22,4 Monserrat and Africa: Ascaris in Liver Tissue 4g3 



Such migration of ascarides into the different organs is attrib- 

 uted to the altered chemico-physical condition of the normal 

 habitat of the parasite brought about by abnormal conditions of 

 the host body such as high temperature in febrile affections. In 

 the present case, it is not at all unreasonable to suppose that the 

 high temperature concomitant with meningitis had rendered the 

 small intestine unfavorable for the parasites and caused them 

 to become erratic. In intestinal ascariasis, as suggested by 

 Crowell, 1 one or more of the ascarides in the small intestine may 

 pass through the ampulla of Vater and cause occlusion, followed 

 by icterus, and symptoms of colic. It is true that in the present 

 case the clinical history records no symptoms that suggest this 

 condition, but it must be borne in mind that the marked clinical 

 signs of meningitis might have masked other symptoms. It 

 is possible that the worms, after ovipositing, might have traveled 

 back to the duodenum without leaving behind any trace of their 

 invasion exept the presence of their eggs. In this connection 

 we might mention here Vierodt's observation, that mature 

 female ascarides can penetrate without doubt into the liver 

 and there deposit eggs which appear exceptionally to undergo 

 segmentation. On the other hand, the eggs possibly laid in the 

 common bile ducts, or in the gall bladder, might have been 

 carried by the back flow of bile caused by some temporary 

 occlusion into the intrahepatic bile ducts, thereby causing 

 necrosis of the portal area and the surrounding liver tissue. 



It is a matter of common knowledge among parasitologists that 

 ascaris eggs are laid normally in the small intestine before 

 segmentation, and are passed outside with the faeces where 

 cleavage of the ovarian cells takes place. The occurrence of 

 segmenting ova in such an organ as the liver, discussed in this 

 paper, is contrary to this common belief. It also shows that a 

 very small amount of oxygen is required to initiate segmentation. 

 Among the eggs we studied in this paper, none was found to 

 have passed the 8-cell stage. This seems to be in conformity 

 with Wharton's observation 2 that "At 37° C. development will 

 begin, but all of the eggs die either in the 4- or the 8-cell 

 stage," if we disregard entirely the time element, which in 

 our case is not determined. Whether or not the eggs in ques- 

 tion could have developed in time into motile embryo stages 



