21,6 Mendoza-Guazon: Schistosomiasis tn the Philippines 559 
Almost throughout the entire length of the colon the mesenteric fat 
is indurated and scarred, especially about the cecum and the rectum. 
Liver weighs 1,347 grams. It appears small and is grossly lobular from 
scarring. The lobules measure 4 or 5 centimeters. On opening the abdo- 
minal wall the liver was concealed by adhesion with the omentum above 
the gall bladder. The surface of the liver is rough and lobular, but there 
is no diffuse induration. Two nodules lie embedded in the capsule ante- 
riorly over the right lobe. They measure 1 centimeter and are firm and 
brownish. The hepatic parenchyma is pale gray. On section there is 
irregular scarring which: seems to be about the larger portal channels 
which are surrounded by a wide zone of tough silvery fibrous tissue. The 
spleen is greatly enlarged, weighing 565 grams. The capsule is slightly 
thickened. On section the cut surface is grayish purple. Trabeculz and 
blood vessels are prominent. Malpighian bodies are diffuse, and on the 
pulp are numerous dots (1 to 2 millimeters) which are opaque, golden 
brown, and seem to follow the distribution of the blood vessels. About 
many of these is a dark red zone of hemorrhage. There are a few small 
points of hemorrhage elsewhere. 
Ureters and urinary bladder appear normal. 
Portal vein clot was removed from portal vein and placed in salt solu- 
tion. Four specimens of Schistosoma, two males and two females, were 
found. Two others were obtained from branches of the splenic vein. 
Typical ova of Schistosoma japonicum were found in scrapings from 
the cecum and from the omentum. 
ANATOMIC DIAGNOSIS 
Mucous erosions of gastric mucosa; gastric and intestinal hemorrhage; 
anemia; chronic colitis (Schistosoma japonicum) ; schistosomiasis (colon, 
omentum; peritoneum, liver, spleen, and lungs). 
The infection of schistosomiasis is of long duration. In fit- 
ting the cases reported in this paper under the classification 
of Houghton,(17) we can place the first and tenth cases as 
terminal. The history of the second case, relative to the 
infection, is unknown. The third had hyperpyrexia due to 
typhoid. The fourth case shows a past history of occasional 
fevers and malaria, and died on account of ruptured appendi- 
ceal abscess. The fifth case died of ulcerative pulmonary 
tuberculosis; the eighth, of cerebral hemorrhage; the ninth, of 
lobar pneumonia; and the tenth, of hzmatemesis. 
The theory that high fever can stimulate the dissemination of 
the eggs is supported by the sixth case who had influenza three 
months before death, and since then had very severe headaches, 
and died with cerebral symptoms. At the autopsy a large ne- 
erotic area was found in the right temporal lobe of the brain and 
another, triangular in shape, in the anterior surface of the 
upper lobe of the left lung. The third and the seventh cases 
also confirm Houghton’s view, for these died of typhoid fever, 
and some of the eggs seem to have been freshly laid in the 
tissues. 
