87 
mucosa they were much fewer, in the subperitoneal layer very infre- 
quent, in the muscular layer absent. In the liver they were confined 
almost entirely to the perivascular tissues, and were most commonly seen 
about the intralobular vessels. They also occurred about the interlobular 
vessels and in the parenchyma. In the lungs they were found only in 
the tissue about the abscess cavity and were seen in but very small num- 
bers. Wherever they were present they were surrounded by small-cell 
infiltration and fibrosis. 
The following comparative measurements of the ova were furnished to 
me by Dr. Shiga, after he had examined my specimens and compared 
them with those of Fujinami and Manson: 
Manson. | Fujinami. Woolley. 
mm. mm, mm, 
Length: ooo 228s cos. 0. 0728 0. 0662 0. 0624 
| Breadths 2-1 ei | . 048 . 0486 . 0436 | 
In the opinion of Katsurada these parasites feed upon the blood and 
in this way produce the anemia which, according to the Japanese reports, 
is a common symptom of the disease. He also (see Stiles) suggests that 
the worms probably form a toxin which perhaps is the cause of the 
enlargement of the liver. The eggs may form embolisms in various 
organs, most frequently in the liver, in which they cause inflammation and 
increase in the connective tissues, producing a type of cirrhosis in which 
the surface of the organ is coarsely and irregularly granulated. ‘These 
changes assist in bringing about more or less prominent portal stasis. 
The eggs in the mucosa and submucosa of the intestine, especially of the 
colon, cause more or less severe inflammation; resulting in part in the 
destruction, in part in the formation, of tissue, changes which are some- 
times followed by the tumor-like growths described by Kanamori, and 
sometimes by ulcers. 
Katsurada believes that the disease originates from stagnant water. He 
says that in summer the water standing in the rice fields becomes covered 
with bubbles which break when in contact with the skin, with resulting 
itching and eruptions. Infection, then, he thinks takes place through the 
abraded skin. In places where artesian-well water is used and where the 
people do not wade in the bubble-covered water the disease is becoming 
less frequent. 
Since visiting the farming districts of Japan I have little doubt 
but that the disease is a water-borne one and that it originates in the 
rice fields or irrigated gardens. The same is true of China. In both 
these countries the fields are fertilized by human excreta to such an extent 
that in many places traveling is most unpleasant because of the odor. 
Under such circumstances the opportunities are excellent for the trans- 
mission of a disease which is caused by a parasite the ova of which are 
