222 COCCIDIUM OVIFORME. 



described by Gubler in Paris, 1 furnishes us with a striking instance 

 of what, under some circumstances, may be the result of their presence. 



The case was that of a stone-breaker, forty-five years of age, who 

 sought admission to the hospital, suffering from disordered digestion, 

 bad appetite, sour stomach, and anaemia. He felt a dull pain in the 

 right hypochondrium, associated with a cachectic appearance. Per- 

 cussion revealed a considerable enlargement of the liver, and palpation 

 disclosed a markedly projecting spherical tumour, lying about the 

 position of the gall-bladder. The diagnosis referred the disease to 

 Ecliinococcus. In the next few weeks the anaemia increased so much, 

 that finally the lips were no longer distinguishable in colour from the 

 rest of the face ; the patient then fell one day to the ground, after 

 which ague, and afterwards violent pains in the body, fever, feeble 

 pulse, vomiting of bile, and collapse followed. After a night of de- 

 lirium, death supervened. 



A post mortem examination showed that the patient had died of 

 peritonitis. In the substance of the much enlarged liver there were 

 found about twenty tumours of cancerous appearance. Most of them 

 were about the size of a chestnut, some even as big as an egg, and the 

 one which had been seen from the outside was of enormous size, 

 12-15 cm. in diameter. Internally, the encapsuled tumours con- 

 tained a thick creamy fluid of a greyish-brown colour, here and there 

 somewhat reddish, in which there were, besides numerous altered 

 epithelial cells and blood corpuscles, countless egg-like bodies, which, 

 according to the figure and description, possessed all the characteristics 

 of Coccidia. At the sharper end of the shell, Gubler saw a small flat- 

 tening " like a lid or micropyle." In many cases the granular con- 

 tents were rolled together into a ball. The wall of the tumour was 

 strongly injected, and was at one point also ulcerated. 



After the above description, I need say nothing further as to the 

 nature and danger of the disease. The patient perished exactly in 

 the same manner as the infected rabbit. It is not, of course, known 

 how the infection occurred, but if one may judge from the extent and 

 intensity of the disease, it must have been often repeated. In France 

 rabbits are very commonly reared in hutches; and one may there- 



1 Gubler, " Tumeurs du foie de'terminees par des oeufs d'helminthes et comparables a 

 des galles observers chez 1'homme," M6m. Soc. JBioL, 1858, with illustrations, and also 

 Gaz. Md., p. 657, 1858, Paris, or Davaine, " Traite* Entoz., p. 288, 2d ed. As the 

 quotation shows, the true nature of the affection was not recognised. Gubler regarded 

 the Coccidia as eggs of Distormtm, although he sought in vain for the worms, and was 

 unable to decide whether the presence of these reputed eggs were only an aggravation, or 

 the cause, of the tumours. I was the first to recognise the true nature of the parasites 

 (see the first German edition of this work, Bd. i., pp. 49 and 740), and the importance of the 

 case was then for the first time rightly appreciated. 



