388 UNIVERSITY OF VIRGINIA PUBLICATIONS 



of the stomach was everywhere smooth and pale. In the upper part of the duodenum 

 were found numerous flat worms, the total length of which amounted to some five 

 or ten meters long. These apparently represented three or four worms which were 

 like the liver worms described previously (fringed tapeworm). Rest of the bowel 

 normal, but contained an excess of sticky mucus. The front teeth were set crooked 

 to the gum, and were loose; mouth and esophagus clear. The mucosa of nasal cavi- 

 ties was injected, slightly ecchymotic and covered with a sticky mucus. The eth- 

 moid and frontal sinuses were clear. 



Kidneys were alike, and appeared normal. Bladder contracted, empty, apparent- 

 ly normal. Internal genitalia apparently normal. Brain and cord presented no 

 abnormality. 



Microscopic report. Heart showed quite a large number of sarco-cysts like those 

 previously described. Most of them were within heart muscle cells. One, however, 

 was found in the space between two groups of muscle bundles. Heart muscle other- 

 wise normal. Lung. The bronchial mucosa stood out clearly and showed no alter- 

 at.ions. The bronchial walls were clear. The lung, everywhere vesicular except for 

 one small focus in which possibly as many as a couple of dozen alveoli were filled with 

 red blood corpuscles. Among the corpuscles and in the alveolar walls were a moderate 

 number of polymorphonuclear leukocytes. It appeared that the chief infiltration with 

 leukocytes was into the alveolar wall. One or two alveoli contained a great excess of 

 desquamated epithelial cells. In one alveolus these cells were packed together, well 

 stained, and almost looked as if they were growing in the alveolus. 



Liver. Section 1 passed through a necrotic region of liver and showed in the 

 margins great irregular proliferation of bile ducts and a large bile duct with papil- 

 lomatous changes in the mucosa together with infiltration of the surrounding tissue by 

 large and small mononuclear cells, eosinophils, and eosinophilic mononucleated cells. 

 Around the dilated duct the necrotic liver tissue exhibited regions in which hem- 

 orrhage was abundant, and many regions where very great fibroblast formation 

 was occurring. The section extended from the liver to the diaphragm. Between 

 the liver and diaphragm was necrotic debris in which was considerable fibrin, many 

 polymorphonuclear leukocytes, fragments of nuclei, and yellowish brown mate- 

 rial apparently disintegrated red blood cells. Many of the polymorphonuclears took 

 a bright acid stain. Granulation tissue was forming from the diaphragm and 

 extending into the exudate between liver and diaphragm. Throughout the sec- 

 tion the replacement of liver tissue by a watery and cellular fibroblastic tissue was 

 marked. In this fibroblastic tissue, atypical bile ducts were abundant. Other sec- 

 tions through liver and diaphragm gave findings practically the same as those de- 

 scribed. In addition there were numerous sarcocysts in the diaphragmatic muscle. 



Spleen apparently normal, pulp very cellular. Pancreas. The cells were large, 

 very much vacuolated, at first sight reminding one of the adrenal. The definite ar- 

 rangement into glands and acini was obscured by the tremendous swelling of the 

 cells. There was, however, no evidence of necrosis, the nuclei for the most part were 

 fairly well preserved although they were rather vesicular with dots of chromatin 

 around the margin, and occasionally they were pyknotic. Kidney. Glomeruli un- 

 altered, moderately full, tubules of cortex very cloudy, pale and vacuolated, frequent- 

 ly showing abundant albumin in the lumen. Adrenal apparently normal, capsule pig- 

 mented; eosinophilic cells were seen between cortical cells. The capsule and periph- 

 eral sinus of the Ijrmph gland were apparently normal, the cortical zone was uniformly 



