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XLI] infected. Of these 42 only 22 were not in good health, and 10 of them had enlarged livers. A history of fever accompanied by an urticarial eruption is generally given— sometimes there are associated with this symptoms of pulmonary congestion. After an interval of several weeks or months, intestinal troubles, in the form of dysenteric discharges, dyspepsia, together with great enlargement of liver and spleen, set in; these persisting, a characteristic cachexia— intense anæmia, ascites, wasting, and progressive debility— supervenes; ultimately, if the patient does not succumb to some superadded disease, terminating— it may not be for many years— in death.

Diagnosis.— All cases of urticarial fever from the endemic districts should be watched for many months, especially if eosinophilia persists after the subsidence of the primary attack, and the stools examined for ova of S. japonicum. All cases of chronic intestinal disturbance, especially if associated with enlargement of liver and spleen, from these districts should be regarded as, possibly, cases of schistosomiasis and have the blood and stools examined. If the ova (Figs. 142, 145) are discovered the diagnosis is established.

Prevention.— Water reported to cause the disease should be boiled, or avoided, for drinking or bathing purposes. Sportsmen, if they must wade in such waters, should wear long boots or waterproof waders. Treatment.— No specific remedy is known. Filix mas may be tried, otherwise the treatment is entirely symptomatic.