40 



The most prominent local and constitutional symptoms 

 are : 



Changes of Aspect. 



The face of the sufferer from threadworms is nearly always 

 markedly pale, or flushes and pales alternately, and usually 

 shows livid or black rings round the eyes. It is also often 

 swollen, especially the eyelids and the upper lip. The pupils 

 of both eyes may be dilated, and their conjunctivas discol- 

 oured *. The facial expression in children, and often in adults, 

 is downcast and depressed 2 , and, indeed, in very many 

 children, the whole aspect is so striking and characteristic, 

 as to attract the instant attention of a trained observer. 



Abnormalities of Appetite. 



In children particularly, some change of the appetite is very 

 frequently the first symptom to attract attention. Most 

 commonly the appetite fails, but, on the other hand, it may 

 be voracious 3 . Moreover, it is noticeable that, even when the 

 appetite is good, bodily nutrition is defective 4 . A capricious 

 appetite is not infrequently noticed. There is a craving for 

 food, even after a meal, or a desire for articles of diet, which 

 are refused when offered, and any such symptoms should be 

 carefully noted. 



Abnormalities of Digestion. 



There is an increase in the flow of saliva into the mouth ; 

 the patient's mouth is always '"' watering," and, if a child, 

 it dribbles. The breath is tainted 5 , or even offensive, and the 

 tongue is foul, coated and flabby, and indented by the teeth. 

 Nausea after food is often complained of, and flatulence, 

 eructations, and borborygmi (rumblings) frequently occur. 



1 " Le visage des persons qui sont 3 " L'appetit varie, tantot il dis- 



affectes de vers est change ; ils parait entierement, et tantot les 



sont ordinairement tres-pales . . . malades sont tres-affames." (TuR- 



les pupilles sont dilatees, et les PIN, V., op. cit., p. 14.) 

 paupieres inferieures entourees d'un 4 " Optime comedentes aegri, par- 



cercle bleuatre." (TuRPiN, V., op. um velnihilnutriuntur." (PHILITES, 



cit., p. 13.) S. C., Dissertatio inauguralis medica 



. le f acies vermineux des febrium verminosarunt patholor/iam 



auteurs : teint terreux ou verdatre, exhibens. Gottingae, 1785, p. 



passant alternati vement de la paleur 34. ) 



a la rougeur . . . physionomie 5 " . . . 1'haleine est fetide." 



triste et abbattue." (FiDELiN, P., (TURPIN, V., op. cit., p. 14.) 

 op. cit., p. 36.) 



