VIII, B, 3 Crowell and Hammack: Intestinal Parasites 163 



been left in the caecum. The mucosa of the appendix is reddened, and 

 shows one minute ecchymosis. Microscopic sections show some conges- 

 tion of the mucosa, some fibrosis of the submucosa, oedema of the 

 muscular and serous tunics, and infiltration of the muscularis by poly- 

 morphonuclear leucocytes and lymphocytes. Two ova of the Ascaris were 

 found overlying the tissue in one section of the appendix." Examination 

 of the fseces of this patient previous to operation had shown the presence 

 of Entamoeba, Trichuris, Ascaris, blood cells, and mucus. No history was 

 given of symptoms which were interpreted as indicative of disease of the 

 appendix. 



CASES 2 AND 3 



Afite-morteni infestation of the liver by Ascaris. — Two cases ' have been 

 encountered in which numerous ascarides had passed through the bile 

 ducts into the liver. In the first case several of the worms in the liver 

 were surrounded by abscesses, one of which had ruptured into the peri- 

 toneum. In the second case there was abundant evidence of inflammation 

 about the bile ducts in the liver, indicating the presence of the worms 

 before death of the host. 



CASE 4 



Post-mortem wandering of the Ascaris. — One case worthy of note oc- 

 curred in a child, whose middle ear was found to contain a live Ascaris 

 after the death of the host. 



Numerous cases have been encountered in which the ascarides were 

 found in the bile ducts, pancreatic duct, stomach, oesophagus, and larynx. 



CASE 5 



Case of possible toxic action of the Ascaris. — This case, which occurred 

 in our series, was reported by Albert and Mendoza at the ninth annual 

 meeting of the Philippine Islands Medical Association. An 8-year-old 

 Filipino, six days before death, was seized with an attack of vomit- 

 ing, followed on the next day by pain in the chest and knee joints. 

 There soon developed external oedema, jaundice, melsena, haemorrhage 

 from the gums, dyspnoea, prostration, and ecchymoses on the right upper 

 eyelid and over the lower extremities. Physical examination on the day 

 before death showed the above conditions, hsemic cardiac murmurs, and 

 evidence of severe anaemia. Blood examination showed: 



Leucocytes 11,500 



Polymorphonuclears 88 per cent. 



Small lymphocytes 9 per cent. 



Large lymphocytes 2 per cent. 



Transitionals 1 per cent. 



Erythrocytes 1,080,000 



Haemoglobin 30 per cent. 



The Widal reaction with B. typhosus was negative, and a blood culture 

 remained sterile. 



There was no fever. 



The autopsy report in full follows. 



^ These cases will be reported in detail by Dr. V. L. Andrews. 



