﻿50 MUSGRAVE. 



one case (PI. 2, fig. 2) an adult parasite was found in an abdominal gland. 

 All types of lesions are observed in the glands and in some, where there are 

 no distinctive abnormal features, ova may occasionally be found. The lymphatic 

 disturbance is usually so extensive as strongly to point to the lymphatic system 

 as the distributing agent of the disease in the body. 



Muscles. — Adult P. westermanii were found in the pectoralis major muscles 

 in 2 of the 8 cases and in 3 the psoas or other muscles contained abscesses. 



Pleura. — The pleura were infected in 7 of the 8 cases, and in most of them 

 the infection was rather severe and extensive. Both hydrothorax and extensive 

 obliterative pleuritis were encountered. 



Lungs. — The lungs were absolutely free from Paragonimus infection in one 

 of the 8 cases and in 1 it was confined to the lungs and pleura?, and in still 

 another the pleurae was involved without invasion of the lungs. The lung 

 lesions, consisting of pneumonic areas, abscess formation, infiltration of tissue, 

 and bronchiectatic cavities, have already been described. 



Pericardium. — Pericarditis, with eggs of the Paragonimus in the pericardium 

 was present in 4 of the 8 cases. 



Heart. — Brown, coarse and friable .muscle was present 3 times and Para- 

 gonimus involvement extending a short distance beneath the epieardium was 

 encountered in the same cases. 



Abdominal cavity. — The tissues and organs of the abdominal cavity usually 

 suffer severely in this disease. 



The omentum was involved in 6 of the 8 cases and in most of these the 

 distribution of the lesions was extensive. 



Chronic peritonitis, consisting of adhesions between adherent adjacent organs, 

 was usually a marked feature. The serous capsules covering the various organs 

 also seemed to suffer extensively. 



Diaphragm. — This organ was more or less involved in every case and in 

 some it was fairly studded with lesions. In one instance only the pleural surface 

 on the left side was involved and in another only the abdominal surface showed 

 lesions. 



Spleen. — Paragonimus lesions were scattered throughout the organ in one 

 case; the capsule was similarly involved in two more and in one there was 

 tuberculosis of the organ. 



Liver. — There were changes for which the Paragonimus infection was at least 

 partially responsible in 6 of the 8 cases. The most general disturbance was 

 perihepatitis, with abscesses just beneath the capsule. In one, there were 

 multiple abscesses containing both amoebae and ova of P. westermanii. There 

 were abscesses containing eggs in Glisson's capsule in one other case and in 

 2 more there was some cirrhosis with eggs in the hyperplastic connective tissue. 



Pancreas. — In 2 cases there were Paragonimus abscess lesions in the pancreas. 



Appendix. — There were parasitic lesions of the appendix in 4 cases. The 

 meso-appendix suffered most, but in 3 the entire organ was affected and in 2 

 there was ulceration of the mucosa. 



Stomach. — This organ was not involved in any instance with the exception of a 

 few ahesions on the serous surfaces in 2 cases. 



Small intestine. — There was infection of this organ in 6 of the 8 cases. 

 In 3 the infection was severe and extended the full length of the gut. In 1 

 only the duodenum was concerned and in 3 others only the lower portion was 

 affected. 



Large intestine. — This organ was affected in 5 of the 8 cases. Tuberculosis 

 was present in one instance. Amoebic and Paragonimus ulceration existed 

 together in case 1 and there were amcebic lesions alone in another. 



