_ be not actually the adult representative of the mutton measle (_Cyst. ovis_), it is quite certain that the scolex in question gives rise to an armed tapeworm, and it is almost equally certain that the adult armed cestode resides in man. In Pruner’s case, which is by no means unique, we have seen that two distinct species of cestode may coexist in the human bearer. It is quite possible that some one may yet have the good fortune to detect the beef tapeworm, the pork tapeworm, and the mutton tapeworm, all together in one and the same host.

On five separate occasions I have detected measles in “joints” of otherwise excellent and healthy mutton brought to my own table, and supplied by the family butcher. On several other occasions I have had these parasites brought under my notice; nevertheless, many persons are either unaware of, or actually deny, the existence of these ovine parasites. Thus, MM. Masse and Pourquier, in the ‘Montpellier Med. Journ.’ for Sept., 1876, make the following statement: “The sheep, not being subject to measles, it seems to us natural to employ the raw meat of that animal whenever it is required for nourishment in the treatment of diarrhœa, in weaning children, in phthisis, and for anæmics.” Clearly, if MM. Masse and Pourquier could have brought themselves to believe that English literature is worth consulting on such matters, they would not have made this statement. Incidentally they also observe, when speaking of beef measles:--“Un fait que nous avons remarqué et que nous tenons à signaler, c’est que nous avons trouvé des cysticerques nageant librement dans l’eau où nous avions plongé de la viande infestée de ladrerie.” Certainly this is a novel experience. That measles should not only get out of their cysts, but should have the power of “swimming freely” in the water is a phenomenon which requires explanation. There must have been some error of observation.

It was in the year 1865 that I discovered the mutton measle (_C. ovis_, mihi); but I am not prepared to say that the parasite had never been seen before, since it is alleged that a two-headed Cysticercus was obtained by Fromage from the liver of a sheep (as cited by Davaine). Be that as it may, my discovery was announced in a communication made at the Birmingham meeting of the British Association in the autumn of 1865, and subsequently at a meeting of the Pathological Society of London, on the 3rd of April, 1866 (‘Path. Trans.,’ vol. xviii, p. 463). After these dates further announcements and verifications appeared, amongst which I can only refer to my remarks “On Beef, Pork, and Mutton, in relation to Tapeworms,” forming an appendix to the first edition of my work on Tapeworms, 1866; to the “Remarks on Cysticerci from Mutton,” contained in the fourth chapter of the Supplement to my introductory treatise on Entozoa, where a figure of the parasite is given, 1869, p. 27; to Dr Maddox’s paper “On an Entozoon with Ova, found encysted in the Muscles of a Sheep,” recorded in ‘Nature,’ May 15th, 1873, p. 59; to the ‘Monthly Microscopical Journal,’ June, 1873, p. 245; to my further communications in the ‘Lond. Med. Record,’ Aug. 6th, 1873; to my ‘Manual,’ 1874, pp. 74 and 105, Ital. edit. ‘Nota Dell’ Autore,’ p. 133; and especially to the article headed “The Mutton Tapeworm,” contained in the 3rd edit. of my little volume on ‘Tapeworms,’ p. 12, et seq., 1875.

In regard to the measle itself, I spoke of it as smaller than the common pork measle. The head is 1/30″ in breadth, and is armed with a double crown of hooks, twenty-six in all, the larger hooks each measuring 1/160″ in length. The suckers are four in number, each having a breadth of 1/100″. The neck and head are abundantly supplied with calcareous corpuscles, being at the same time marked by transverse rugæ. The data on which I founded my brief description of the scolex were chiefly based on the examination of a specimen which had been procured by Prof. Heisch from the interior of a mutton chop. Subsequently much fuller details of the structure of the scolex were supplied by the illustrated memoir of Dr Maddox (above quoted). This excellent microscopist, however, announced the presence of immature ova within the Cysticerci themselves. As the notion of the existence of eggs in larval cestodes was altogether at variance with what we know of the phenomena of tapeworm life, I suggested that the author might have mistaken the egg-shaped calcareous corpuscles (which I found so abundant in my own specimens) for the ova. In the interests of truth I felt bound to characterise certain of the conclusions arrived at by Dr Maddox as simply incredible, but I regarded his memoir as forming “an important contribution to our knowledge of the structure of the mutton measle.” I had no idea that in pointing to errors of interpretation I should offend the excellent author. However, a long letter appeared in the ‘London Medical Record,’ in which Dr Maddox showed that he was much vexed that I should have “impugned” the “accuracy of his conclusions.” He defended his position with the support of no less an authority than Dr Macdonald, F.R.S., the distinguished Assistant Professor of Naval Hygiène at the Victoria Hospital, Netley. Dr Maddox says:--“We were quite alive to the anomalous position. Hence the exceptionability of the case rests on more than my own evidence.” In regard to this unfortunate dispute I will only add the expression of my conviction that Drs Maddox and Macdonald will eventually become satisfied that no cestode scolex is capable of displaying either mature or immature ova in its interior.

