sion and reasoning, periods of apathy and 
bad temper, etc. 
Complications and secondary affections. 
Infection with Sch. M. is so common 
that the coincidence of other pathological 
conditions must necessarily be very frequent. 
Thus liver abcesses may be due to amoebia- 
sis and may be attributed to the schisto- 
soms, simply because theit eggs are found. 
Appendicitis of other origin may take place in 
an appendix, infiltrated with eggs. Even sym- 
ptoms which are generally observed in Schis- 
tosomum-infection may be partly due to com- 
plicating conditions, as tuberculosis, syphilis, 
alcoholism and heart diseases. In severe af- 
fections of the rectnm (which seem particu- 
larly frequent in Egypt) the Sch, haemato. 
bium may be partly responsible. Haemorrhoids 
may be altogether independent or a conse- 
quence of cirrhosis hepatis. Anal fistule may 
be independent or due to mixed infection. (I 
dont know of any attributable to Sch. M. 
alone). Adenoms and papilloms, found from 
the ileum to the rectum in increasing num- 
ber, may be due to intense and long stan- 
ding infections but the malignant degenera- 
tion of them ought to be considered a com- 
plication. Haemoptvsis, observed in chronic 
cases, may be dependent on other causes. 
On the other hand the parasitism of Sch. 
M. may favour complications and secondary 
affections. It certainly proves the existence 
of sanitary conditions which favour an infec- 
tion, not only by other worms but also by 
protozoa and bacteria. 
Pathological anatomy. 
The results ofthe parasitism of Sch. M. 
are better unterstod by macro-and microsco- 
pical investigation of the anatomo—patholo- 
gical conditions than by the symptoms, ob- 
served in life. These results allow us to ap- 
proach certain questions which are still so- 
mewhat obscure. 1 shall first state my perso- 
nal observations made on animals experimen- 
tally infected. 
In rabbits, guinea pigs and white rats, 
125 
ihe presence of the blood flukes is hard to 
prove during the first period after experi- 
mental infection, evidently, because they have 
not yet reached their final habitat. This agrees 
with the results of other helminthological ex- 
periments. The youngest and smallest spe- 
cimens were found by LEIPER in the liver 
of white rats. 
After three weeks, we may count with 
positive results. On opening the animal, the 
mesenterial veins are full of blood and 
the tissues are so transparent that the males 
are easiey seen, their white colour being in 
contrast with the surrounding blood. They 
are found in all thelarger branches, from the 
stomach to the end of the intestine, without 
any preference for the last part. By dilacera- 
tion of the liver in physiological salt solution, 
a similar number may be obtained. The fe- 
males are found in about equal numbers 
with the males occupying their canalis gynae- 
cophorus but after some time the sexes se- 
parate. 
In recent infections, the veins, although 
full of flukes, show no distinct lesions. The 
neighouring tissues, the liver and the intesti- 
ne are free from macroscopic alterations. 
Complete development and egg produc- 
tion require one or two weeks more. Even 
in heavy infections the eggs do not appear 
immediately in the excrements which shows 
that their emigration is slow. 
After many months the larger veins may 
be found empty, but sections of the liver and 
the intestine show some males and many fe- 
males, isolated in the smaller veins. 
In the liver the females are found in the 
small interlobular veins, more rarely in dila- 
ted capillaries or small arteries, never in bile- 
ducts or in the glandular tissue. The bloods 
vessels seem very congested but there is no 
inflammatory reaction around them. In the 
inicial time, eggs in liver preparations are 
rarer than sections of flukes but they are 
often surrounded by an infiltration of round 
cells. In severe infections of older standing 
the whole interstitial tissue may be thus in- 
filtrated, which may be considered as the 
