TEEMATODA 53 



confluent. In some instances there are villous or fungus-like 

 thickenings, ulceration and separation of portions of the 

 mucous membrane, with varying degrees of coloration, accord- 

 ing to the amount of the extravasation, which becomes con- 

 verted into grey, rusty-brown, or black pigment deposits. A 

 gritty or sandy deposit is often superimposed, consisting of 

 ordinary lithic-acid grains mixed with eggs and egg-shells. Eggs 

 are readily detected in the urine, these having escaped from the 

 ruptured vesical vessels. The lining membranes of the ureters 

 and renal cavities are also more or less affected ; the kidneys 

 being frequently enlarged and congested. It must, however, 

 be borne in mind that in all these organs the true seat of the 

 disorder is the blood, which forms the proper habitat of the 

 Bilharzia ; and this being the case, the worms as well as their 

 escaped eggs may be found in any of the vessels supplying the 

 diseased organs. In one instance, quoted by Leuckart, Grie- 

 singer found a number of empty eggs in the left ventricle of 

 the heart, and from this circumstance it was supposed that 

 they might be carried into various important organs, or 

 even plug up the larger vessels. As before stated, however, 

 the parasites are more particularly prevalent in the vessels of 

 the bladder, mesentery, and portal system. The effects upon 

 the intestinal mucous membrane are, in most respects, similar 

 to those occurring in the urinary organs. Blood extravasations, 

 with thickening, exudation, ulceration, and fungoid projections, 

 appear in and upon the intestinal mucous and submucous 

 tissues ; these appearances, of course, being more or less 

 strongly marked according to the degree of infection. 



In regard to the treatment of the helminthiasis, I am pre- 

 cluded from entering into details here ; nevertheless, I am glad 

 to perceive that the principles which I long ago enunciated 

 have received approval both at home and abroad. As stated 

 in my ' Lectures ' our object should be not to interfere with, 

 but to promote nature's curative efforts. If I read the patho- 

 logical facts correctly, she seeks to bring about this result by 

 erecting artificial barriers which serve to moderate the bleeding. 

 In this way, under ordinary circumstances, the life of the 

 bearer is sustained, or held in the balance until the parasites 

 either perish or cease to be capable of causing active disease. 

 Depend upon it, this is the principle which should guide 

 physicians in their treatment of the Bilharzia disorder. If the 

 adult parasite were merely attached to the lining membrane of 



