A REMARKABLE CASE OF BILHARZIOSIS 



13 



The large bowel was the seat of an extreme polyposis (see Fig. 6). 

 Numbers of papillomata were ranged from coecum to anus, in all 120 

 were counted. These outgrowths varied in size from a pea to a hazel 

 nut, some few being even larger. They were broadly pedunculated as a 

 rule, or sessile, were nodular or mulberry-like, and were smooth or 

 slightly roughened in places, presumably from the action of foecal matter 

 rubbing over them. These polypoid growths are a well-known and 

 frequent manifestation of intestinal bilharziosis, but I do not remember 



D 



Fig. 7. — Section of Papilloma (x 6). 



A. Hypertrophied Lieberkuhnian crypts on side of tumour. 



B. Masses of ova in centre of tumour. 



C. Hypertrophied sub-mucosa of intestine, 



D. Ova in submucous tissue. 



to have seen them in such numbers before, nor so uniformly scattered 

 throughout the whole large intestine. Moreover, it is not often that 

 bilharzial papillomata are seen above the ileo-coecal valve. I have 

 examined a number of these growths (from the present case), and so far 

 all that I have microscopically inspected are crowded with bilharzia ova 

 (see Fig. 7). This is worthy of emphasis, inasmuch as the ova are very 

 often absent from these intestinal growths. 



(51) E I 



