ECHINOCOCCOSIS OF THE LIVER. 



287 



ifiili 



Fio. 131. — Echinococcus 

 bladder worm or hydatid. 



visceral lesion, but as they call for a complete examination, the prac- 

 titioner is almost forced to a certain conclusion by the fact that the 

 examination remains negative except in re- 

 gard to the liver. The liver seems large and 

 sensitive, and may sometimes be considerably^ 

 hypertrophied, for cases have been seen in 

 the ox where the normal weight of 10 to 12 

 lbs. has been increased to 60 or even 100 lbs., 

 while in the pig, whose liver normally weighs 

 4 lbs., the weight has been as high as 20 or 

 40 lbs. In such cases percussion and pal- 

 pation show that the liver extends beyond the 

 right hypochondriac region and invades a 

 large portion of the corresponding flank. But 

 such great enlargement is exceptional, and 

 when only a dozen vesicles are present, al- 

 though the functions of the liver may be 



seriously disturbed, the information obtained by physical examination 

 is seldom sufficient to justify an exact diagnosis. The 

 liver is found to be enlarged and thickened ; otherwise 

 the examination gives negative results. 



The diarrhoea may result from failure of the liver to 

 secrete sufficient bile to destroy intestinal toxins, or to 

 carry on its glycogenic function ; but it may possibly be 

 the direct result of chronic intoxication by the contents 

 of the vesicles. 



Experience has shown, in fact, that in man, when a 

 superficial vesicle becomes ruptured, the peritoneal cavity 

 is flooded with the contents of the cyst ; the daughter 

 cysts adhere to the peritoneum, and that almost invari- 

 ably vascular disturbance occurs, accompanied by itching 

 of the skin and an eruption resembling that of urticaria. 

 The liquid of the vesicles contains an active tox- 

 albumin. 



Diagnosis. In certain cases, diagnosis is possible, and 

 even easy, l)ut in others it is extremely difficult and ahnost 

 impossible. 



Prognosis. The prognosis is always grave, for if the 



lesions in the liver do not produce death, as usually 



happens, they so profoundly aflect the animals' general 



state, that it is no longer worth while to keep them alive. 



No practical treatment exists. In exceptional cases it certainly might 



be possible, although in the large herbivora always difficult, to expose 



Fig. 132. — 



Tceninecliino- 



