ANKYLOSTOMIASIS 151 



abundant. There is no tendency to early decomposition 

 in uncomplicated cases. Rigor mortis is not well 

 marked. 



The voluntary muscles are pale and sodden, and all 

 the organs appear to be anaemic. There is excess of clear 

 fluid in the serous cavities. 



The lungs may appear absolutely white, or white 

 streaked with black the remnants of carbonaceous 

 deposits. If an examination be made within a few hours 

 of death their weight is much below normal the two 

 together sometimes weighing less than 20 oz. If the 

 examination is delayed they are sodden and cedematous, 

 and may be above normal weight. Vesicular emphysema 

 is common. 



The heart is always pale, soft and friable, and there is 

 much fatty degeneration. The cavities are frequently 

 dilated, but there is no muscular hypertrophy, the weight 

 being less than the average. 



The liver is sometimes so fatty that it will float in 

 water. The colour, in the most anaemic cases, is best 

 described as " dusky chrome yellow," a term applied to it 

 in 1847 in British Guiana. This tinge is due to the exten- 

 sive deposits of ha^mosiderin or yellow pigment in the 

 hepatic cells. If in addition there has been malaria the 

 colour is modified. When the anaemia or fatty changes are 

 not so advanced the liver may appear as a yellowish brown 

 or red. 



The intestines in an advanced case are so anaemic that 

 the mucosa may appear quite white. Small petechiae are 

 often numerous. These are found round the point of 

 attachment of worms and show a central spot where 

 worms have been attached. Frequently there is abun- 

 dant adherent mucus covering the mucosa. This may 

 be stained or streaked with blood. The worms are 

 found most abundantly in the jejunum, and become 

 scanty in the ileum, and are very rarely found as low 

 down as the ileo-caecal valves. A few are usually present 

 in the second and third parts of the duodenum. 



