PARASITIC DISEASES OF THE LIVER. 



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no fever, and the appetite, as also the lacteal secretion, is kept up 

 for a long time. The opening of a cyst in the pectoral cavity may 

 lead to a fatal pleurisy. 



3. Echinococcus cysts in the heart sometimes produce apoplecti- 

 form death through their rupture (Harms, Haussmann, Eivolta, 

 and others). 



4. Echinococcus in the muscles produces, as a rule, lameness; 

 Johne has found a cyst in the psoas of the horse. 



Prog-nosis. The prognosis is grave when one important organ 

 contains a large number of these cysts ; in such a case they may 

 produce death. The presence of only one in the heart is a very 

 dangerous lesion. It is possible that these cysts become calcified or 

 caseated, and it has been seen that the presence of numerous hydatids 

 in the lung and the liver is perfectly compatible with all the appear- 

 ances of health. Nevertheless, when we succeed in establishing a 

 certain or nearly conclusive diagnosis, the most advisable proced- 

 ure, and the most practical, will be the slaughtering of the animal. 



Dififerential diagnosis. The increase in the size of the liver 

 shown by an abnormal dulness, the sensitive condition of the 

 right hypochondrium, and the finding of hepatic embossments by 

 means of rectal exploration, are symptoms sufficient to establish 

 the diagnosis. In taking only the first two into account, we may 

 confound echinococcosis of the liver with the condition of gestation, 

 or of hydrometria, pyometria, uterine and ovarian tumors, abdom- 

 . inal gestation, etc.; but these various morbid conditions are easily 

 recognized by rectal exploration. Concerning ascites, the signs 

 obtained by percussion, and the modifications which take place in 

 the local symptoms by the single fact of dorsal decubitus, charac- 

 terize it sufficiently. The differential diagnosis from cancerous 

 tumors of the liver or a considerably developed hydronephrosis is 

 more embarrassing ; these affections, however, are rare. 



Echinococcosis of the lung must be differentiated from tubercu- 

 losis. According to Harms, the diagnostic symptoms would be 

 the following: 1. In echinococcosis the cough is often absent, or 

 is very slight, while in tuberculosis it is never wanting and is 

 usually severe. 2. The gurgling noise is pathognomonic of the 

 presence of the echinococcus in the lung. 3. In echinococcosis the 

 respiration is more frequent, more painful ; the dyspnœa increases 

 rapidly ; it is not in proportion to the general condition of the sub- 

 jects, which is often excellent. 4. The friction bruits are always 



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