21,6 Mendoza-Guazon: Schistosomiasis in the Philippines 557 
Physical examination indicates lobar pneumonia, acute pericarditis, and 
dilatation of the heart. 
Leucocytic count, 32,050 per cubic centimeter, and blood smear is nega- 
tive for all the forms of malaria. : 
Stool examination is negative. 
Urine contains a decided trace of albumen and few pale granular casts. 
Morbid anatomy.—Autopsy 2990. Body of an emaciated adult, male 
Filipino, with about 100 cubic centimeters of clear yellowish fluid in the 
pericardial cavity, and fibrinous exudate over the surface of the right 
lung. The right ventricle of the heart is dilated. Right lung shows 
fibrinous pleurisy and lobar pneumonia. Liver weighs 1,607 grams. The 
lower edge is 8 centimeters below the costal ribs. There are areas of 
depression over its surface. It is brownish gray, hard, and firm; the sur- 
face is granular. On section numerous yellowish areas are present on the 
cut surface. In the sigmoid there is a hard nodule, which on section shows 
clear fluid surrounded by a thick capsule. Round worms and whipworms 
are present in the intestines. 
HISTOPATHOLOGY 
Liver.—Schistosoma nodules in the interlobular septa and fatty degene- 
ration. Lung, red hepatization. The nodule in the sigmoid is composed of 
fibrous tissue with a cavity in the center containing a blue-staining mate- 
rial. 
ANATOMIC DIAGNOSIS 
Lobar pneumonia, right; fibrinous pleurisy; dilatation of the heart; 
cirrhosis of the liver; schistosomiasis, liver; cyst, colon. 
TENTH CASE 
Clinical history —C. V., male, Filipino, 21 years old, born in Leyte and 
residing at present in Manila, was admitted to the Philippine General Hos- 
pital on May 27, 1922, pulseless and semiconscious due to profuse hem- 
atemesis. Companion states that patient has been in good health and that 
the day before admission he went to bed hungry, after heavy exercise. On 
the following morning and several times during the day he vomited blood. 
In the evening of the same day, he vomited so much blood that he collapsed. 
On admission, he was very weak, collapsed, with profuse cold perspira- 
tion, pulseless, and semiconscious. The lungs and heart were apparently 
normal. No epigastric tenderness. In the ward his hematemesis was un- 
controllable, and he died early on the following morning. 
Clinical diagnosis—Hemorrhage, gastric. 
The autopsy was performed four hours after death by Dr. E. W. Good- 
pasture. 
Morbid anatomy.—Autopsy 9132. Body is that of a young Filipino 
-male, well formed and well nourished. On removal of the sternum the 
lungs are found to be pale and expanded. There are firm fibrous ad- 
hesions posteriorly over the lower lobe and at the base on each side. Some 
congestion posteriorly. Near hilum posterior of left lung is a firm yel- 
lowish nodule (1 centimeter) lying on and attached to the pleura and 
embedded in a small indentation of the surface. On section through the 
lungs a few small scars are present in each posteriorly in lower lobes. 
On opening the abdominal wall the peritoneal surfaces are found to be 
pale. There are numerous fibrous adhesions about the liver and colon. 
