J. A. Innes and a. E, Campbell 49 



" On 1600 medico-legal autopsies performed at Chicago, Mitchell 

 never found a single helminth." Lejar (1897), Guinard (1900) and 

 Girard (1901) had cases of T. trichiurus in the appendix. Menetrier 

 (1909) published several cases : Brumpt found the worm in 4 % of 

 cases (autopsies), Railliet only once found the nematode in 119 cases, 

 but the ova were often present in the appendix. In a table compiled 

 by Blanchard and Braun in 1880, they give the percentage of infected 

 caeca at Greenwich as 68 % to 75 %, so that in all probability the 

 appendix infection must have been correspondingly high. 



Scope of Present Investigation. 

 This comes under five heads : 



To determine (1) The percentage of infected cases. 



(2) The relationship of age to infection. 



(3) The nature of the infecting parasite. 



(4) The relationship of the parasite to appendicitis. 



(5) The probable mode of infection. 

 Methods : 



We have examined over 150 appendices representative of all types of 

 appendicitis, but for the sake of accuracy the first 50 or 60 appendices 

 examined were rejected. The chief reason for this was that we might be- 

 come thoroughly accustomed to make a reliable examination, to identify 

 quickly and definitely any worms, if these were present, and to attain 

 some degree of precision in the enumeration of the parasites. It also 

 gave us an opportunity of testing various methods for the examination 

 of appendices. Ultimately the following procedure was adopted, and 

 the next series of 100 appendices was examined in this manner. Every 

 appendix was examined within two to four hours after its removal from 

 the body, and the routine examination was made in almost all cases in 

 the laboratory. 



The appendix was slit open along the attachment of the meso- 

 appendix, from the proximal end. Great care was taken in making the 

 first cut at the proximal end, as we have often found the worms to be 

 most numerous at that point. In many cases, where single worms were 

 found, they were found in that region. Having laid the appendix open, 

 we transferred it carefully to a large Petri dish half filled with normal 

 salt solution. If worms were present, the females stood out clearly, 

 and these were removed and counted. The mucosa of the appendix 



