96 ENTOZOA FOUND IN MAN. 



ducts, or into the structure of the liver. The pus 

 m.^y Le discharged through the dilated duct ; or 

 w) en the abscess has no direct or large -sized com- 

 munication with the duct, the pus is retained, and, 

 instead of the ascaris lumbricoides being contained m 

 an empty and ulcerated cavity, it will be surrounded 

 by a quantity of purulent matter. Sometimes the 

 abscesses are numerous, as is the case in suppuration 

 of the liver ; these may communicate with each other, 

 or be scattered throughout the entire mass of that 

 organ, and they may become of considerable size, and 

 extend towards the lungs, with which or with the 

 the pleura a communication may be finally esta- 

 blished. It may also happen that one of these 

 abscesses may open externally, at the epigastrium, or 

 in the right hypochondrium, and thus afford a means 

 of exit to the lumbrici, whose passage through the 

 substance of the liver would not be suspected, if 

 it were not for the simultaneous escape of bile from 

 the wound. 



The symptoms produced by the presence of lum- 

 brici in the biliary ducts are very variable ; and, 

 although the affection of the liver may attract atten- 

 tion, the cause of it is not usually suspected. The 

 most frequent symptoms which were observed in the 

 cases which have been recorded were those of acute 

 hepatitis, viz., pyrexia, pain in the hypochondrium, 

 jaundice, convulsions, vomiting, and diarrhoea ; these 

 symptoms were permanent in some cases, and came 

 on in paroxysms in others. 



The entrance of lumbrici into the biliary ducts 

 must almost always be attended by grave conse- 

 quences, as the probability of their return into the 



