A REMARKABLE CASE OF BILHARZIOSIS 



II 



ova. On transverse section of the appendix the lumen was perfectly 

 circular, and occluded by a solid mass of soft material. External to this 

 was a delicate whitish ring (mucous membrane), then a wide brownish 

 ring of ova-infiltrated tissue (submucous tissue) and bounding the whole 

 was a distinct ring of white (muscle and serosa). Thus the accumulation 

 of ova was present between the mucosa and the muscular coat, and here 

 the ova were innumerable, lying in a hyaline material, this region com- 

 posing nearly two-thirds of the entire diameter of the appendix, the 

 muscular coats being pushed out and partially atrophied. The increase 



Fig. 5.— Section through appendix vermiformis (x 6). 



A. Muscular coat. 



B. Greatly thickened submucous coat, the dark areas being masses of ova. 



C. Amorphous mass in lumen of appendix. 



in thickness of the appendix was due to hypertrophy of the submucous 

 coat, and to the innumerable ova therein embedded (see Fig. 5). 



Internally, the bowel was equally interesting. The mucous mem- 

 brane was unduly hyperaemic throughout. Peyer's patches were normal, 

 but the solitary follicles were somewhat enlarged. A few superficial 

 ulcers were seen in the ileum, from one to three centimetres in linear 

 extent, and 5 cm. broad, they lay with their long axis traverse to the 

 axis of the bowel, were of very slight depth, clean based with somewhat 

 firm, rounded margins. In the ileum were a few pedunculated polypi. 



(49) E 



