nales causing spermatorrhœa. In the latter case, ova may be detected in the semen. In other instances the ureters and kidneys become involved and grave disease of these organs ultimately ensues. In consequence of the suffering which these aggravated forms of infection produce, the patients become anæmic, wasted, debilitated, and a ready prey to intercurrent disease.
Milton has pointed out the extreme frequency of urinary fistula in Egypt, the result of schistosomum disease of the urethra. These fistulæ may occur anywhere in the neighbourhood of the genitals, but are especially common in the perineum and posterior surface of the scrotum, and originate from schistosomum disease of the pubic surface or roof of the urethra just in front of the bulb, the eggs of the parasite being deposited in the mucous or submucous tissue. Stricture of the urethra is by no means uncommon from a similar cause, especially in the case of fistulæ connected with the floor of the urethra.
Vaginitis and cervicitis have been known to be produced by this parasite. On the vulva papillomatous masses containing schistosomum ova are, according to Madden, very common.
Besides the lesions of the genito-urinary organs, rectal symptoms have been described and the characteristic ova of S. hœmatobium have been found in the rectum. Frequently, however, another species (S. mansoni), which invariably extrudes its eggs through the intestine, has been confounded with the old classic species. The intestinal lesions give rise to dysenteric-like symptoms. Very often mucus and blood are passed without any fæcal matter, and the continuous straining may be distressing, especially when large polypoid masses protrude from the anus. I have seen a case (which had been diagnosed and treated as syphilis) of which extensive condyloma-like growths around the anus, in the perineum and groin, and full of ova, were a remarkable feature.
Pathological anatomy.— The character of the changes brought about by S. hœmatobiumvaries
