NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
SCHISTOSOMA SPINDALIS, MONTGOMERY, 1906 & SCHISTOSOMA NASALIS, N. SP. 11
one on each side, between the secretory glands and the cuticle. About the middle
of each main canal, a short length of the wall, which appears to be rigid contains
two patches of cilia. Each of the main canals, after reaching the level of the ven-
tral sucker, bifurcates into two tributary canals, one of which proceeds anteriorly
and the other posteriorly. The anterior one passes forwards and near the anterior
third of the body it bifurcates again into two fine collecting tubules each ending in
a flame cell, one cell being near the middle of the body and the other just behind the
penetrating organ. The posterior tributary canal proceeds backwards, parallel to
the main canal, and at about the level of the bladder bifurcates into two fine collect-
ing tubules. One of these fine tubules is short and ends in a flame cell near the
bladder, and the other fine tube passes into the tail stem and ends in a flame cell.
The flame cell formula can be summarised as follows:—
2×[2+1+(1)]=6(+2).
Thus it is seen that this cercaria has three pairs of flame cells in its body and one
pair in the tail stem.
The caudal excretory canal arises at the posterior opening of the bladder, the
so-called " eyelet" aperture, and passing along the whole length of the tail stem, it
bifurcates into the rami and ultimately each opens into a funnel shaped excretory
pore situated at the end of each furcal ramus.
The cercaria conforms to the description of Cercariae Indicae XXX Sewell, 1922
and it is concluded that both are identical. (Text-fig. 3).
FIG. 3. Cercariae Indicae XXX. (After Sewell.)
The cercaria of S. spindalis, which has been described by Soparkar [1921], is
bigger in size than the one described above and the most important difference is
that this cercaria has four pairs of flame cells in its body and one pair in the tail
stem. Its flame cell formula can be represented thus :—
2×[2+2+(1)]=8(+2).
12 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
The comparison of the flame cell formulae of both at once suggests that the
cercaria of S. spindalis and that of the nasal schistosome are two different entities
and naturally the adults that develop from these two should also be different. It
is interesting to note that Sewell [1930] in his classification of the Apharyngeal
Brevifurcate Distome Cercariae, places Cercariae Indicae XXX in his Group I,
along with S. haematobium, S. japonicum and S. mansoni, in which the cercariae
have three pairs of flame cells in the body and one pair in the tail. In his Group II,
which shows the first step in evolution in the flame cell pattern, he places the
cercariae of S. spindalis in which the posterior flame cell in the body is an additional
one. Hence there are four pairs of flame cells in the body and one pair in the tail
in this group of cercariae.
The author infected over 40 clean Limnea leuteola (Lamarck) and Planorbis
exustus (Deshayes) with miracidia of nasal schistosomes from experimental calves in
April 1933. The mortality in among those snails was high and only about six
Limnea and 14 Planorbis survived at the end of seven weeks and of these two
Limnea and one Planorbis were found to discharge Cercariae Indicae XXX. This is
another piece of confirmatory evidence in the life-history of the Nasal Schistosome.
A section of the digestive gland of one of the infected snails is seen in P1. I,
fig. 4.
EXPERIMENTAL INFECTION AND INCUBATION PERIOD.
The cercariae chosen for infection were concentrated and enumerated according
to the method adopted by Fairley and Mackie [1930]. Of the three calves selected
for infection, calf No. 410 was drenched with 60,000 cercariae, calf No. 411 was
infected through the mucous membrane of the nose with 60,000 cercariae, and the
third. No. 409, was infected with 15,000 cercariae through the nasal mucous mem-
brane and 30,000 cercariae by drenching. Rao [ 1933 ] has already published a
preliminary report on this experimental infection and it is enough to say here that the
calf No. 411 showed typical ova and live miracidia in its nasal discharge in 84 days
after the first date of infection, calf No. 409 showed them in 88 days and calf
No. 410 took 100 days to show them in its nasal discharge. Hence the period of
incubation appears to be about three months. This finding in experimental calves
agrees with what Rao [1932 ] said after analysing the histories of naturally infected
animals in Nammiandal village near Tiruvannamalai. It is seen that the calf
drenched with cercariae took a longer time to develop the disease and at the same
time the attack was a mild one. The other two calves, on the other hand, showed
severe symptoms of the disease though calf No. 409 got a smaller dose.
