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XLIV] practically innocuous, is now held to be the cause of a serious disease of the liver, which may terminate fatally; indeed there can be no doubt of this when one considers that in some of the cases recorded several thousand parasites were present. However, we should not forget possible confusion with another grave distomiasis of Japan and other Eastern countries, due to Schistosomum japonicum.

When the infection is severe the liver becomes



enlarged, and chronic diarrhœa, with recurring attacks of jaundice, sets in. Later, anasarca appears, and gradually a cachexia, resembling that of sheep-rot, is established, which, in the course of several years, may prove fatal.

It would be well to bear this parasite in mind in approaching the diagnosis of obscure hepatic disease associated with diarrhœa and jaundice in patients from the East. The discovery of the ova (Fig. 165) in the stools should guide to a correct diagnosis.