614 VARIOUS FORMS OF ECHINOCOCCUS. 



not come to lie inside the bladder space, but are fixed on externally, 

 as Kuhn long ago described in the case of his acephalocysts. 1 



In my earlier investigations I often saw this process of proliferation 

 in cases of multiple Echinococci, and am still prepared to maintain the 

 correctness of the observations. Naunyn has indeed urged a theoretical 

 objection, which seems to me, however, as though directed rather 

 against the form of my representation than against the actual facts. 2 



But before I enter into a discussion of the question, I must again 

 expressly note that not all Echitwcocci, even in the above cases, 

 exhibit this process, but only a few generally those which are of a 

 medium calibre. But since, as a rule, several daughter-bladders are 

 thus formed at once, these are often found seated on the mother-bladder 

 in groups attaining about the size of a pea. 



FIG. 330. Proliferation of the membrane of an Echinococcus (nat. size). 



The formation of daughter-bladders does not proceed directly from 

 the external surface, but begins in the thick cuticle, and indeed in its 

 deeper layers. At a definite point we notice at first, between the two 

 lamellae, a little heap of granular substance which presses the adjacent 

 layers apart, and after some time becomes surrounded by a special 

 cuticle. By repeated excretion of cuticular layers the granular heap 

 becomes the centre of a special system of ever-increasing lamellae. 



It is not, however, only the formation of new envelopes which 

 determines the growth of the embedded body, but also the increase in 

 the mass of the contents, which gradually lose their former appearance, 

 clear up, and pass through the changes which have been already 

 described in treating of the development of the primary Echinococcus- 

 bladders. At a certain developmental stage one finds the same stellate 



1 Megnin has lately observed a very remarkable case of this kind ("Sur une nouv. 

 forme de ver vesicul.," Jaurn. de TAnat. et de la Physiol., p. 6, 1880). This was an 

 Echinococcus which was developed in the leg of a horse, and had to a large extent 

 penetrated and displaced its muscles. The Echinococcus of the upper part of the leg 

 observed by Kanzow, and more closely examined by Virchow (Archiv f. patkol. Anat. t 

 Bd. xxix., p. 180), ought also to be noted. 



2 On the other hand, my observation has been confirmed by Pagenstecher ( Vcrhandl. 

 nat.-med. Vereins, Heidelberg, Bd. i., p. 5), and Rasmussen (loc. cit.), I have since 

 observed that in 1857 Levison made the same observations (" Disquis. nonn. de Echino- 

 coccis," Dissert, inaug. Gryphiae). 



