32 PARASITES OF MAN 



membrane was well bile-stained, and there was evidence of 

 biliary colouring matter in the faecal contents of the. bowels. 

 On carefully dissecting out, and then laying open, the biliary 

 ducts in a portion of the right lobe of the liver (the rest being 

 preserved entire), numbers of distomata were found within them, 

 lying singly, flattened, and generally with the anterior extremity, 

 or " oral sucker," directed towards the periphery of the organ, 

 the posterior extremity towards its centre ; or in twos, threes, 

 or even little groups of fours, variously coiled upon themselves 

 or upon each other. The lining membrane of the biliary canals 

 was found abnormally vascular, its epithelial contents abundant 

 (catarrh ?), and, among these, ova could be detected under the 

 microscope. Sections of the liver, hardened and then examined 

 in glycerine, showed fatty infiltration of the lobular structure, 

 but not to any advanced degree ; the bile ducts considerably 

 dilated, their walls thick and hypertrophied, but nothing else 

 abnormal, or in any way remarkable. The weight of the liver 

 was 3 Ibs. In the transverse and descending colon numerous 

 indolent-looking, shallow, pigmented ulcers were found, and in 

 the rectum others evidently more recent and highly injected. 

 The submucous tissues throughout were abnormally thickened. 

 The intestinal contents consisted of only about three ounces of 

 thin yellowish (bilious) faecal fluid, with small bits of opaque 

 mucus. This was carefully washed and examined, but no flukes 

 were discovered. About a dozen distomata escaped from the 

 liver on making the primary incisions, and quite twice this 

 number was found subsequently within the biliary canals. Only 

 a portion of the right lobe has, as I have said, been dissected, 

 so that it may be confidently stated that probably not less than 

 a hundred of these flukes must have infested this liver. All 

 were found dead, but it must be remembered that the autopsy 

 was performed thirteen hours after the death of the patient. 

 It is remarkable that in this case, as in the one before described 

 by me, no distomata were found in the gall-bladder. The 

 presence of these parasites in the bile-ducts seems to have led to 

 catarrhal inflammation of their lining membrane and abnormal 

 thickening and dilatation of their walls, but there is no evidence 

 of their having caused sufficient obstruction to produce choloeinia, 

 as in the case just referred to, and no marked pathological 

 change could be detected in the lobular structure of the liver." 

 After referring to the anatomical descriptions of the worm, 

 as recorded by myself (in ' Entozoa ') and by Lewis (in the 



