ROUNDWORM ASCARIS LUMBRICOIDES—SCHWARTZ 475 
MIGRATION OF ASCARIS LARVAE IN MAN 
The most conclusive proof of the migration of Ascaris larvae in the 
human host was furnished by Koino (10) in Japan in 1922. Koino 
was familiar with Stewart’s investigations and with those of one of 
his own countrymen, Yoshida (27), who, in 1919, had confirmed 
Stewart’s work on the migration of Ascaris larvae in rodents, and in- 
fected himself by swallowing some of these larvae that had gotten 
as far as the lungs. After experimenting with rats and mice, Koino 
became interested in determining whether the symptomatology as- 
sociated with the hepatic-pulmonary migration of Ascaris larvae in 
man would be similar to that. which he had seen in rodents. He 
therefore subjected himself, and his younger brother, aged 21, to an 
experimental inoculation with Ascaris eggs. It was a fortunate coin- 
cidence that he fed the embryonated eggs of the pig Ascaris to his 
brother, and that he swallowed the eggs of the human Ascaris. The 
results he obtained supplied much-needed information on the biologi- 
cal difference of the worms from the two hosts. 
Koino inoculated his brother with 500 pig Ascaris eggs. This was 
followed by a slight rise in his body temperature by the third day; 
from then to the eighth day his brother’s temperature was subnormal] 
in the morning and normal or somewhat elevated in the evening. By 
the ninth day it had risen to 39° C. (102° F.); the fever continued 
during the next 3 days and then the temperature came down to nor- 
mal. Along with the fever the patient developed a cough, which 
gradually increased in severity, and he brought up a watery, non- 
sanguineous mucus. He also experienced pains in the chest and had 
rales all over the chest. Eight days after their onset, the symptoms 
disappeared and the patient recovered. No evidence of liver involve- 
ment was discovered by physical examination. No larvae were found 
in his sputum. 
Koino himself swallowed 2,000 human Ascaris eggs in order, as he 
stated, to ascertain whether the symptoms observed in his brother 
were actually caused by the migration of the parasites. Like his 
brother, Koino developed a slight fever on the third day and reached 
a temperature of 39.8° C. (103.6° F.) the next day. By the ninth day 
after the onset of fever his temperature had returned to normal but 
had attained 40.2° C. (105.3° F.) before it began to subside. Along 
with the fever he had chills, a severe headache, and increased respira- 
tion and pulse rates, and on the fifth and sixth days after the onset 
of symptoms he experienced very severe respiratory difficulty, and 
his face became cyanotic. The number of respirations reached 56 
to 58 per minute, then began to decrease along with the lowering of 
the temperature. By the 9th day the respiration rate was down to 
24 per minute, and by the 16th day it was normal. His pulse rate 
