324 INFECTIOUS ENTERO-HEPATITIS 
“Turkey No. 14.—About 5 months old. Taken from a flock August 8 because of 
lack of strength to keep up with the rest when driven. Indications of diarrhoea. 
Placed in a coop, where it died during the night. Examined next morning. 
“Slight odor of decomposition. A few small warts on skin of neck. The various 
organs were found normal, with the following exceptions: 
“Mucosa of duodenum almost blackish, from intense injection and pigmentation of 
villi. 
“Both ceca diseased. The left is slightly distended. On serous aspect two yellow- 
ish spots, with markedly injected borders, corresponding to thickenings of the walls 
near the blind end of tube. The mucous surface of one is smooth; to the other an 
exudate is attached. Besides the thickening of these spots, the free half of this cecum 
is somewhat thickened uniformly. 
“The right cecum is very much distended over two-thirds of its length. From the 
serous surface local thickenings are recognizable, which have a yellowish, mottled 
appearance. The small intestine is firmly attached to one of these. ~The disease has, 
however, not invaded the wall of the latter. The border of these spots is intensely 
hyperemic. When the cecum is slit open its width is three to four times that of the 
undisturbed tube, and the thickness of the wall varies from one-eighth to one-half of an 
inch, being not less than one-eighth of an inch over three-fourths of the entire length. 
When the brownish feces were washed away the increased local thickenings were 
found covered with firm exudates, usually attached in but one spot. 
“Sections were examined of that portion of the caecal walls which was very much 
thickened, and to which the contiguous small intestine was inseparably attached by the 
new growth. 
“The mucosa of the cecal portion had sloughed away, while that of the imbedded 
small intestine was intact. The neoplastic tissue between cecum and intestine was 
fully 1 cm. (two-fifths inch) thick. Inasmuch as the infiltration probably followed the 
narrow mesentery between cecum and intestine the original boundary lines of the cecal 
wall are no longer recognizable. The muscular coat of the cecum may be traced for 
only a short distance into the neoplasm, when it appears. Microparasites were not seen 
distinctly in the diseased tissue. 
“The liver is very much enlarged, and dotted everywhere with roundish spots of 
varying appearance. The majority are from 5 to 12 mm. in diameter, round or 
slightly oval. The center of each is usually oceupied by a group of yellowish dots and 
the circle is bounded by a narrow yellowish ring. The space of the circle is mottled 
brownish. Among these spots there are also circles of a completely yellowish color. 
On the convex surface of the left lobe there is a very firm, ring-like, yellowish mass, 
cutting like firm cheese. 
“In crushed preparations of fresh liver tissue from within the brownish circles many 
giant cells are seen. They consist of a meshwork of protoplasm of a rather coarsely 
granular character inclosing spheres which appear homogeneous. The giant cells are 
up to 30 in diameter. 
“Sections of liver tissue hardened !m alcohol and in Foa’s solution were also examined. 
The foci of disease contain necrotic areas in which are numerous giant cells each inclos- 
ing a number of micro-parasites. In some portions there is much cell infiltration in the 
interlobular tissue around the portal vessels. Among the cells the protozoa are recog- 
nizable.” 
