Page:Tropical Diseases.djvu/860

804 Treatment. So far no specific treatment has been found for this disease. The patient should be removed to a non-infected area and given nourishing food. Recently salol has been reported as beneficial in the analogous liver-fluke disease of sheep.

Synonym.— Distoma japonicum (R. Blanchard, 1886).

This trematode is found in Japan, where it is common in man, and in cats, dogs, and pigs. It is smaller than C. sinensis, 6-13 mm. in length by 1.8-2.6 mm. in breadth. There are no pigment granules in the parenchyma. Kobayashi has found cats commonly infected with this parasite; he has also found an encysted distome in the muscles of certain fresh- water fish—Pseudorasbora parva, Leucopodia guntheri, and others— especially near the villages of Kogo and Sanban, near Okayama. Eggs of this distome are found in the fæces of kittens one month after they have been fed on the flesh of such fish. On dissection of these kittens numerous adult distomes were found in the bile-ducts, gall-bladder, hepatic ducts, pancreas, and even in the duodenum. Kobayashi was also able to infect rabbits and guineapigs in the same way. Twenty -two days after the first infection the distomes were found to be mature and to contain eggs. In the younger stages the worms possess spines which are deciduous.

The fish act only as the second intermediary host; the first intermediary host still remains to be found.

Pathogenesis.— Lesions similar to those caused by C. sinensis are attributable to C. endemicus, together with a grave cachexia characterized by enlargement of the liver, diarrhœa, and ultimately anasarca. Prophylaxis.— Manifestly the Japanese habit of eating raw fish is to be deprecated. Animals and men harbouring the parasite should be prevented from fouling water— whether used for drinking, bathing, or for agricultural purposes.