BILHAKZIA HJIMATOBIA. 203 



constitution eventually becomes undermined ; pneumonia often 

 sets in, and death finally ensues. On making post-mortem exami- 

 nations the following pathological facts come to light. In cases 

 where the disease has not very far advanced, minute patches of 

 blood-extravasation present themselves at the mucous surface of 

 the bladder, but in more strongly pronounced cases the patches 

 are larger or even confluent. In some instances there are villous 

 or fimgus-like thickenings, ulceration and separation of portions of 

 the mucous membrane, with varying degrees of coloration, according 

 to the amount of the extravasation, which becomes converted into 

 grey, rusty-brown, or black pigment deposits. A gritty or sandy 

 deposit is often superimposed, consisting of the ordinary Hthic 

 acid grains mixed with eggs and egg-shells. Bilharz detected ova 

 in the urine, these having probably escaped from the ruptured 

 vesical vessels producing the extravasations and hasmaturia. The 

 lining membranes of the ureters and renal cavities are also more or 

 less affected ; the kidneys being frequently enlarged and congested. 

 It must, however, be borne in mind that in all these organs the true 

 seat of the disorder is the blood, which forms the proper habitat 

 of the Bilharzia ; and this being the case, the worms as well as 

 their escaped eggs may be found in any of the vessels supplying 

 the diseased organs. In one instance, quoted by Leuckart, Gi-rie- 

 singer found a number of empty eggs in the left ventricle of the 

 heart, and from this circumstance it was supposed that they might 

 be carried into the various important organs, or even plug up the 

 larger vessels. As before stated, however, the parasites are more 

 particularly prevalent in the vessels of the bladder, mesentery, 

 and portal system. The effects upon the intestinal mucous mem- 

 brane are, in most respects, similar to those occurring in the urinary 

 organs. Blood extravasations, with thickening, exudation, ulcera- 

 tion, and fungoid projections, appear in and upon the intes- 

 tinal mucous and submucous tissues ; these appearances, of course, 

 being more or less strongly marked according to the degree of 

 infection. 



