682 THE ANIMAL PARASITES OF MAX 



inflammation extends to the capsule from the pelvis, resulting in a 

 purulent nephritis. In infections of longer duration, the affected 

 kidneys become changed into so-called kidney sacs, while the kidney 

 itself continuously shrinks. Owing to the worm fixing its posterior end 

 in the ureter, and owing to an inflammatory swelling of the mucosa 

 of the ureter, the passage of urine becomes very difficult. 



The symptoms resemble those caused by a foreign body, e.g., 

 kidney pain, suppression of urine, dysuria, discharge of blood and 

 pus with the urine. But these symptoms are not sufficient for 

 a diagnosis ; this can only be established by finding eggs or the 

 parasite itself in the urine. 



Moscato 1 records a case with chyluria, pain in the region of the 

 right kidney, and hysterical symptoms. During an hysterical attack 

 a specimen of Eustrongylus gigns was discharged in the urine, and the 

 chyluria and nervous affections disappeared. In a case described 

 by Stuertz 2 of an Australian with chyluria due to Eustrongylus gigas 

 the chyluria had existed for seven years. In the urine the eggs of 

 Eustrongylus gigas were found. The cystoscopic examination showed 

 that turbid urine was discharging from the left ureter. Nephrectomy 

 was considered. 



Ancylostoma duodenale (Ancylostomiasis). 



Whilst up to quite modern times it has been generally maintained 

 that the great majority of worm diseases cause more or less marked 

 symptoms, the exact investigations of the last few years have made 

 it plain that the great majority of people with worms are not only 

 perfectly healthy, but the most careful clinical observations show no 

 single sign of any ill-effect of the intestinal parasites on the health 

 of the host (Lobker and Bruns 3 ). If infection has led to the 

 development of only a few ancylostomes, then injury to the general 

 health is, as a rule, scarcely noticeable. In order to produce severe 

 illness the presence of several hundred worms in the intestine is 

 necessary, and in general the intensity of illness varies in exact 

 proportion to the number of worms. Then the duration of the infec- 

 tion comes into play : the longer the human organism is submitted 

 to the injurious effect of the parasite, the clearer is the effect on the 

 host. Besides, the resistance of the individual has to be considered. 

 Whilst a more robust person can harbour without ill-effect for a 

 longer time a larger number of ancylostomes, the symptoms of the 

 disease become more markedly and much sooner apparent in weakly 

 persons or in those weakened by other diseases. 



1 Moscato, quoted by Predtetschensky, Zeitschr. f. klin. Med., xl. 



- Stuertz, Ges. d. Charite-Aerzte in Berlin, June 26, 1902. 



3 Lobker and Bruns, Arb. (ins. dem. kaiser L Gesitndheitsamte, 1906, xxiii. 