In another set of experiments two calves were infected with large numbers of
cercariae of S. spindalis. One calf No. 458 was infected only through the nasal
SCHISTOSOMA SPINDALIS,
MONTGOMERY, 1906 & SCHISTOSOMA
NASALIS,
N. SP.
13
mucous membrane and another calf No. 459 was infected by drenching alone. In
these two calves, the former showed plenty of ova in its dysenteric motions on the
46th day after the first date of infection and the latter showed a few ova on the
76th day. This experiment also indicates that the calf drenched with cercariae took
a longer time to show the infection. It would appear from this that calves infected
by drenching get a less intensive infection than those infected through a mucous
membrane. It suggests, therefore, that the cercariae poured into the rumen get.
mixed up with the ingesta and most of them die there and only a few that come
in close contact with the mucous membrane burrow through and get the chance to
complete their development. Fairley and Jesudasan [ 1930 ] infected two goats
by applying cercariae of S. spindalis to the tongue and mucous membrane of the
mouth, while in another goat they poured the cercariae into the rumen through
a stomach tube. They found, on post-mortem examination, a larger number of
schistosomes in the goats infected through the mucous membrane, than in the one
infected through the stomach. The authors themselves appear to be doubtful about
the cercarial invasion, in situ, in the rumen and say that only those cercariae that
happened to be regurgitated into the gullet and the mouth apparently completed
their development into adults. The findings of the author in his experimental
calves confirm this.
Therefore in nature, cattle, unlike buffaloes, apparently get infected through
the mucous membrane of the mouth and gullet and possibly through the skin of
the legs when they drink or wade through cercarial infected water. Presuming that
the natural infection is by ingestion, it would appear that continued infection daily
over a considerable period is required, to produce such a degree of infection as could
be detected clinically.
EARLY SYMPTOMS IN EXPERIMENTAL CALVES INFECTE
INDICAE XXX.
The first symptom seen in these calves was a redness of the nasal mucous
membrane, coryza and sneezing. These symptoms appeared in exactly six weeks
after infection. About ten days later the mucous discharge increased and simul-
taneously the mucous membrane became oedematous, which caused the narrowness
of the nasal calibre, giving rise to a peculiar blowing sound during respiration.
About eleven weeks after infection, there appeared on the oedematous mucous mem-
brane, raised patches studded over with tiny abscesses shotty to the touch. The
contents of these abscesses showed typical ova of nasal Schistosomes. At this stage
the nasal discharge became thickened and appeared more or less mucopurulent and
later became rusty and showed streaks of blood. One interesting feature observed
in calf No. 411 was a relief in symptoms of distressed breathing periodically. The
14 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
distressed breathing synchronised with the appearance of the raised patches with
the shotty abscesses on its surface and when these abscesses burst, the patches
seemed to subside somewhat and the breathing became less noisy. This confirms
Malkani's [ 1933 ] observations, apparently in advanced cases, in which the growths
are said to undergo disintegration and get sneezed out leaving a raw surface and
when this occurred the animal was temporarily relieved of the distressed breathing
till the lesions increased in size again. In the experimental calves Nos. 409 and
411, the breathing became so difficult, during certain periods, as to interfere with
feeding and rumination, with the result that they fell off condition. Experimental
calf No. 410, which was infected by drenching with cercariae showed only a few
discrete abscesses on slightly tumified mucous membrane, and beyond slight
blowing during respiration, did not " snore " while breathing as the other two
calves did. A sagittal section of the nasal chambers of this calf is shown in P1. II,
fig.l.
POST-MORTEM FINDINGS.
Calves Nos. 409 and 410 were destroyed, but calf No. 411 died after an injec-
tion of Tartar Emetic. Sagittal section of the heads of these calves were examined.
Raised patches with abscesses and ulcers were found mostly in the vestibule of the
nasal fossae, on the lower half of the turbinated bones and on the walls adjoining.
