Page:Tropical Diseases.djvu/794



Definition of endemic hæmaturia.— A chronic endemic disease caused by Schistosomum hœmatobium ( = Bilharzia hœmatobia, Distomum hœmatobium), giving rise to cystitis and hæmaturia, or to proctitis, or to other symptoms, and characterized by the presence of the ova of that parasite in the urine, or in the fæces, or in both.

History and geographical distribution.— The frequency of hæmaturia in the natives of Egypt, and in visitors to that country, has long been remarked. The explanation was supplied by Bilharz, who, in 1851, discovered the cause in a peculiar digenetic trematode which Cobbold proposed to name Bilharzia in honour of its discoverer.

In 1864 Dr. John Harley recognized the characteristic ova in cases of hæmaturia from Natal. The disease has since been found in many other parts of Africa, more particularly along the eastern side of the continent as far south as Port Elizabeth. Balfour found it in the Soudan. According to Low it is very frequent in the natives of Uganda. It is met with in West Africa and is very common in Rhodesia. In Egypt, judging from Bilharz's, Griesinger's, and Sonsino's post-mortem records, it is present in quite one-half of the population; in one village, Marg, Leiper found that no fewer than 90 per cent, of the children were infected. It occurs also in Arabia, Syria, Persia, Mesopotamia, Cyprus, and Mauritius. Nelson records two cases in Western Australia in individuals who had never been out of that country;