VIII, B, 3 Crowell and Hammack: Intestinal Parasites 169 



blood was not examined. At autopsy the following anatomical diagnosis 

 was made: 



Acute colitis (bacillary dysentery) ; acute lymphadenitis, mesocolic; 

 subacute splenitis, malarial; infarcts of spleen; acute parenchymatous 

 degeneration of liver and kidney; malarial pigmentation of liver, pan- 

 creas, and lungs; congestion and oedema of lungs; hookworms; and 

 haemorrhages and erosions in mucosa of small intestine. 



Bacillus dysenterias was isolated from the mucosa of the large intestine. 



The description given of the intestines was as follows: 



In the duodenum are found a few hookworms, one being attached 

 within 5 centimeters of the pylorus. In the jejunum they are found in 

 great numbers both attached and free. At the points of attachment of 

 many, and also between them, are small hsemorrhagic areas which are 

 sometimes visible from the serous surface. Over a number of these there 

 occur shallow erosions of the mucosa. In the lower 10 centimeters of the 

 ileum there is marked hyperaemia of the mucosa. The mucosa of the 

 ileocaecal valve is swollen and reddened. Throughout the large intestine 

 the mucosa is greatly swollen, oedematous, and hyperaemic. The greatest 

 congestion occurs in the ascending and sigmoid portions. In many places 

 small ulcers have formed, most frequently on the tips of the folds of 

 the mucosa. The swelling and congestion extends into the appendix. 



Sections taken through the areas in the small intestine mentioned as 

 haemorrhagic show a destruction of epithelium and glandular tubules. The 

 mucosa and submucosa immediately beneath are oedematous, and many 

 leucocytes and erythrocytes are present. Extending for a short distance 

 each way from this, situated deep in the submucosa, there is a thin layer 

 of extravasated blood. 



The lesions in the small intestine in this case can with a very great 

 degree of probability be ascribed to the hookworms, while the lesions of 

 the large intestine are those of bacillary dysentery. 



OXYURIS 



The incidence (1 per cent) of Oxyuris has been so small and 

 its presence is of so little pathologic importance that no further 

 comment will be made upon it. It is possible that it may have 

 been overlooked in a number of our cases. 



ENTAMCEBA 



Our figures on the incidence of Entamoeba (5 per cent) refer 

 only to those cases in which there was a recognizable amoebic 

 colitis. Routine examination of the faeces at autopsy has not 

 been performed. Musgrave and Clegg(7) found 26 per cent 

 of 587 individuals harboring amoeba, from an examination of 

 the faeces, and Garrison (i) found 23 per cent in 4,106 prisoners. 

 These authors did not differentiate between pathogenic and 

 nonpathogenic amoebae, and according to Walker (15) individuals 

 may harbor amoebae without suffering from amoebic colitis. 