In calf No. 411, a few discrete abscesses were also found high up on the turbinated
bones. In all these cases, the veins on the floor of the nasal cavity and on the
dorsal, ventral and alar folds of the nasal mucous membrane, looked corded and
prominent. This is of some significance, because, these branches of the Spheno-
palatine vein seem to form plexuses in those places and in them were found a large
number of schistosomes. When the epithelium of this part of the mucous mem-
brane was stripped, the schistosomes in the veins underneath were made visible and
collected with ease. In fact from calf No 409, in about an inch and a half square
of the mucous membrane from these regions, over 40 pairs and 10 single schistosomes
were collected. It has been possible to collect over 300 schistosomes from portions
of nasal lesions of the three experimental calves.
From the situation of the nasal lesions, in the early cases, it would appear that
the lesions begin in the folds of the mucous membrane referred to and the floor of
the nose just below the turbinated bones and from here they extend superiorly up
to the lower part of the olfactary region as the cases became chronic.
Soon after the calves were destroyed, the schistosomes were collected and they
were all alive. It was therefore possible to study them alive and also to note any
variation in their lengths caused by different methods of fixing, etc.
PLATE II.
1. Section of head ; calf 410 showing lesions.
2. Note the proximity of Worms to the surface. Note the number of veins.
3. Submucosa contains large veins, some big enough for three pairs.
PLATE III.
1. Note the abscess raising of epithelium and giant cells in places.
Note organised clot in one vein marked.
2. Note the ulcer reaching the vein containing worms.
3. Proliferation of the epithelium into the tissue.
4. Oram of S. nasalis.
Note the bubbles inside the horns of the ovum.
SCHISTOSOMA SPINDALIS, MONTGOMERY, 1906 & SCHISTOSOMA NASALIS, N. SP. 15
The mucous membrane of the maxillary and frontal sinuses was found to be in
a state of inflammation in patches but the scrapings of these failed to show any ova of
schistosomes.
In calf No. 411 which died 38 hours after an injection of 5 grains of antimony
Tartaratum in 20 c.c. of water, an interesting and what appears to be an important
finding, was a large number of nasal schistosomes in the clot of blood in the right
heart, pulmonary artery and its branches. This calf died suddenly, apparently of
heart failure, due to the dead schistosomes finding their way in large numbers into
the jugular vein and then to the heart and blocking the branches of the pulmonary
artery. Apparently the death of the calf was not due to the toxic action of the drug,
5 grains to 200 lbs. of body weight. From a portion of the nasal lesions of this calf
over 100 dead worms, mostly males, were collected. The lesions in the nose in this
calf were much more pronounced than in the other two.
From the portal veins of calf No. 409, 416 male and 16 female S. spindalis were
collected and form the mesenteric veins 60 males and 15 females were obtained.
Calf No. 411 contained only a dozen pairs of S. spindalis in its mesenteric veins and
5 male worms in the portal vein. Calf No. 410 yielded only four males from its
portal vein and 50 pairs from the mesenteric veins.
SOME OBSERVATIONS ON HISTOPATHOLOGY.
Sections of the mucous membrane from various parts of the nasal fossæ were cut
and examined. It appeared from these that the important portions concerned are
the turbinate folds of the mucous membrane, viz., the dorsal and ventral turbinate
folds and the alar fold. In addition to these the mucous membrane of the lower
parts of the turbinate bones and the lower parts of the nasal septum were also found
involved. The mucous membrane of the vestibule has a covering of stratified
squamous epithelium and the rest of the region above is covered over with pseudo¬
stratified ciliated epithelium. The underlying mucosa contains a line of tubulo
alveolar glands having mucous and serous alveoli and in between these glands there
are many small capillaries. Below the line of these mucous glands, the sub-mucosa
shows, particularly in these turbinate folds, a rich venous plexus, simulating
cavernous tissue having several strata of freely anastomosing veins. Sections from
an early case of nasal schistosomiasis show in these areas, numerous schistosomes
inside almost all the veins adjoining the line of mucous glands. [ Figs. 2 & 3,
Plate II & Fig. 2, Plate III.) It is seen that the ova which are so near the surface
are liberated by way of the miliary abscesses and are thrown out to complete their
biological cycle. Sometimes the ova get into the glands which get destroyed owing to
the abscess formation. These early miliary abscesses just fill the thin strip of
C
16 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
tissue above the plexus and raise the epithelium which ultimately gives way,
allowing the ova to escape. (Fig. 1, Plate III). Hence the time taken by
these abscesses to burst is less in the early phases of the disease and naturally
therefore tissue reaction is also less than in older cases. In these early abscesses
there is evidence of the formation of a few plasmodial giant cells around some ova
and only around these ova there appears to be a very thin layer of " actino-body ".
