TULLE in a case from Martinique, infected 
most likely by Sch. M. only, though the au- 
thor speaks in somewhat vague terms of the 
coexistence of eggs with terminal spine. His 
descriptions agree with those of the authors 
who observed very severe cases and some of 
them may be found also in less intense in- 
fections. Similar lesions may also appear in 
Sch. japon. infections which are frequently 
severe. 
LETULLE describes superficial ulcera- 
tions of the mucosa, different from those de- 
pendent on amoebiasis. In other places he 
noted a proliferation leading to the formation 
of polypoid pedunculated growths with the 
caracter of adenoms. They might be traver- 
sed by a fibrous axis and have an ulcerated 
surface. 
LIEBERKUEHN’S glands may be de- 
stroyed by ulceration, atrophy or cystic dila- 
tation, followed, suppuration, or become hy- 
pertrophic or hvperplastic. The epithelium 
shows the corresponding alterations without 
undergoing a typical proliferation. 
The interstitial tissue of the mucosa also 
shows signs of, sometimes extreme, hypertro- 
phy The capillaries may appear numerous 
and distended, while the interstitial tissue may 
force the glands assunder and spread on the 
surface of the mucosa, below the epithelium 
when it still exists. Interstitial hemorrhages 
and pigment deposits were never seen. 
The muscularis mucosae is not reached 
by the ulceration nor does it show other al- 
terations than hyperplasia. 
The submucosa is transformed into scle- 
rotic tissue, while the adipose cells disappear. 
The layers of the muscularis propria only 
show general hypertrophy, real or apparent. 
The serosa was also sclerotic in LETUL- 
LE’s case, but the products of parasitism, 
observed in other cases, were not seen. 
The lymph vessels show no alterations, 
except some cellular infiltration near to the 
foci of inflammation and ulceration. They are 
not used for the migration of the worms 
and eggs. The lymph follicles are not inva- 
ded by the parasitical process. Also the nerves 
and ganglia show no lesions. 
127 
Except in the parts which pass through 
the muscular layers, the veins undergo a 
special and characteristic process of hyper- 
trophic and sometimes obliterating endophle- 
bitis. The remaining free space is generally 
excentric, the process being limited to part 
of the intima. It may be seen alo on the 
mesenteric vessels and in the veins of the 
pelvis, which do not properly belong to the 
portal circulation. A hyperplasia of the media 
is also noted here. 
Oviposition and migration of the eggs. 
The main quesiions are: How do the 
eggs reach the extravascular tissue and how 
do they arrive in the intestinal contents? The 
solution of these questions is very difficult 
but seems to have hardly troubled most of 
the authors. Following LETULLE, they took 
for granted that the females advance in the 
small veins until they plug the narrower vessel, 
and then depose their eggs in them. 
They think that the increased pressure, fol- 
lowing the plugging of the veins, forces them 
through the wall, and that afterwards they 
make their way to the diffent places were 
they are found. As for the eggs found in 
the luugs, in the brains etc. they were suppo- 
sed to be carried by the bloodstream. 
What may be the force which makes 
the eggs, relatively large and motionless 
bodies, advance in the tissues? Here the 
authors evidently thought of the eggs with 
terminal spines, which might help the pro- 
gress in one direction while the other blunt 
end prevents a retrograde movement. But 
the lateral spine would not help the advan- 
cing, while it might oppose any motion in 
which the spineless end does not go first. 
And the eggs of the Sch. Japonicum have not 
even got a spine. It is true that a diminuti- 
ve thorn has been described, but it is gene- 
rally not terminal and is often missed alto- 
gether, as well in preparations from stools, 
as in preparations from tissues. It seems far 
from constant. Also the point is often curved 
and generally not very sharp. 
Nobody seems to have considered, that 
it would be much easier for the worm to 
