548 The Philippine Journal of Science 1922 
groups, the individuals of which are blackish and greenish. There are 
also three or four polypoid rounded excrescences of the mucosa in the 
colon. Between these the mucosa is apparently slightly thickened and 
there are other rounded pale elevations which apparently represent nodules 
beneath the mucosa. The mesocolic, mesenteric, and retroperitoneal glands 
are slightly enlarged; they are firm and yellowish gray. The vermiform 
appendix is somewhat dilated tortuous and has surrounding adhesions 
causing its distortion. Minute dissection of the mesentery, mesocolon, 
and mesenteric and mesocolic glands fails to reveal the presence of any 
parasites visible to the naked eye. 
Liver is rather small and is surrounded by firm adhesions binding it to 
the diaphragm. In the middle of the anterior surface of the left lobe 
is a rather deep incisure with rounded margin, the base of which is formed 
by fibrous tissue. The organ is firm, the capsule thickened, and the sur- 
face nodular and yellowish brown. The nodules vary from a few milli- 
meters to several centimeters in diameter. The depressions between them 
are not deep. On section the liver is firm and cuts with considerable 
difficulty. The cut surface is yellowish brown, and the liver lobules are 
not distinct. There are large thick strands of fibrous tissue scattered 
irregularly throughout the organ, and in the parenchyma are fairly soft 
yellowish areas which are not elevated, averaging from 3 to 5 millimeters 
in greatest diameter. These are very numerous and widely scattered 
throughout the organ. There is some pale firm tissue about the branches 
of the portal vessels within the liver. No parasite is found in the intra- 
hepatic vessels or bile ducts. Liver weighs 1,195 grams. 
Note.—Scrapings from the nodules in the large intestine contain eggs of 
Schistosoma, apparently japonicum. 
ANATOMIC DIAGNOSIS 
Electrical burn of thorax, arms, thigh, heart, lungs, aorta, and verte- 
bre; chronic polypoid colitis; schistosomiasis; chronic interstitial hepatitis 
(schistosomiasis) ; chronic perihepatitis; congestion of stomach and duode- 
num; chronic lymphadenitis (mesenteric, mesocolic, and retroperitonea)) ; 
fatty degeneration of kidneys. 
Note.—The liver shows portal cirrhosis and the presence of ova. 
THIRD CASE 
Clinical history—J. A., male Filipino, 23 years of age, single, born in 
Samar, now residing in Manila, complained of fever and headache. Date 
of admission to the Philippine General Hospital, July 9, 1915. : 
Present illness—Five days ago had headache, coldness of the body, and 
chill followed by fever. He did not have any pain in the joints nor cough. 
The chill appeared again and recurred two or three times daily. He was 
constipated for about four days. 
Physical examination.—Slight dyspnea, no cyanosis. The circulatory 
and respiratory systems are apparently normal. The pulse is small and fre- 
quent, but regular. The lower border of the spleen is one finger below 
the costal margin. Sensorium is clear; knee jerks are diminished. 
July 9, 1915.—Convulsions in the upper extremities and eyes staring 
upward. Neck is rigid, Kernig’s sign is positive. Pulse is filiform. No 
fluid comes out from the lumbar puncture. Temperature is 40 to 41° C. 
Laboratory examination—Urine shows decided trace of albumen and 
abundant red blood cells. The white count is 8,600, with 49 per cent poly- 