The presence of typical " actino-body " on the egg shell is apparently found on those
ova which have to migrate from a deeper layer of tissue formed in lesions of some
duration. It is interesting to note here that Hoeppli [1932] remarks, that the
radiating structures observed on the shell of the eggs of S. japonicum, in sections of
tissue, represent the secretion of the lateral glands of the miracidium which becomes
strongly oxyphilic outside the egg shell and the effect of the secretion is probably
one of softening and destruction. The latter portion of his observations confirms
what Rao [1932] said about the formation of the " actino-body ". In sections of
nasal lesions from cases of just over two months duration many typical pseudo-
tubercles with zones of young fibrous tissue of varying thickness are met with.
Since these abscesses are formed repeatedly in the layer of tissue containing the
glands, plenty of granulation tissue is formed and added repeatedly, causing an
increase in thickness of the tissue there and due to uneven contraction of this fibrous
tissue undulations appear on the surface of the mucous membrane. The size of these
undulations depends on the severity of the contractions and the duration of the
disease. The undulations are covered over with the tumified mucous membrane
studded with abscesses, and in long standing cases such undulations represent the
so-called sessile nasal growths.
As regards the blood vessels, they are all in a state of complete or partial
engorgement. The bilharzial toxin present seems to elicit demonstrable cellular
response. There is perivascular infiltration and also intercellular oedema in the
surrounding tissue. Schistosomes are found free in the veins near the line of
mucous glands and even in deeper strata. Some of the veins are almost exposed
after bursting of these abscesses and if, owing to pressure, the vein ruptures there is
haemorrhage and also escape of the worms with the blood. (Fig. 2, Plate III.)
In some veins, clots are found surrounding dead schistosomes apparently undergoing
phagocytosis in situ. The walls of such vessels are in a state of disintegration.
In some veins the blood clots are in a state of organisation with or without
canalisation. In calf No. 410, there appeared to be complete obliteration of the
larger blood vessels and the whole area was a mass of fibrous tissue.
The size of the blood vessels in these folds of mucous membrane and in the base
of the nasal septum is apparently large enough for even two or three pairs of
worms together. (Fig. 3, Plate II.) It appears therefore that the veins in the
SCHISTOSOMA SPINDALIS, MONTGOMERY, 1906 & SCHISTOSOMA NASALIS, N. SP. 17
plexus in those places permit enough expansion for easy lodgment of schistosomes
which enable their full development.
In sections of almost all growths from the nose from animals, even from those
cases of only two months duration, it was always possible to see the epithelium
growing into the tissue especially in places where frequent bursting of abscess leave
behind ulcers. In places it appeared as if the epithelium was infiltrating into the
tissue. This proliferation of epithelium was well seen in the vestibule where the
mucous membrane is covered by stratified squamous epithelium. (PL. III,
Fig. 3.) Some of the mucous glands show increased secretion in their acini and
ducts. In some places the epithelium of the ducts of these glands show prolifera-
tion. In some ducts, ova are occasionally met with acting as so many plugs. The
mucous glands in many places showed degeneration. Fairley and Mackie [1930]
suggest that there is a tendency to hepatic carcinoma in S. spindalis infection and
in the lesions of the nose there appears to be a similar tendency of epithelial
proliferation. Dew [1923] also mentions the epithelial proliferation in the bladder
caused by the frequent escape of schistosome ova.
