J. A. Innes and a. E. Campbell 53 



Relationship of Age to Infection. 



Our series of cases was mainly composed of adults, whose ages 

 ranged from 15 to 53 years, and the commonest age of infection with 

 Oxyuris in the appendix seems to be between the 21st and 24th years. 

 At present it would be difficult to say with certainty that children show 

 a higher percentage of infection, but probably such is the case. The 

 figure given by Still (1909) of 20 % is higher than the average figure for 

 adults in this country, but Brumpt (1910) and Railliet (1911) both give 

 much higher figures for adults in France. This question, therefore, 

 still remains open. 



Nature of Infecting Parasite. 



In the course of this investigation, only one species of parasite was 

 met with, viz. : 0. vermicularis. We understand, however, that at the 

 Royal Infirmary one or two cases have been found of Trichocephalus 

 trichiurus in the appendix. Undoubtedly the occurrence of this worm 

 in cases of appendicitis is very rare in this part of the country. 



Other observers note that T. trichiurus is much less frequently found 

 than Oxyuris, but it seems strange that in 1880 Blanchard and Braun 

 should have found the worm in the caecum 11 times out of 16 cases 

 examined by them at Greenwich. No record of Ascaris lumbricoides 

 having been found in the appendix could be obtained. 



Relationship of the Parasite to Appendicitis, 



This opens up a much disputed question, and as it lends itself to 

 wide discussion, we propose to deal with this in a separate contribution 

 which will be published shortly by one of us (J. A. I.). It will be 

 sufficient to remark here that we think it very probable — in view of 

 collected clinical data — that worm infection of the appendix gives rise, 

 in many cases, to certain symptoms and to a definite type of history 

 which are of diagnostic importance. From the table of cases investi- 

 gated by us, it win be evident how largely recurrent appendicitis bulks 

 in the total series, and also that of the infected cases, 65 % were of the 

 recurrent type. 



Gangrenous appendices never showed the presence of any worm 

 parasites, but we corroborate the fact already pointed out by von Moyt 

 (1902) that the subacute and chronic inflammatory changes are more 

 characteristic of Oxyuris infection. 



