554 The Philippine Journal of Science 1922 
Chronic fibrous tubercles, some of which contain small amounts of cai- 
careous material in the center, are present in the right lung. The bronchi 
contain much mucus, and the mucosa is congested. The peribronchial 
lymph nodes are slightly enlarged. The lymph nodes around the dia- 
phragmatic arch are enlarged and yellowish. 
The spleen is very small, wrinkled, and dark blue; it weighs 85 grams. 
The liver is larger than normal; it is dark blue and mottled with minute 
pearllike dots. These are definitely circumscribed and vary in color from 
bluish opalescent to opaque pale yellow. The liver cuts easily, and the 
cut section shows some areas of hemorrhages. The liver tissue is friable, 
soft, and dark blue; the lobules are not distinct. The liver weighs 1,390 
grams. 
Alimentary system shows marked congestion and the presence of as- 
caris, trichuris, and ankylostoma; otherwise it is apparently normal. 
Brain.—On removing the dura the brain presents an opaque, swollen, 
uniform grayish yellow tissue with very shallow sulci. On removing the 
brain from the skull a small puncture was made into the right temporal 
lobe from which a thick greenish fluid came out. This fluid has no odor 
and contains large green clumps. The brain has a more-dilated right hemi- 
sphere, and on section through it the temporal lobe shows a greenish puru- 
lent material and necrotic brain tissue. The peduncle of this side is also 
swollen and opaque, and there are many petechial hemorrhages in it. The 
left petrous bone is congested, but the right contains necrotic material. A 
careful examination shows that the right ear has a slight discharge. 
Smears from the exudate show many streptococci and long fine bacillary 
forms. Cultures were found positive for streptococci and Bacillus in- 
fluenze, 
Histological sections from the intestines and mesenteric lymph nodes 
were not taken. 
HISTOPATHOLOGY 
Liver.—Congestion and numerous nodules of different sizes containing 
ova. 
Lung.—Large areas of necrosis, similar to those of the first case, con- 
taining dead and well-preserved foreign-body giant cells, catarrhal cells, 
plasma cells, eosinophiles, and round-cell infiltration, walled off by gran- 
ular tissue where cells of the same type can be recognized. Sections 
stained for acid-fast bacilli are negative. No ova, however, can be seen 
in the sections. The triangular area in the left lung shows marked fibrosis 
in the interlobular septa, in the wall of the bronchioles, and in the alveolar 
septa near these structures. 
Brain.—Polynuclear-cell infiltration in the swollen walls of the congested 
capillaries. Section of the large area of necrosis shows a wall similar 
to that found in the lung. No ovum is seen in the section. 
ANATOMIC DIAGNOSIS 
Abscess, brain; dilatation of the heart; bronchiectasis and interstitial 
pneumonia, local, lung; chronic adhesive pleurisy; schistosomiasis, 
It has been mentioned before that hyperpyrexia may favor 
the dissemination of ova. Is the necrosis in the brain and in 
the lung of this case caused by emboli of ova which became 
infected afterward with pyogenic microéganisms? Are these 
