DISTOMA HEPATICUM. 265 



through the ductus choledochus and during the time of the resi- 

 dence of the Disloma in this canal, at least at the commencement 

 and when the first Distoma are about to pass outwards, and then 

 only temporarily and with a rapid change, we have no exact 

 reports or observations on the sheep, and certainly none as to the 

 human subject. 



Towards the 'periphery and in the finest gall-ducts the eggs of 

 the Distoma often collect in quantities; they appear half dried, 

 form a greasy but granular mass, and are capable of effecting a 

 total obliteration of the gall-ducts attacked. In particular places 

 we find a biliary deposit upon or surrounding the isolated eggs ; 

 this is the first attempt of nature to make use of these eggs as 

 the nucleus of future biliary concretions. The same masses of 

 eggs occur in the greasy masses of the gall-bladder, and here 

 generally floating about freely, so that, without exaggeration, we 

 may speak of the occurrence of millions of eggs in such livers. 

 There is also no doubt that gastric symptoms of various kinds will 

 occur in a secondary series, and that the general nourishment 

 must suffer. How far permanent or temporary obstruction is 

 produced by the temporary retention and diminished secretion of 

 bile, I cannot say. It is certainly more essential that digestion 

 ceases from the disturbed secretion and flow of bile, whence 

 results a high degree of that chlorotic state, which, according to 

 the statements of experienced farmers, shepherds, and veterinary 

 surgeons, at once characterises the animals suffering from Distoma, 

 by a turbidity, great want of lustre, and a rather greasy appear- 

 ance of the eyes, so that the above observers can detect the exis- 

 tence of the Distoma from the eyes. This seems, however, a 

 very deceptive symptom. 



Diagnosis. — The local circumstances, the endemic occurrence 

 of Distoma in a district, the great humidity of preceding years, 

 and the moist soil of the meadows may perhaps, with the above- 

 mentioned circumstances, furnish the sheep-breeder and the 

 veterinarian with data for the diagnosis of the presence of 

 Distoma ; but for the surgeon these last-mentioned circumstances 

 are certainly quite valueless, and the first-mentioned ones, as they 

 associate themselves with other liver-complaints, are of such 

 doubtful significance, that it is quite impossible to found upon 

 them even a diagnosis of probability. There is only one possi- 

 bility of establishing the diagnosis of Distoma in the living 