BIBLIOGRAPHY (No. 15). _Cobbold_ (l. c., _supra_), 1865-75.--_Idem_, “On Measly Meat, &c.,” the ‘Veterinarian,’ Dec., 1876.--_Idem_, “The Mutton Tapeworm (_T. tenella_),” No. 16 in my revised list of Entozoa, the ‘Veterinarian,’ Dec., 1874.--_Diesing, C. M._ (_Tænia tenella_, Pruner nec Pallas), in “Revis der Cephalocotyleen,” ‘Sitzungsb. der Math.-Mat. Class d. k. Akad. der Wissenschaften,’ Bd. xlix, s. 369, 1864.--_Maddox_ (l. c., _supra_), 1873.--_Mayrhofer, J. C._, ‘Die helminth. des Menschen,’ Erlangen, 1854.--_Pruner_, ‘Krankheiten des Orients,’ s. 245, 1847.

_Tænia lophosoma_, Cobbold.--This is a good species notwithstanding the doubts that have been expressed by Heller and others regarding it. I have called it the ridged tapeworm in consequence of the presence of an elevated line coursing the whole length of the body, which measures about eight feet. The reproductive papillæ are remarkably prominent and uniserially disposed throughout the entire chain of proglottides. It is quite an error to suppose that this species is a malformed cestode, or that it has any resemblance to Küchenmeister’s variety of tapeworm from the Cape of Good Hope. Neither does it in the slightest degree resemble the remarkably malformed _T. mediocanellata_ described by Mr Cullingworth. Of the distinctiveness of this parasite as a species, any one may satisfy himself by an inspection of the nearly complete strobile preserved in the Pathological Museum attached to the Middlesex Hospital Medical College. From the examination of several mature proglottides detached from this specimen, I find their average breadth to be one fifth of an inch, by three quarters of an inch in length. Their greatest thickness does not exceed the 1/13th of an inch. The eggs resemble those of other tapeworms, and offer a diameter of about 1/850″ from pole to pole.

BIBLIOGRAPHY (No. 16).--_Cobbold_, “Parasites of Man,” in the ‘Midland Naturalist,’ April, 1878, p. 98.--_Idem_, ‘Tapeworms,’ 1st edit., p. 52, 1866; 3rd edit., p. 27, 1875.--_Cullingworth_ (see Bibl. No. 18).--_Davaine_, ‘Les Cestoïdes,’ l. c., p. 573.--_Heller_, l. c., s. 594.

_Tænia nana_, Siebold.--As regards the dwarf tapeworm, unless Spooner’s case be genuine, there is but one solitary instance on record of its occurrence in the human body; moreover, we have no evidence of its having existed in any other host. It was discovered by Dr Bilharz, of Cairo, at the post-mortem examination of a boy who died from inflammation of the cerebral membranes. Prodigious numbers existed. The largest specimen measured only one inch in length. To the naked eye these worms resemble short threads, and consequently they might very readily be overlooked. The head is broad and furnished with a formidable rostellum armed with a crown of hooks. These hooks have large anterior root-processes, which, extending unusually forward, impart to the individual hooks a bifid character. By far the best account of this worm is furnished by Leuckart, to whom I am indebted for a specimen.

BIBLIOGRAPHY (No. 17).--_Cobbold_, ‘Entozoa,’ p. 244.--_Davaine_ (l. c., Bibl. No. 2), p. 574.--_Heller_, l. c., s. 606.--_Küchenmeister_, l. c., Eng. edit., p. 141.--_Leuckart_, l. c., Bd. i, s. 393.--_Von Siebold_ and _Bilharz_, in Von Sieb. and Köll. Zeitschr., Bd. iv.--_Spooner_, ‘Amer. Journ. Med. Sci.,’ 1873.--_Van Beneden_, ‘Iconographie,’ l. c., pl. iii, fig. 17.--_Weinland, ‘Diplacanthus nanus,’_ l. c., p. 85.

