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Synonyms.—Distoma westermani: D. ringeri; D.pulmonis; D. pulmonale; D. cerebrale; Mesogonimus westermani; M. pulmonalis; M. ringeri.

History.— This disease and the characteristic ova appearing in the sputum of the subjects were described by Baelz and the author in 1880. Ringer, in 1881, was the first to find the mature parasite which was afterwards described by Cobbold under the name Distomum ringeri; subsequently it was recognized to be identical with the previously described Paragonimus westermani of the tiger. The main features of its life-history and pathological bearings have been worked out recently by Japanese observers. Geographical distribution.— Endemic hæmoptysis occurs in China, Japan, Korea, Formosa, and the Philippines. In many of the endemic districts a notable percentage of the population is affected. Thus, Kakami states that in certain Korean villages 32 per cent, of the men, 48 per cent, of the dogs, and 1 to 2 per cent, of the pigs are infected with the parasite causing this peculiar form of hæmoptysis. It is not improbable that, as knowledge extends, the disease will be found to exist in other countries. The cause, Paragonimus westermani, has been found in the United States in the cat, in the dog, and in the domesticated hog; ere long, therefore, we may hear of endemic hæmoptysis in man in America. The Chinese and Japanese are nowadays to be found in almost every land, and doubtless they carry with them their peculiar parasites— Opisthorchis sinensis, Fascio