T. Bentham 81 
Autopsy : Liver small and shrunken, covered all over with small excrescent thickened 
areas, lighter in colour than the normal liver tissue. There was a large primary carcinoma 
present the size of an orange. The gall-bladder was full of Clonorchis sinensis, and on making 
a small cut into any part of the surface of the liver, two or three flukes emerged. It was 
calculated that there were about 5000 of these organisms in the liver tissue alone. The 
pancreas contained a few flukes and its surrounding mesenteric glands were much enlarged. 
T e ^ u ^ es whlch were tak en from the gall-bladder were green in colour and contained no 
blood, but those from the liver were full of blood and fleshy in colour. They measured 
14-21 mm. in length by 4-5 mm. in breadth. A large number of the parasites were examined 
with a view to finding out whether there was also an infection with Opisthorchis felineus, but 
all the worms were found to be Clonorchis sinensis. Sections of liver tissue showed carcino¬ 
matous thickening of the burrows in which the worms lived, surrounded by a small amount 
of normal liver tissue. Numerous eggs of this fluke were found in the burrows and in spaces 
in the new tissue. Unfortunately, only a small piece of the liver was kept, but a fair number 
of flukes were preserved, some of which are now in the Wellcome Bureau, London. 
It is to be noted that a large number of these cases suffering from Helmin¬ 
thiasis showed an appreciable eosinophilia but rarely—especially patients who 
had an Ankylostoma infection. It is true that a large number of the men were 
not very heavily infected, but this blood condition was not evident in the 
Chinese mentioned above, nor was it noticeable in the Burmese soldier with 
the large Ascaris infection. 
The variation of an eosinophil count is well shown by the following table 
compiled from films made on successive days from the patient, infected 
with Strongyloides stercoralis , already described as a member of Group I 
(p. 73). 1 
Polymorphs 
Large 
Date 
Lymphocytes 
mononuclears 
Eosinophils 
o/ 
/o 
o/ 
/o 
o/ 
/o 
O' 
/O 
14. xii. 17 
37-5 
30 
3 
29-5 
15. xii. 17 
30-3 
28-7 
26-7 
14-3 
16. xii. 17 
42-5 
37-5 
6-5 
13-5 
17. xii. 17 
40-7 
18-3 
37-7 
8-3 
18. xii. 17 
51 -6 
24-6 
11-3 
12-5 
19. xii. 17 
41-9 
12-7 
28 
17-4 
20. xii. 17 
56-7 
19-8 
7-5 
16 
21. xii. 17 
52 1 
19 
12-5 
16-4 
29. xii. 17 
26 
20 
43 
11 
10. i. 18 
31-9 
12-4 
50-7 
5 
13. ii. 18 
59 
20 
8 
13 
In this series of counts there seems to have been a drop in the number of 
eosinophils after two doses of calomel on 14 and 15. xii. 17, but the count 
appreciably rises again until thymol was given on 29. xii. 17. It dropped to 
only 5 per cent. 11 days after this treatment. The other methods of treatment 
tried during the period from 5. i. 18 to 11. ii. 18—when treatment was stopped 
—have already been noted on p. 74. During the whole of this time embryos 
of Strongyloides were as numerous as on the first examinations. 
Parasitology xii 