_Tænia Madagascariensis_, Davaine.--This appears to be a well-defined species although the head has not yet been seen. It probably forms the type of a distinct genus. Dr Grenet, stationed at Mayotte (Comores), twice encountered single specimens passed by two young children, eighteen and twenty-four months of age respectively. The proglottides have their genital pores uniserially arranged, and they show, in their interior, remarkable egg-capsules, from 120 to 150 in number in all, each containing from 300 to 400 eggs. These give a long diameter of 1/625″ for the outer envelope and 1/1250″ for the inner, or shell proper. The embryo measures only the 1/2500 of an inch.

A full account of this parasite, with figures, is given by Davaine (‘Les Cestoïdes,’ l. c., Bibl. No. 2, p. 577 _et seq._).

_Tænia marginata_, Batsch.--Although I possess no certain evidence of the occurrence of this parasite in its adult condition in the human bearer, yet there is a tapeworm in the Edinburgh Anatomical Museum referable to this species, which was said to have been obtained from the human body. This worm is very common in the dog.

The principal evidence demonstrating the occurrence of the larval representative of this species (_Cysticercus tenuicollis_) in man, rests upon the two cases recorded in Schleissner’s ‘Nosography’ of Iceland. One of the alleged instances, however, has been proved by Küchenmeister and Krabbe to be that of an echinococcus; so that, after all, there only remains the solitary case observed by Schleissner himself, in which the parasite can fairly be considered as the “slender-necked hydatid.”

To the above, however, may probably be added a specimen preserved in the Anatomical Collection at King’s College, London. It was found connected with an ovarian cyst.

_Tænia elliptica_, Batsch.--This parasite is readily recognised not merely by its delicate form and small size, but also by the circumstance of its supporting two sets of reproductive organs in each mature joint. Their outlets are situated at the centre of the margin of each segment, one on either side. Ordinarily infesting the cat, this worm is a mere variety of the common _Tænia cucumerina_ of the dog. At all events, from the evidence put forth by Eschricht, seconded by Leuckart, there is every reason for believing that one or other of these closely-allied varieties is liable to infest the human body. It was originally stated by Eschricht that he had received a _Tænia canina_ which had been passed by a negro slave at St Thomas, Antilles. This is a synonym of _T. elliptica_, which must therefore be very rare in the human body, possibly only occurring in the negro race.

In regard to the source of this parasite, it has been shown by Melnikow that the scolex of _Tænia cucumerina_ resides in the louse of the dog (_Trichodectes latus_), and thus it is exceedingly probable that the scolex of _Tænia elliptica_ resides in the louse of the cat (_Trich. subrostratus_). How man becomes infested is not so clear. Melnikow’s paper on the juvenile state of this cestode is contained in the ‘Archiv für Naturgeschichte’ for 1869, and is illustrated by a figure of the measle.

_Tænia flavopuncta_, Weinland.--Regarded as a new species, the discovery of this little tapeworm is due to the investigations of Weinland. In Dr Jackson’s ‘Catalogue of the Boston Medical Improvement Society’ an account of the contents of a phial is recorded as follows:--“Specimen of Bothriocephalus, three feet in length, and from half a line to one line and a quarter in width, from an infant. The joints are very regular, except at one extremity, where they approach the triangular form, are very delicate, and but slightly connected, as shown in a drawing by Dr Wyman.” It is further stated that the infant was nineteen months old, and that the worm was discharged without medicine, its presence having never been suspected. It was presented by Dr Ezra Palmer in the year 1842. On examining the fragments, Dr Weinland found, instead of a solitary specimen, at least six different tapeworms, all of them being referable to a hitherto undescribed species. There were no heads; nevertheless, it was ascertained that the worms varied from eight to twelve inches in length, the joints or segments being very broad, and at the same time narrowed from above downwards. The parasite was named “the spotted tapeworm,” in consequence of the presence of yellow spots near the middle of the joint. They represent the male organs of reproduction, the outlets of which, as in my _T. lophosoma_, occur all along one side of the body or strobile. In Weinland’s estimation this parasite forms the type of a new genus which he calls _Hymenolepis_. A full account of the worm is given in his well-known essay (l. c., Bibl. No. 2).