34 



contaminate the food, or may even be swallowed directly, 

 if the patient puts his fingers to his mouth. Itching at the 

 nose x has been described as a symptom of the disease, and is 

 said to be a frequent cause of such a transference of the ova 

 from anus to mouth. But, by whatever means, the impreg- 

 nated ova must reach the host's stomach for true infection to 

 occur, and it is impossible to insist too strongly on the 

 importance of this point. Directly they arrive there, a new 

 generation is started, and this vicious cycle may be, and often 

 is, repeated indefinitely for months or years. 



Possibilities of Spontaneous Cure. 



Whereas, if such auto -infection be prevented by the most 

 scrupulous care and cleanliness, no fresh generation can arise, 

 and the existing one ultimately dies out (spontaneous cure), 

 since the ova cannot be hatched in the bowels of the sufferer, 

 but must be re-swallowed. Upon this fact is based the so- 

 called hygienic, or expectant treatment, which relies on 

 measures of cleanliness only, to prevent auto-infection, and 

 upon control of diet to obviate fresh infection from without. 

 Since these dietetic restrictions must consist in withholding 

 all fresh vegetables and fruit, it is hardly necessary to enla rge 

 on the hardships they involve. 



VII. PREDISPOSING CONDITIONS. 



Age. 



From the earliest time it has been known that this form of 

 helminthia&is is most common in children 2 , and this observa- 

 tion is entirely beyond question 3 . Indeed, at one time, 



or less, frequently had occasion 2 " Oxyuris vermicular is may 



to demonstrate this fact to our emphatically be called the children's 



patients." (CoBBOLD, T. S., Human pest." (COBBOLD, T. S., Worms, a 



parasites, London, 1882, pp. 57, 58.) series of lectures, London, 1872, 



1 " . . . the troublesome itch- p. 80.) 



ing . ... is met by scratching and 3 All intestinal worms attack 



rubbing with the fingers. It is children in preference to adults : 



therefore possible, that the eggs " Quum omnes intestinorum vermes 



may even thus be introduced into turn Oxyuris praecipue in infantium 



the nose. . . . As a matter of corpore inesse videtur." (ZuM- 



fact, the larvae of Oxyuris have been BUSCH, J., De diagnosi atque therapia 



found in the nose." (BRAUN, M., symptomatum oxyuri vermiculari 



op. cit., p. 339.) effectorum, Gryphiae, 1865, p. 7.) 



