DIFFERENTIAL DIAGNOSIS 



363 



necrotic tissue contained in the larger nodule.s, but they are 

 almost invariably found in the smaller ones. In a few sections 

 the tapeworm has been traced through the mucosa to the 

 nodule in the muscular tissue in which its head appeared. In 

 the earlier stage of the nodular development, there is a cell in- 

 filtration about the head of the worm. This process continues 

 until the infiltrated tissue reaches a considerable size. 



A larger form is commonly found 

 in the intestinal contents. Although 

 macroscopically they appear to be dif- 

 erent, Dr. Stiles has found that they 

 are presumably of the same species. 



§ 291. Differential diagnosis. 

 Tuberculosis is the only known dis- 

 ease for which this affection is liable to 

 be mistaken and it is of much impor- 

 tance that the two diseases should not 

 be confounded. The diagnosis has 

 not in ni}' experience been difficult, as 

 in every case the attached tapeworms 

 were readily detected upon a close ex- 

 amination of the intestinal contents, pj(^_ -2. (/) Cross 

 or of the mucous membrane of the section of a nodular con- 

 infected portion of the intestine. 

 However, the worms are quite small 

 and could easily be overlooked in a 

 hurried or cursory examination. In 

 case of doubt, if the affected intestine worm between villi and 

 is opened, and the mucous surface hooks zvithin the muscle. 

 washed carefully in a gentle stream of water, the small worms 

 will be observed hanging to the mucous membrane. This 

 discovery, in the absence of lesions in the liver or other 

 organs, would warrant the diagnosis of the tapeworm disease. 

 Although much is written concerning tuberculosis in fowls, 

 the investigations of poultry diseases in America thus far show 

 that it is not common among fowls in this country. 



taining necrotic cheesy tis- 

 sue. ( 2 ) Cross section show- 

 ing beginning of necrotic 

 mass about head of a tape 

 worm, (j) Section shoiving 



