SUPPLEMENT 653 



carried out otherwise as a cause of the frequency of perityphlitis. 

 Matignon 1 does not agree with this opinion, as in spite of the extra- 

 ordinary frequency of intestinal worms in China, he has only seen 

 one case of appendicitis in four and a half years, and Des Barres 2 

 expresses himself in similar fashion. Out of twenty-one cases of 

 appendicitis Kirmisson 3 discovered the ova of Trichocephalus eighteen 

 imes and the ova of Ascarides in three of these cases ; in twelve cases 

 of enteric fever the examination for eggs was negative nine times. 

 Moty 4 considers Oxyuris to be the sole cause in his three cases of 

 appendicitis. Girard 5 ascribes to Trichocephali the role of more 

 or less septic foreign bodies which may bring about the entry of 

 intestinal bacteria into the appendix, and Triboulet 6 describes a 

 case of appendicitis which he considers was due to Ascaris. In 

 Morkowitin's 7 case numerous Oxyuris had clearly caused the 

 appendicitis, von Genser 8 records the case of a boy, aged 5, who 

 was operated on for appendicitis, and who passed through the opera- 

 tion wound a living Ascaris on the eighteenth day after the operation. 

 In the first case communicated by Schiller 9 the disappearance of the 

 typhlitic swelling after the discharge of the Ascarides pointed to the 

 etiological significance of the parasites, and the same obtained in a 

 further case published at an earlier date by Czerny and Heddaus. 10 

 In a case abstracted by Kaposi 11 Trichocephali appear to have been 

 a contributory cause in the production of the appendicitis. In a 

 further case reported by Schiller, where the appendix was removed, 

 was shown that Oxyuris had given rise to a pronounced appen- 

 dicular colic. In a girl, aged 13, who died from diffuse peritonitis, 

 Schwankhaus 12 found that an Ascaris had perforated the appendix. 

 Ramstedt 13 found in an extirpated appendix a whole " tangle" of 

 Oxyuris, and believes in the possibility of their having provoked the 

 inflammation ; he recommends an examination for entozoa before 

 the operation, without, however, after Metschnikoff's example, sub- 

 stituting worm treatment for the operation. Rostowzeff 14 ascribes 

 only a minimal direct etiological significance to intestinal worms 



1 Matignon (abstract), Munch, med. Wochenschr., 1901. 



2 Des Barres, Gaz. des Hop., 1903. 3 Kirmisson, Annal. de Med. et Chir. des Enf., 1901. 

 4 Moty abstract), Munch, med. Wochenschr., 1901, p. 910. 



G irard, Annal. de I'Inst. Pasteur, 1901. 



6 Triboulet,- Soc. med. des Hdp. de Paris, 1901. 



7 Morkowitin (abstract), Ce ntralbl. f. d. Grenzgebiete, 1902. 



8 v. Genser, Wien. med. Wochenschr., 1901. 



9 Schiller, Beitr. z. klin. Chir., 1902, xxxiv. 



10 Czerny and Heddaus, ibid., xxi. 



11 Kaposi, ibid., xxviii. 12 Schwankhaus, Amer. Fract., 1901. 



13 Ramstedt, Deutsch. med. Wochcnschr., 1902. 



14 Rostowzeff, Russ. med. Rundschau, 1903. 



