85 
The pathologic details of the Japanese cases, as described by Katsurada 
(Scheube), are as follows: 
At autopsy the liver is less than normal in size and its surface is marked by 
small nodules, larger than those observed in Laennec’s cirrhosis and smaller than 
those of the usual gross form. The capsule of Glisson is thickened. Microscopical 
observation shows connective tissue increase and round-cell infiltration in the 
capsule of Glisson in which the ova lie, in part in the lumen or in the walls of 
the portal capillaries and in part in the connective tissue. There are also fibrous 
nodules and tubercle-like areas which contain ova, although these are not com- 
monly seen in the parenchyma. In addition to their location in the liver, the 
eggs are also found in the intestinal wall (especially that of the large intestine), 
in the mesentery, in the mesenteric glands, the lungs, and the brain. In the 
intestinal wall they especially occur in the submucosa and often are present in 
such numbers as to cause the mucosa over them to become bulged out or even 
eroded, Kanamori (Scheube) found in one case, in the rectum and sigmoid, 
adenomas resembling the new growths described by Kartulis in Bilharziosis. In 
the lungs and brain the eggs are encountered in tubercle-like masses, surrounded 
by round-cell infiltration and an increase of connective tissue. 
In Catto’s case the liver and spleen were both enlarged. The condition of the 
peritoneum suggested that repeated attacks of peritonitis had occurred. The 
appendices epiploice were thickened and in places were matted together. The 
recto-vescical pouch was almost obliterated. The mesenteric lymph glands were 
enlarged. The liver was apparently cirrhotic. The colon was thickened and its 
mucous membrane was swollen, hyperemic, and friable, and presented small 
circular, superficial erosions and patches of necrosis. The rectum was adherent 
to the bladder. The mucosa of the ileum was congested and formed thickened 
patches. The stomach, pancreas, adrenals, kidneys, heart, and lungs showed no 
gross lesions. In sections of the liver, mesenteric glands, and bowel small oval 
bodies were found which were at first believed to be coccidia. Subsequent examina- 
tion disproved this and showed them to be the ova of a trematode. Nematode 
embryos were found in smears from the large intestine’ and in the vessels of a 
mesenteric lymphatic gland. In sections of the meso-colon, adult trematodes were 
found in blood vessels, and in the uterus of one of these were oval bodies corre- 
sponding to those seen free in the tissues in other sections. The parent worms 
were encountered in small groups at the bifureations of the small mesenteric 
vessels. Where the ova had accumulated in certain places they had provoked a 
small-cell infiltration which gave rise to a proliferation of fibrous tissue. In the 
intestine, from cecum to anus, the ova roughly occupied two concentric layers— 
the one subperitoneal where they were comparatively scarce, the other submucous 
where they were innumerable. They were also plentiful in the mucosa, and more 
numerous in the necrotic areas, in which situation they were seen apparently to 
be in the process of extrusion. 
The rectum and appendix were the parts most affected in the entire intestinal 
tract. Ova were found throughout the small intestine, but only in patches and 
in comparatively small numbers. They were plentiful in the liver, lying singly 
or in large or small clumps embedded in the hypertrophied fibrous tissue. They 
were also found in the thickened trabecule of many of the enlarged mesenteric 
glands. Ova were also encountered in the outer wall of the gall bladder, in the 
pancreas, liver capsule, the fibrous coat of the mesenteric vessels, mesenteric, 
pylorus, duodenum, jejunum, and ileum. Ova of Trichocephalus dispar and 
Ascaris lumbricoides were also seen in the bowel. 
The case to be described was one of the series which formed the basis 
of a report on the pathology of intestinal ameebiasis by Dr. Musgrave 
