Somatic Tæniasis (Solium Cysticercosis)

It is now well known that infestation of the muscles, eyes and brain with the cysticerci of a cestode occurs in India. MacArthur (1934) and other officers of the R.A.M.C. have drawn attention to cysticercosis as a cause of epilepsy in soldiers who have served in India. The mode of infection is doubtful, as only a small proportion of such epileptics admit infection with a tapeworm. Diagnosis of somatic taeniasis is usually made on a>ray evidence?the partially calcified cysticerci showing up well on skiagrams. The case now reported was referred to me for investigation in August 1941 by Lieut.-Col. A. Innes Cox, i.m.s., then District Medical Officer, Madura. Lieut.-Col. Cox had confirmed his diagnosis of somatic taeniasis by biopsy?the material being reported as cysticercus by the Professor of Pathology, Madras Medical College. The patient was a cultivator from a village in the Ramnad district. He was 25 years of age, and had always been of a slim build. He went to hospital because of a gross alteration in his physical appearance which had come to resemble that of a professional wrestler?to the amusement of his friends and dismay of his household (figure 1, plate XIX). He had noted a change over a period of six months only. The patient had never kept pigs at any time, and was not in the habit of eating pork. He had eaten no pork within the past four years prior to admission, and was not aware of having harboured a tapeworm at any time. His appearance was certainly suggestive of a professional strong man. Palpation of the neck, shoulders and thighs revealed the presence of thousands of slippery, blubbery swellings. The superficial ones slid under the fingers like soft peas, but the palpating hand got the impression of great masses of such material throughout the whole of the pectoral and pelvic girdles, upper arm muscles, thighs and hips. Multitudes of swellings could be seen in the cervical and facial r-egions, visible from a distance (figure. 2, plate XIX)--when the masseter muscles were clenched.?