An interesting feature is that the bilharzial pigment is almost absent in the
lesions of the nose when compared to the quantity present in the lungs of these
cases.
The sections of lungs from calf No. 411 showed that all the blood vessels were
engorged with exudation in the alveoli in some places, causing a picture akin to
venous congestion. The amount of pigment present in the lungs was very great,
and most of it was in the endothelial cells of the capillaries. In some of the
capillaries the pigment was seen in broken chains in the blood. (P1. V, figs. 2 & 3.)
The sections of lungs from calves Nos. 409 and 410 showed evidence of what
looked like worm embolism in the smaller branches of the arteries with the usual
tissue reaction and changes near it. A few pseudo-tubercles were also present.
(P1. V, fig. 4.)
EXPERIMENTAL INFECTION WITH CERCARIAE OF S. SPINDALIS
After the publication of the paper on the identity of the nasal schistosome by
Bhalerao [1932] these experiments were done to find out if S. spindalis produced
nasal schistosomiasis. The finding of S. spindalis in the experimental calves
infected with nasal schistosomiasis was an expected contingency since the snails
collected at Bandarlapalli harboured both the cercariae of S. spindalis and Cercariae
Indicae XXX, the larval nasal schistosomes. Though there appeared to be no
snail showing double infection, yet it was possible to have overlooked a couple of
snails discharging cercariae of S. spindalis which got mixed up with the others.
Two calves were chosen for infection and the cercariae of S. spindalis were obtained
C 2
18 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
from snails collected from Spur Tank, Egmore, a locality which is apparently free
from nasal schistosomiasis. Great care was taken to examine large numbers of
cercariae from each snail before they were utilised for experimental infection.
Calf No. 458 was infected through the nasal mucous membrane and it received a
total of 127,000 cercariae in 14 days and calf No. 459 which was drenched with an
equal dose of cercariae over the same period. It is interesting to note that call
No. 458 passed blood-stained faeces on the 40th day and from the 46th day
onwards its faeces showed a fairly large number of typical ova of S. spindalis.
This animal did not show any lesions nor ova of schistosomes in its nasal discharge
and it was destroyed on the 86th day after infection. If S. spindalis were the
cause of nasal granuloma, with the enormous dose of cercariae of S. spindalis which
this animal received in comparison to the dose of Cercaria Indicae XXX received
by calves Nos. 411 and 409, the calf in question should have developed the lesions
in the nose within the same time as taken by calf No. 411. Calf No. 459 was kept
under observation for 118 days and likewise neither showed any nasal lesions nor
any ova in the nasal discharge as compared with calf No. 410 which did so in
100 days after drenching with a smaller dose of Cercariae Indicae XXX. These
findings are, in the author's opinion, very significant. In calf No. 459 ova of
S. spindalis could be detected in the faeces in small numbers from the 70th day
onwards, and it passed blood stained faeces occasionally.
POST-MORTEM FINDINGS IN CALVES INFECTED WITH S. SPINDALIS.
The nasal cavities in both the calves were examined and no lesions were
present. The scrapings from the nasal mucous membrane did not reveal any ova of
schistosomes. The portal system of calf No. 458 was teeming with S. spindalis.
From this calf over 4,000 worms, including females, were collected and as many
worms perhaps remained uncollected in the smaller radicles of the mesenteric and
the portal veins. In all the females examined, there were a large number of ova in
the uterus of each and each ovum possessed the typical shape obtained for that
species. (PI. I, Fig. 3.)
The worms from the portal vein were all counted and there were 916 single
males and 57 pairs. The percentage of males was about 94.1 and that of the
females 5.9. Of the parasites collected from the mesenteric veins about 96 per
cent. were pairs and 4 per cent. were single males.
From calf No. 459 only one dozen single males and two pairs were collected
from the portal vein and over 250 pairs were removed from the mesenteric veins.
The percentage of males to females in the portal vein was 83.3:16.7 respectively.
Sections of the liver, large and small intestines from these calves, particularly
from calf No. 458 revealed a very large number of pseudo-tubercles and verminous