. Fig. 131.—Echinococcus bladder worm or hydatid. visceral lesion, but as they call for a complete examination, the prac- titioner is almost forced to a certain conclusion by the fact that the examination remains negative except in re- gard to the liver. The liver seems large and sensitive, and may sometimes be considerably hypertrophied, for cases have been seen in the ox where the normal weight of 10 to 12 lbs. has been increased to 60 or even 100 lbs., while in the pig, whose liver normally weighs 4 lbs., the weight has been as high as 20 or 40 lbs. In such cases percussion and pal- pation
. Fig. 131.—Echinococcus bladder worm or hydatid. visceral lesion, but as they call for a complete examination, the prac- titioner is almost forced to a certain conclusion by the fact that the examination remains negative except in re- gard to the liver. The liver seems large and sensitive, and may sometimes be considerably hypertrophied, for cases have been seen in the ox where the normal weight of 10 to 12 lbs. has been increased to 60 or even 100 lbs., while in the pig, whose liver normally weighs 4 lbs., the weight has been as high as 20 or 40 lbs. In such cases percussion and pal- pation show that the liver extends beyond the right hypochondriac region and invades a large portion of the corresponding flank. But such great enlargement is exceptional, and when only a dozen vesicles are present, al- though the functions of the liver may be seriously disturbed, the information obtained by physical examination is seldom sufficient to justify an exact diagnosis. The liver is found to be enlarged and thickened; otherwise the examination gives negative results. The diarrhoea may result from failure of the liver to secrete sufficient bile to destroy intestinal toxins, or to carry on its gij^cogenic function; but it may possibly be the direct result of chronic intoxication by the contents of the vesicles. Experience has shown, in fact, that in man, when a superficial vesicle becomes ruptured, the peritoneal cavity is flooded with the contents of the cyst; the daughter cysts adhere to the peritoneum, and that almost invari- ably vascular disturbance occurs, accompanied by itching of the skin and an eruption resembling that of urticaria. The liquid of the vesicles contains an active tox- albumin. Diagnosis. In certain cases, diagnosis is possible, and even easy, but in others it is extremely difficult and almost impossible. Prognosis. The prognosis is always grave, for if the lesions in the liver do not produce death, as usually happens, they so profoundly affect the ani
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