49 



are so extremely alarming. Medical advice is summoned, 

 the child is drugged, after a rough and ready diagnosis ; but, 

 in nine out of ten cases, the fact is overlooked that " worms " 

 are the principal cause of fits. 



Pulmonary Consumption and Tuberculosis. 



It is well-known that pulmonary consumption, and other 

 tuberculous diseases, frequently co-exist with threadworms, 

 and intensify their evil results. In some cases, doubtless, the 

 tuberculous condition, with its consequent debility, may be 

 a predisposing cause of the parasitic invasion ; but, not 

 improbably, this sequence of events may, particularly in the 

 case of children, often be reversed ; and thus threadworm 

 disease ultimately leads to general tuberculous infection and 

 premature death. 



Local Complications. 



Locally, the irritation of the worms may cause piles, or 

 haemorrhoids, especially in children ; and prolapsus ani, or 

 falling of the bowel, may be another result of the disease. 

 The skin of the perinaeum, when affected with pruritis ani, 

 forms a particularly favourable soil for the development of 

 other skin diseases. Eczema, therefore, often supervenes, 

 usually of the moist variety. 



Mucous colitis may be either a complication or a pre- 

 disposing cause, as any excess of mucus 1 in the intestine is 

 undoubtedly favourable to the Oxyuris. 



Complications due to Wandering. 



Though usually found only in the ileum, coecum, colon and 

 rectum, it is an accepted fact that threadworms occasionally 

 wander from their usual haunts to other parts of the body 2 , 

 and give rise to a variety of complications ; among which 

 may be mentioned : jaundice, chronic appendicitis and 

 periappendicitis, verminous tubercles 3 , peri-rectal abscesses, 



1 " Nulla vermium frequentior 3 " The Oxyuris may traverse the 

 habita est causa, quam mucus in- intestinal wall, and has been found 

 testina oblinens." (PALMER, J. F., in the peritoneal cavity, where they 

 op. cit., p. 4.) may form verminous tubercles in 



2 " Brera en a vu dans 1'oeso- Douglas's fossa, or peri-rectal ab- 

 phage une quantite innombrable, scesses." (OsLER, W., The Princi- 

 Bianchi pretend en avoir vu dans pies and Practice of Medicine,, New 

 les ventricules du cerveau." (TuR- York and London, 1909, p. 

 PIN, V., op. cit., p. 7.) 39.) 



