BY A. JEFFERIS TURNER, M.D. 101 



and that is, that it possesses a mouth furnished with horny 

 teeth. With these it chngs to the mucous membrane of the 

 human intestine, sucking the blood of its host into a thick 

 muscular- walled pharynx. The quantity of blood extracted by 

 one worm is insignificant, but that taken by hundreds or thou- 

 sands of worms during the course of months and years becomes 

 very considerable. Under normal conditions the worm never 

 leaves its habitat in the bowel, but once there remains estab- 

 lished for many years at least. The female worms discharge an 

 enormous number of minute eggs. These pass from the body 

 of the host by millions ; and can be detected by microscopical 

 examination ; thus making the recognition of the presence 

 of the parasite an easy matter. 



The symptoms manifested by infected individuals are those 

 of gradually progressive anaemia, or want of blood, varying in 

 degree according to the number of parasites present. There is 

 gradually increasing pallor of the face and lips, with gradually 

 increasing weakness, and, in some cases, abdominal pain and 

 digestive disturbance. Usually, except in extreme cases, the 

 patient remains well nourished. This condition of pallor and 

 weakness may last for years without increasing. In other cases 

 the anaemia may progress so far as to be directly fatal ; or, more 

 commonly, the already weakened patient is carried off by some 

 intercurrent ailment. In children, who so far have been the 

 most frequent sufferers noted in Queensland, there is one symp- 

 tom sometimes but not always present, which cannot fail to 

 attract attention. This is a morbid propensity for eatmg earth, 

 or indeed any kind of dirt. Earth-eating may occur in children 

 who are quite free from cmchi/lostoma, but it is of special im- 

 portance, as we shall see, as exposing them to the risk of 

 continually increasing infection, if they happen to reside in an 

 infested district. 



What now is the life-history of this parasite, and how does 

 it come to attack human beings ? Our knowledge of its life- 

 history is not yet quite complete, but this much may be taken 

 as fairly certain : Firstly, that the worm does not multiply in 

 the intestine, but that every individual found there has been 

 taken through the mouth from without. Secondly, that the 

 eggs, which are discharged in such myriads, have been observed 

 to develop in damp earth into minute larval worms ; and these, 



