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The echinococcus is a tiny cestode which is the factor in the production of the well…known hydatid cysts which may be found in any part of the body。 Delafield and Prudden report the only instance of multilocular echinococcus seen in this country。 Their patient was a German who had been in this country five years。 There are only about 100 of these cases on record； most of them being in Bavaria and Switzerland。
The filaria sanguinis hominis is a small worm of the nematode species； the adult form of which lives in the lymphatics； and either the adult or the prematurely discharged ova （Manson） block the lymph…channels； producing the conditions of hematochyluria； elephantiasis； and lymph…scrotum。 The Dracunculus medinensis or Guinea…worm is a widely…spread parasite in parts of Africa and the West Indies。 According to Osler several cases have occurred in the United States。 Jarvis reports a case in a post…chaplain who had lived at Fortress Monroe； Va。； for thirty years。 Van Harlingen's patient； a man of forty…seven； had never lived out of Philadelphia； so that the worm must be included among the parasites infesting this country。
In February； 1896； Henry of Philadelphia showed microscopic slides containing blood which was infested with numbers of living and active filaria embryos。 The blood was taken from a colored woman at the Woman's Hospital； who developed hematochyluria after labor。 Henry believed that the woman had contracted the disease during her residence in the Southern States。
Curran gives quite an exhaustive article on the disease called in olden times 〃eaten of worms；〃a most loathsome malady。 Herod the Great； the Emperor Galerius； and Philip II of Spain perished from it。 In speaking of the Emperor Galerius； Dean Milman； in his 〃History of Latin Christianity；〃 says； 〃a deep and fetid ulcer preyed on the lower parts of his body and ate them away into a mass of living corruption。〃 Gibbon； in his 〃Decline and Fall；〃 also says that 〃his （Galerius's） death was caused by a very painful and lingering disorder。 His body； swelled by an intemperate course of life to an unwieldy corpulence； was covered with ulcers and devoured by immense swarms of those insects who have given their names to this most loathsome disease。〃 It is also said that the African Vandal King； the Arian Huneric； died of the disease。 Antiochus； surnamed the 〃Madman；〃 was also afflicted with it； and Josephus makes mention of it as afflicting the body of Herod the Great。 The so…called 〃King Pym〃 died of this 〃morbus pedicularis；〃 but as prejudice and passion militated against him during his life and after his death； this fact is probably more rumor than verity。 A case is spoken of by Curran； which was seen by an army…surgeon in a very aged woman in the remote parts of Ireland； and another in a female in a dissecting…room in Dublin。 The tissues were permeated with lice which emerged through rents and fissures in the body。
Instances of the larvae of the estrus or the bot…fly in the skin are not uncommon。 In this country Allen removed such larvae from the skin of the neck； head； and arm of a boy of twelve。 Bethune； Delavigne； Howship； Jacobs； Jannuzzi and others； report similar cases。 These flesh…flies are called creophilae； and the condition they produce is called myiosis。 According to Osler； in parts of Central America； the eggs of a bot…fly； called the dermatobia； are not infrequently deposited in the skin； and produce a swelling very like the ordinary boil。 Matas has described a case in which the estrus larvae were found in the gluteal region。 Finlayson of Glasgow has recently reported an interesting case in a physician who； after protracted constipation and pain in the back and sides； passed large numbers of the larvae of the flower…fly； anthomyia canicularis； and there are other instances of myiosis interna from swallowing the larvae of the common house…fly。
There are forms of nasal disorder caused by larvae； which some native surgeons in India regard as a chronic and malignant ulceration of the mucous membranes of the nose and adjacent sinuses in the debilitated and the scrofulous。 Worms lodging in the cribriform plate of the ethmoid feed on the soft tissues of that region。 Eventually their ravages destroy the olfactory nerves； with subsequent loss of the sense of smell； and they finally eat away the bridge of the nose。 The head of the victim droops； and he complains of crawling of worms in the interior of the nose。 The eyelids swell so that the patient cannot see； and a deformity arises which exceeds that produced by syphilis。 Lyons says that it is one of the most loathsome diseases that comes under the observation of medical men。 He describes the disease as 〃essentially a scrofulous inflammation of the Schneiderian membrane； 。 。 。 which finally attacks the bones。〃 Flies deposit their ova in the nasal discharges； and from their infection maggots eventually arise。 In Sanskrit peenash signifies disease of the nose； and is the Indian term for the disease caused by the deposition of larvae in the nose。 It is supposed to be more common in South America than in India。
CHAPTER XVI。
ANOMALOUS SKIN…DISEASES。
Ichthyosis is a disease of the skin characterized by a morbid development of the papillae and thickening of the epidermic lamellae； according as the skin is affected over a larger or smaller area； or only the epithelial lining of the follicles； it is known as ichthyosis diffusa； or ichthyosis follicularis。 The hardened masses of epithelium develop in excess； the epidermal layer loses in integrity； and the surface becomes scaled like that of a fish。 Ichthyosis may be congenital； and over sixty years ago Steinhausen described a fetal monster in the anatomic collection in Berlin； the whole surface of whose body was covered with a thick layer of epidermis； the skin being so thick as to form a covering like a coat…of…mail。 According to Rayer the celebrated 〃porcupine…man〃 who exhibited himself in England in 1710 was an example of a rare form of ichthyosis。 This man's body； except the face； the palms of the hands； and the soles of the feet； was covered with small excrescences in the form of prickles。 These appendages were of a reddish…brown color； and so hard and elastic that they rustled and made a noise when the hand was passed over their surfaces。 They appeared two months after birth and fell off every winter； to reappear each summer。 In other respects the man was in very good health。 He had six children； all of whom were covered with excrescences like himself。 The hands of one of these children has been represented by Edwards in his 〃Gleanings of Natural History。〃 A picture of the hand of the father is shown in the fifty…ninth volume of the Philosophical Transactions。
Pettigrew mentions a man with warty elongations encasing his whole body。 At the parts where friction occurred the points of the elongations were worn off。 This man was called 〃the biped armadillo。〃 His great grandfather was found by a whaler in a wild state in Davis's Straits； and for four generations the male members of the family had been so encased。 The females had normal skins。 All the members of the well…known family of Lambert had the body covered with spines。 Two membe