Page:Tropical Diseases.djvu/966

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908
DISEASES OF THE SKIN

which it springs with remarkable activity. It at once attaches itself to the skin, and proceeds to make a meal on the blood. Animals are sometimes killed in this way; men even have been known to succumb to the repeated small bleedings by these pests. It is necessary, therefore, when passing through jungle hinds in which leeches abound, to have the feet and legs carefully protected. The bite is not infrequently the starting-point of a troublesome sore.

In the south of Europe and in the north of Africa the horse-leech, Hœmopis sanguisuga, sometimes gets into the gullet and nostrils of men as well as of animals. It has occasionally caused death by entering and occluding the air-passages. In Formosa I heard of and saw several instances of a similar form of parasitism, both in men and in monkeys. To what particular species the leech in these cases belonged I do not know. Doubtless, when very young the leeches were taken in unperceived with foul drinking-water, and, wandering round the soft palate, found their way into the nose. Occasionally, in the cases I refer to, the animals would protrude from the nares and wander over the upper lip. For a long time they contrived to elude all attempts at capture. By dipping the face in cold water they could generally be persuaded to show themselves. In one instance the leech dropped out spontaneously. In another— an American naturalist who had been travelling much in the interior of Formosa, and who had suffered from severe headache and profound anæmia, the results of repeated epistaxis— I succeeded in removing the leech by attaching through a speculum a spring forceps to its hinder end, and afterwards injecting salt and water. It would be well, therefore, to bear in mind that in tropical countries persistent headache, associated with recurring epistaxis, may be caused by a leech in the nostril.