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764 patient during life suffered from disorder of speech and tremor in both upper and lower extremities, with headache and mental disturbance, later from vertigo and Jacksonian fits (two or three daily), and finally from right hemiplegia.

Katsurada has drawn attention to the fact that S. japonicum does not affect the bladder. The two cases described in Chinamen confirm this experience. There are, therefore, important pathological and

Fig. 145.—Eggs of S. japonicum, x 250. (Photograph by Dr. J. Bell.)

clinical features which, in addition to the zoological characters of the parasites, show that S. japonicum is specifically distinct from S. hæmatobium and S. mansoni.

Symptoms.—The disease produced by S. japonicum, sometimes called "Katayama disease," is a grave one, and when pronounced proves fatal sooner or later. The gravity of any given case will depend, amongst other things, on the degree of infection and the circumstances of the patient. Of 1,077 persons near Shushima, Japan, examined by Koiki, 42 were found