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XLIII] Treatment.— Hitherto no means of expelling this parasite from the lungs has been discovered. In the case of cerebral distomatosis it might be possible by an operation to remove the parasite and associated tumour, and thus afford a chance of recovery in what has hitherto proved a fatal condition.

Prophylaxis in this, as in so many animal parasitic diseases, principally lies in the direction of securing a pure water-supply for drinking and bathing purposes, and avoiding all uncooked articles of diet which might be supposed to contain the young parasites. The sputum should be destroyed. NOTE.— Musgrave (Philippine Journal of Science, March, 1907) has shown that paragonomiasis is not uncommon in the Philippines. He met with 17 cases in one year. He gives a detailed account of the pathological anatomy of this helminthiasis, bringing out especially the important fact that in a proportion of instances the infection is of a general character, the peculiar bluish cyst-like burrows of the parasite occurring in many organs and tissues. The infiltration of the tissues by the eggs produces, especially in serous membranes, little brownish-red patches, sometimes quite visible to the naked eye. The intestinal submucosa is a common seat of infiltration, and here the presence of the ova may give rise to inflammatory reaction, ending, perhaps, in ulceration and in the appearance of ova in the stools. In reading Musgrave's paper I was particularly struck by the statement that in one of his cases he found no fewer than 100 mature parasites congregated in a psoas abscess. It is usually believed that the flukes enter their vertebrate hosts as cercariæ, and that they at once proceed to their permanent habitat and to sexual maturity. If this be the case with P. westermani, it is difficult to understand how, without any special anatomical lead, so large a number as 100 cercarite contrived to arrive at exactly the same spot.