VIII, B, 3 Crowell and Hammack: Intestinal Parasites 165 



for the firmer areas which are darker and contain practically no air, being 

 rather leathery in consistence. The portion at the lower part of the right 

 lower lobe on section cuts readily and is made up of an intensely haemor- 

 rhagic mass in which no structure can be differentiated. Peribronchial 

 nodes are not enlarged. The larger pulmonary vessels are free. 



Spleen is not enlarged and has a normal appearance, except for marked 

 pallor. The lymphoid tissue is not prominent. Spleen weighs 42 grams. 



Adrenals are normal in size and appearance. 



Kidneys are imbedded in a small amount of fat. Ecchymosis over the 

 left kidney has already been referred to. Kidneys are of normal size. On 

 stripping the capsules, minute haemorrhages are visible on the internal 

 surface of the capsules. The surfaces aie smooth and very pale. On 

 section they are of normal appearance except for very marked pallor. 

 The pelves and ureters are free. Both kidneys weigh 101 grams. 



Urinary bladder is considerably distended with clear urine. Its mu- 

 cosa is pale and smooth. 



Intestine. — There are very numerous ascarides in the small intestine 

 and stomach. These number about 150. A few ankylostomata and many 

 trichurides are also present. There is considerable blood-stained fluid 

 throughout the intestine and numerous ecchymoses, especially in its upper 

 portion. 



Stomach contains some ascarides and few ecchymoses on its mucous 

 surface. 



Pancreas is practically surrounded by hsemorrhagic tissue, but on 

 section is of normal size and appearance, except for very marked pallor. 



Gall bladder and bile ducts are normal. 



Liver is of about normal size with a thin capsule, and on section the 

 cut surface is smooth, showing rather prominent bile ducts. The color is 

 pale yellowish brown. Lobular markings are fairly distinctly visible. 

 Liver weighs 458 grams. 



Along the vertebral column, extending through the diaphragm at the 

 oesophageal opening and continuing retroperitoneally to the bifurcation of 

 the aorta, is a very extensive haemorrhagic mass which is firm, 2 to 3 centi- 

 meters in radius, its center being about the aorta. The mesenteric lymph 

 nodes are enlarged, pale, and firm. 



Structures of the scalp and calvarium are normal. Dura mater is ad- 

 herent to the inner surface of the calvarium. There is no excess of fluid 

 in the meninges over the hemispheres. The brain itself is firm and very 

 pale. 



On section into the right knee joint, it is found to contain clear fluid, and 

 there is one minute petechia anteriorly in the capsule of the joint. On 

 section into the left knee joint, it is also found to contain clear fluid, and 

 all the muscle tissue posterior to the joint shows extensive haemorrhagic 

 infiltration. 



TRICHURIS 



Our figures (34.4 per cent) on the incidence of Trichuris are 

 a little below the average (40.79 per cent) established by 

 Willets(6) in his compilation of the statistics of investigators 

 in the Philippine Islands, but are higher than those of three 

 of the investigators. Our records in this case probably rep- 

 resent the true incidence of the condition in the cases examined 



