63 
Incision of the dark or ochre-coloured nodules shows various sized 
cavities containing- immature adult oesophagostomes; the dark 
contents appear to be simply degenerated blood cells. The ochre- 
coloured cysts contain degenerated erythrocytes, and pus cells with 
many bacteria ; the spots in the walls of the cysts are patches of 
necrosis or calcareous deposits (Plate II, fig. i). Here, again, each 
cyst contains only one worm. The majority of these cysts appear to 
have originated in the subperitoneal fascia and to have spread into 
the external muscular layer. The peritoneal covering is enormously 
thickened by very old and tough adhesions which are difficult to strip 
off without rupturing some cysts. 
Appendix vertniformis (Plate II, figs, i and 2). 
The appendix at its junction with the caecum is surrounded on two 
sides, by a firm, dark-bluish tumour mass which so distorts its orifice 
as to make it almost impossible to pass a probe through the lumen into 
the caecal cavity. On opening up the canal the tumour mass is found 
to consist of a series of five cystic subperitoneal tumours, involving 
the wall of the caecum, and of a couple of large submucosal cysts 
which have invaded the neighbouring plica sigmoidea, with consequent 
bulging of the mucosa. The wall of the caecum at the junction is 
thickened and honeycombed with the five small subperitoneal cysts, 
each containing a worm. 
About 1 cm. from the tip of the appendix is a bean-shaped nodule, 
8 mm. by 10 mm., which is growing from the subperitoneal fascia 
of the wall. It does not involve the lumen. Microscopic 
examination reveals two small cysts, which are situated near the 
large one but are developed in the submucosa. 
ASCENDING COLON 
Exterior. 
The walls of the ascending colon for its whole length are covered 
with thickened adhesions containing enlarged glands, fat and omental 
tissue. On attempting to strip the walls of these masses, many small, 
dark-coloured, cystic tumours are ruptured and small worms disclosed. 
So numerous are the tumours that it is impossible to remove the 
adhesions completely without spoiling the specimen. 
