110 
“ Kidiievs ; Eight weighs 175 grams. Section pale, cortical markings not well . 
seen; relation between cortex and medulla is normal; capsule strips readily; pelvis, 
is normal. Left kidney weighs 135 grams. Answers to the description of its fellow. 
“L'reters, bladder, testicles, and adrenals present no abnormal appearances. . 
“Liver ; Extends 4 cm. below costal arch; capsule smooth and glistening — presents 
yellowish mottled appearance. Cut surface mottled yellow and red, lobules well 
seen. Liver cuts with decreased resistance. "Weighs 1,600 grams. Bile ducts pat- ; 
ent, bile dark brown, no concretions. Pancreas shows no changes. 
“ Stomach: Of normal size, externally is normal; mucosa is covered with much 
grayish-yellow mucus; no parasites. i 
‘ ‘ Small intestines : External appearance normal. Intestines contain a very large | 
amount of very tenacious mucus. In the duodenum was found one hook worm. 
One hundred and fifty were found in the jejunum and upper part of ileum, being ! 
most numerous in the upper and middle jejunum. None found in last 18 inches of j 
ileum. They were very adherent, and were in the proportion of about four females i 
to one male. At point of attachment of some of the parasites was found a small I 
ecchymotic spot, and scattered along the rest of the mucosa a few other ecchymotic I 
spots were seen — possibly points of previous attachment. The mucus in places was | 
blood-stained. Mesenteric glands were enlarged and of a pinkish color. Appendix | 
lies in false pelvis to the outside of psoas muscle and behind cecum — bound down : 
by fibrous adhesions and curled at its tip. | 
“Spinal cord shows no microscopic changes. | 
“ Bone marrow removed from femur. Marrow is yellow and very fatty. At two f 
.points it had a reddish color, but was even here practically all fat. f 
Anatomic diagnosis: I. Uncinaria duodenalis ot small intestine. 2. Ecchymosis of | 
intestinal mucosa, and hemorrhage into intestinal lumen. 3. General anemia and 
edema of dependent portions of body. 4. Bilateral hydrothorax. 5. Hydroperi- 
cardium. 6. Edema of lungs and caseous tuberculosis of lower left lobe. 7. Slight 
atheroma of aorta. 8. Fatty degeneration of heart and liver. 9. Aberrant corda 
tendina. 10. Passive congestion and fatty degeneration of liver. 11. Chronic inter- 
stitial splenitis.” 
AVesterx States. 
'vrT<i<ir»T’'T?T '' 
St. Louis, 1893___ ^ 1 case. 0 death. ^ 
Blickhahx’s (1893a) case; probably imported from Germany and caused by Agchy- 
lostorna duodenale. See Stiles (1902 b, p. 208). j 
St. Louis, 1901 1 case, 0 death. ; 
Dyek’s (1901) case. See Stiles (1902 b, 213). ^ 
CALIFORXIA. 
San Francisco, 1902 2 cases, 0 death. 
\ 
Letters from Drs. G. H. EvAxsand Mary Haltox, 1902: Two soldiers who returned 
from the Philippines. Through the kindness of the observers I was able to exam- 
ine specimens from one of these cases, and to convince myself that they belonged 
to the American species. The previous history of the patient was not obtained. 
San Francisco, 1903 2 cases, 0 death, d 
Beowx (1903, p. 107) : Three patients infected with 2 of these (natives j 
of Porto Rico) were also infected with Uncinaria. - | 
? Locality 3 cases, 0 death. 
L. Miffitt’s (cases cited by Capps, 1903a). Two cases from Mexico, one from the 
Philippines. Diagnosis by ova. 
