﻿PARAGONIMIASIS IN THE PHILIPPINES. 47 



inent that for convenience in discussion I will somewhat arbitrarily 

 give the following classification : 



{n) The non-suppurating lesion. 



{b) The tubercle-like lesion. 



(c) The suppurating (abscess) lesion. 



(d) Ulcerative lesion. 



Skin. 

 Mucosa. 



Bronchial. 



Intestinal . 



(a) The non-suppurating lesion may or may not be an early one. It 

 has three subtypes. 



1. Those found on serous surfaces sucli as the pleura? and, less fre- 

 quently, the pericardium or meninges. These lesions are nearly always 

 located at some point of adhesion between serous surfaces and consist in 

 raised, brownish-colored, slightly roughened areas, which are moderately 

 firm and which often contain ova, (See PL I.) 



2. Those found in the loose connective tissue, for example in the 

 subserous tissues of the intestine, and less frequently in the lung, liver 

 and elsewhere. They consist in a simple infiltration of the tissue with 

 eggs, without to any extent alterating the normal histological picture 

 (see PL IX, fig. 1) ; sometimes there is seem moderate inflammatory 

 reaction and in more advanced ones some increase in connective-tissue 

 formation. These lesions are almost certainly early ones and immedi- 

 ately precede the ones about to be described. 



3. Those which consist in a simple hyperplasia of connective tissue, 

 containing ova. They are sometimes located in the cirrhotic liver and 

 more often in the submucous and subserous coats of the intestine, and 

 in the lung. 



4. The pneumonic areas often encountered in the lung. These pneu- 

 monic areas closely resemble similar lesions from other causes and may 

 or may not contain parasites or ova. They probably, at least in part, 

 follow lesions of types 2 and 3. 



o. Tubercule-UJce lesions most often are found in the lung, but 

 occasionally are also observed in other organs. 



Miura and other observers described such lesions as closely resembling 

 miliary tubercles, but I have not found such exceedingly small and defi- 

 nite ones of this type. However, in the lungs and elsewhere caseating 

 nodules are encountered which are from 2 to 10 millimeters in diameter 

 and which are almost or quite indistinguishable from similar ones of 

 tuberculous etiology. 



c. The suppurating lesions. — These are of two kinds, the first showing 

 early formation of abscesses, which in appearance resemble ordinary 



