Chinese Medical Journal

14 THE CHINESE MEDICAL JOURNAL

crabs. Seven or eight months later he developed abdominal pain and “hematemesis.” Thus it appeared almost certain that the patient had paragonimiasis infection.* An additional epidemiological evidence in favor of the diagnosis of paragonimiasis was the fact that according to the medical literature (12), cats and dogs in Chengtu had been found to harbor lung flukes indistinguishable from Paragonimus westermani. The patient responded well to a subsequent course of chloroquine therapy which abolished all abdominal signs and symptoms and restored the blood picture to normal. This gratifying therapeutic result following specific treatment constitutes a further proof that the patient had paragonimiasis. :

Case 6. Patient P’eng, a girl of 18 from Kirin province, was transferred to the Central People’s Hospital for further observation from another hospital in Peking in January 1955 for severe headache and vomiting. The results of our intradermal test and complement fixation test of the serum for paragonimiasis were both strongly positive. Complement fixation test of the cerebrospinal fluid was, however, negative. Earlier specimens of cerebrospinal fluid before the complement fixation test was made showed marked increase of eosinophils which gradually disappeared within two weeks. No sputum. Roentgenogram of the chest showed normal findings. (Detailed account of this case particularly in respect of the relationship between eosinophilia and paragonimiasis will be reported separately). Careful questioning showed that the patient had always lived at Yenpien in Kirin province, where the people have the habit of eating a kind of raw crayfish called Laku. In the past the patient herself had often eaten uncooked erayfish. It seems practically certain that all her symptoms were caused by paragonimiasis. Following the discovery of this case, a brief epidemiological survey was made at Yenpien, which comfirmed that the locality is an endemic area of paragonimiasis hitherto unknown. ,

It is clear from the above cases, particularly Case 5 and Case 6 that we can determine, without our actual presence, new areas of paragonimiasis if full use of the three diagnostic methods are made. Szechuan and Kirin provinces from where no paragonimiasis cases have been reported before are now considered as endemic regions. Undoubtedly, these methods when extensively adopted will be very useful in investigating the epidemiology of paragonimiasis in all suspected or endemic areas.

SUMMARY AND CONCLUSION

1. Three’ procedures constituting an advance in the diagnosis of paragonimiasis particularly in cases with obscure, atypical, early, latent or iInapparent infection without discharge of ova in excreta are presented. 2. Six very obscure cases are reported to illustrate the value of the new diagnostic triad.

* A recent survey made by us in Wenkiang district of Szechuan province has actually implicated that district as a paragonimiasis infected area. Details of this survey will be published later in the Chinese Medical Journal.