ON FORMER OBSERVATIONS OF URINARY BILHARZIASIS AND WUCHERERIOSIS

On the occasion of a book near completion on the great clinician Pierre Rayer (1793-1867), a pioneer of infectious pathology, are presented here two of his works concerning parasitic tropical pathology. The first (1838) signed by Rayer alone deals with an hematuria observed in patients from Mauritius. He distinguished several forms of the disease and described 15 observations which he compared to Egyptian hematuria of which the parasitic agent (Bilharzia (= Schistosoma) haematobium) will not be described before 1852 by Th. Bilharz. A very recent paper by Julvez (1999) confirms the persistence of this parasitic disease in Mauritius. The second paper published in 1850 with his disciple Casimir Davaine (1812-1882) concerns a case of elephantiasis of the Arabs (wuchereriosis) occurring in Guadeloupe (French West Indies). The authors describe carefully the anatomo-pathological features of the amputated hand and forearm of the patient. They could not be aware of the the parasitic etiology of the disease which although suspected by J. Hendy (1784) will be demonstrated only during the second half of last century (Demarquay, 1863; Wucherer, 1866; Lewis, 1870 and Bancroft 1876 who observed microfilariae and filariae of the Nematode presently named Wuchereria bancrofti in the blood and lymph of the patients). Its transmission by mosquitoes (Aedes, Culex) will be demonstrated by P. Manson (1878). These little-known observations are examples of clinical descriptions of tropical parasitic diseases before the discovery of the parasites involved. As such they deserved to be recalled here.