726 THE ANIMAL PARASITES OF MAN 



(Schlesinger and Weichselbaum 1 ). In the discussion of myiasis 

 intestinalis we give the evidence of Schlesinger and Weichselbaum, 

 as well as that of Wirsing, 2 to which must be added a number 

 of other investigations. 



In a great number of acute cases apparently only the stomach was 

 affected, there being no signs in the intestine. In these cases sudden 

 illness is noticed, colic, sometimes unbearable pains in the region of 

 the stomach, pyrosis, vomiting or continuous intense inclination to 

 vomit, occasionally even with the mixture of blood. Frequently a 

 general feeling of malaise, twinges of pain in the muscles, and attacks 

 of giddiness were notified, very rarely fever. Generally all the 

 symptoms disappeared in a short time when the larvae had been 

 removed by an act of vomiting or by washing out the stomach. 



It is well to note that in the history of many cases the pains 

 preceding the expulsion of the larvae are stated to be extremely 

 violent. 



Acute myiasis of the intestinal canal frequently runs a course 

 without special symptoms and is only an accidental condition ; one 

 . has, however, in such cases to guard against errors. The faeces may 

 be deposited in vessels or places where fly larvae are in great numbers, 

 or a subsequent infection of the faeces with the eggs or larvae of flies 

 may have taken place. Only when the inspection of the excrement 

 immediately following defaecation proves the presence of living larvae, 

 and when there were certainly no fly larvae in the vessel previously, 

 can one speak of the passing of fly larvae from the intestine. More 

 frequent than the cases showing no special symptoms are those with 

 pronounced disturbances in the intestinal passage, obstruction or 

 diarrhoea (also constipation and diarrhoea alternately), violent and 

 sometimes agonizing abdominal pains (Pottiez 3 ), which preceded 

 the evacuation of the larvae and subsided after their removal. General 

 symptoms, like weakness, languor, transitory vague pains, loss of 

 appetite, sickness, rarely fever, giddiness, attacks of faintness, epileptic 

 attacks (Krause 4 ) are observed. In a few cases blood and pus have 

 been noticed in the evacuation of the bowels. 



In the cases of chronic myiasis of the intestine the aspect of the 

 disease is dominated by the complex symptom of colitis mucosa. 



The following features are noticeable, namely, the intermittent 

 passing of blood, the influence over the expulsion of the larvae of 

 mechanical procedure (massaging of the abdomen), the duration of 

 the process for several years, the sometimes enormous number of 



1 Schlesinger and Weichselbaum, Wien. klin. Wochenschr,, 1902, i. 



2 Wirsing, Zeitsehr.f. klin. Med., 1906, Ix. 



8 Pottiez, Bull, de I'Acad. royale de Med. de Belgique, xv. 

 1 Krause, Deutsch. med. Wochenschr., 1886, xvii. 



