IRRITATION DUE TO INTESTINAL WORMS. 141 



certain resemblance to elephantiasis, and have been often regarded 

 as such. 1 



Under such circumstances, it is not surprising to learn that worms 

 by their movements frequently cause disturbance, and often very 

 serious disturbance, in the intestine and other viscera. They excite 

 irritation, which in delicate lining membranes naturally leads to 

 catarrhal and inflammatory states proportionate in intensity to the 

 number and activity of the parasites. 



A striking proof of the correctness of this statement is furnished 

 by the Trichince, which immediately after their introduction give rise 

 to a series of pathological phenomena in the intestine, 2 which, in 

 cases where the parasite is abundant, are so intense that the patient 

 sometimes appears as if attacked by cholera. In rabbits and other 

 small animals death not unfrequently supervenes at this stage. On 

 dissection the intestine is seen to be strongly injected, and the mucous 

 membrane is covered by a thick layer of dead epithelial cells, forming, 

 as it were, a false membrane. In the same way it has been found 

 that the so-called " Cochin-China diarrhoea " (which we had the first 

 opportunity of stiidying closely only a few years ago, through the 

 French soldiers who suffered from it) is determined by a small parasitic 

 thread- worm (Anguillula intestinalis), and its Ehabditiform embryos, 

 which in incredible numbers infest the intestine throughout its whole 

 length, from the stomach downwards, and even fill the ducts of the 

 associated glands. Many thousands of these worms are voided at 

 each stool, while the Trichince, on the contrary, which live between 

 the villi, are but rarely expelled. The voided worms are, however, 

 continuously replaced, and hence a state of anaemia soon ensues ; and 

 it is this which, in spite of the continual diarrhoea, keeps the intes- 

 tine from exhibiting signs of congestion. One of the common thread- 

 worms, the so-called " maw- worm " (Oxyuris vermicularis), also occurs 

 sometimes in great numbers, and then it not unfrequently happens 

 that mucus and even bloody diarrhcetic stools result. 



Nor do thread-worms only occasion such intestinal phenomena 

 when they occur in great numbers, but tape-worms may do so likewise. 

 In proof of this assertion, I may refer to the fact that the intestine of 

 the dog, so generally infested by Tcenia ecliinococcus or T. cucumerina, 

 exhibits, as far as the worms extend, a loosened and reddened mucous 



1 Here we might also cite the case of Stephanurus dentatus ( = Sclerostomum pinguicola), 

 which occurs very abundantly in swine in North America and Australia. It inhabits the 

 fatty masses near the kidneys, and riddles them in all directions, producing cavities filled 

 with pus (see p. 46). The affected swine suffer pretty constantly from paraplegia. 



2 The existence of these intestinal affections was for a while emphatically disputed by 

 Virchow, Knoch, Zenker, and others, until the epidemics at Hettstadt, and especially 

 at Htdersleben, established my observations beyond cavil. 



