ASCARIASIS 311 



In warm and muisl soil a spiril embryo is seen in one month, but 

 requires to be ingested by man before hatching and developing into 

 the adult form. 



The source of infection is by polluted vegetables, fruit, water, and 

 soiled hands. The eggs ])ass unaltered tiirough the alimentary canal 

 of the house-fl\', hence house-flies are carriers (Stiles). 



The eggs liatch out in the small bowel where the adults remain as 

 spindle-shaped yellowish worms, the male 15 to 25 cm. long by 3 mm. 

 thick. The female is from 20 to 40 cm. long. They look very like the 

 ordinary ground worms. The male carries two spicules posteriorly, 

 and there are aboul seventv papillcC around the cloaca. 



The vulva of the female is at the junction of the anterior and middle 

 thirds of the body. 



The eggs are tisuallv in the small intestine but have been seen post 

 mortem in the stomach, oesophagus, nose, larynx, trachea and bronchi, 

 more rareh' in the li\-er, pancreatic duct and vermiform appendix. 



SYMPTOMATOLOGY. 



Symptoms are often nil. 



Skin eruptions and irritation ma}^ be present. 



If manv are present there ma)' be signs of toxemia or intestinal 

 obstruction. Odd worms may wander in many places, when -the 

 symptoms are according to the mechanical obstruction caused, as when 

 one passes into the stomach, vomiting may set in. 



Passes into the appendix, inflammation of that organ arises, 

 ,, ,, large gut, an ulcer may be perforated, 



,, bile duct, an abscess may result, 

 ,, duct of Wii"sung, pancreatic instifficiency and death, 

 ,, ,, nose, itching and discharge. 



They have caused obstruction, perforation, peritonitis and death 

 (Prasad). 



In searching the faeces for eggs one must remember that : — 

 The eggs may have an albuminous coating, or 

 They may be decorticated, or 

 They may be unfertilized, or 



They may have become embr^'os, each stage presenting a different 

 picture. 



TREATMENT. 



Give santonin, grains i to 3, each morning for three days. 

 Accompany this by calomel in equal doses. 



For children give one-sixth of a grain of each for each year of life 

 for three days. 



Repeat the treatment after one week if the eggs are still present. 

 Santonin in excess may cause yellow blindnt-ss. 





