Parasites: A Treatise on the Entozoa of Man and Animals: Including Some Account of the EctozoaCobbold, T. Spencer (Thomas Spencer)
Science
Parasites: A Treatise on the Entozoa of Man and Animals: Including Some Account of the Ectozoa
Cobbold, T. Spencer (Thomas Spencer)
Helminths; Parasites
The pathological collection connected with St George’s Hospital
displays several good hydatid preparations, the entire series
representing at least twenty-two separate cases. Of these, fifteen are
referable to the liver, that is, if we include Dr Dickinson’s case,
already published, where hydatids were found within the hepatic duct.
There are two renal cases; also one from the brain (Dr Dickinson’s
case), and another where an hydatid was expectorated. Besides these,
there are three other highly characteristic examples of echinococcus
disease affecting the region of the neck, breast, and axilla
respectively.
The museum of the London Hospital Medical School contains a large
collection of parasites. Out of fifty-seven preparations of entozoa, I
found twenty-two referable to hydatids; and, so far as I could gather,
all of them belonged to different cases. Only one case seems to have
been published in detail. This, though a very old preparation, is a
fine example of an hydatid, nearly three inches in length, occupying
one of the cerebral hemispheres (‘Edinb. Med. Journ.,’ vol. xv). There
is a second brain case, where the vesicles were of small size, but very
numerous. Of the other twenty cases, fourteen belong to the liver, two
to the spleen, one to the lung, one to the uterus; one being a very
large hydatid of doubtful seat, and another being referable to the
lumbar region, where it formed a tumour containing “a large number of
small hydatids.” Amongst the more remarkable specimens is that described
in the MS. catalogue as “a true hydatid cyst developed in connection
with the broad ligament.” This preparation, unique of its kind, shows no
trace of the ovary, which, indeed, seems to have disappeared altogether.
One of the liver cases should rather be classed as abdominal, since the
large cyst is situated between the diaphragm and liver, pressing upon
the latter organ below and also upon the lung above, but apparently not
involving either of these viscera structurally. Another very striking
case is that in which there is an external opening communicating with
the cyst in the liver, and an internal opening through the diaphragm
communicating with the lungs and bronchial tubes. The patient had
actually coughed up liver hydatids by the mouth, and had passed others
through the right wall of his abdomen. There is another liver case in
which the hydatids, in place of escaping externally, had gained access
to the inferior cava; and if I understand the MS. record rightly, in the
same patient a second hydatid communicated with the portal vein, and
a third with the hepatic vein. Lastly, I must add that there is yet
another fine preparation of liver hydatids, occurring in a lad, nineteen
years of age. He had, it seems, met with “a slight accident, and died
with obscure head symptoms;” but the odd part of the case is that at the
post-mortem examination there was positively nothing found that could
explain the patient’s death.
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