618 VARIOUS FORMS OF ECHINOCOCCUS. 



that in many cases he found the mother-bladder beset with brood- 

 capsules and heads sometimes by itself, and sometimes along with the 

 daughter-bladders. Where the proliferating and sterile bladders occur 

 together, the former are sometimes (Levison, Helm) characterised by 

 a more transparent nature. 



As to the age, or perhaps more correctly the size, of the Echino- 

 coccus associated with the appearance of the daughter-bladders, only 

 an uncertain answer can be given. So far as I know, there is no 

 authentic case in which an Echinococcus smaller than a walnut con- 

 tained hydatids, which casts doubt on Davaine's statement mentioned 

 above. But that the production of daughter-bladders does not exclude 

 the formation of heads, is evident enough from the fact that along with 

 the latter one often sees bladders of all possible sizes, from that of an 

 apple to that of a pin-head, with all intermediate stages. 



This continued proliferation explains also the large size of the 

 daughter-bladders, which is observable in many cases of hydatidose 

 Echinococcus. We know instances where the number might have been 

 estimated at thousands. 1 Most of these reports, however, are of 

 somewhat early date, and we are somewhat inclined to place them in 

 the same category as the reports of tape-worms 800 yards long. I 

 myself, I must confess, belonged to the ranks of these sceptics, until, 

 through Professor Luschka, I became acquainted with a case not a 

 whit inferior to any of these older reports. 



The case was that of a woman sixty years of age, who for several 

 decades had suffered from a tumour which was for a while considered 

 as an extra-uterine foetus, until its increasing size and the absence of 

 distinct confirmatory symptoms led to the abandonment of this 

 diagnosis. On post mortem examination the tumour was seen to be 

 a huge Echinoccocus, which originated in the liver, and had gradually 

 grown to become a sac weighing thirty pounds. Within it there was 

 an immense number of daughter-bladders, some thousands at least, 

 varying from the size of a fist to that of a pea and less, but neither 

 heads nor hooks could be found. 



Echinococci with some hundred bladders are more frequent, but 

 as a rule the number remains below this, and is often about 25-50. 

 These differences depend partly, but not wholly nor exclusively, on 

 the age of the Echinococcus. In an Echinococcus weighing from eight to 



1 Besides the cases collected by Davaine (loc. cit., p. 365), in which the number in 

 some cases amounts to 9000 ( !), I may also note Russell (Dubl. Journ. Med. Sci., vol. xii., 

 No. 35, 1837), and Knaffl (Oesterr. med. Jahrb., Bd. xx., Stuck 3 ; Schmidt's Jahrb., 

 xxviii., No. 10), where two cases of "several thousands" are reported. Even in the 

 domestic animals such cases occur. My uncle, F. S. Leuckart, once saw a fat pig whose 

 abdominal cavity was filled with "several thousand hydatids," which originated from a 

 recently ruptured Echinococcus in the liver, which it had almost entirely destroyed. 



