636 THOMAS E. BROWN AND JOHN H. KING 



(d) Ascariasis. 



(e) Oxyuriasis. 



(/) Trichocephaliasis. 

 (g) Trichonosis. 

 (h) Myiasis. 



As a group these parasitic diseases are not associated with striking 

 metabolic complications. A few of the individual infections, however, 

 do produce metabolic disturbances and these will be briefly considered. 



(a) Teniasis. Infection with the tapeworm may be entirely with- 

 out symptoms, or very severe symptoms may result from harboring the 

 parasite in the body. A tapeworm may largely use up the food supply 

 of the host, it may irritate the mucous membrane of the intestinal tract or 

 it may elaborate toxins which affect the body deleteriously. Severe anemia 

 and nervous disturbances are met with in some cases, and in long standing 

 infections there develops a considerable grade of emaciation. 



(b) Uncinariasis and Anchylostomiasis. Hookworm infection, while 

 it especially involves the blood-forming and nervous systems of the body, 

 is also accompanied by marked deterioration of the nutrition of the body. 

 The anemia and inferior mental states of individuals infected with 

 this parasite is associated often with marked wasting of the body, giving 

 the typical pot-bellied aspect to its victims. Development, mentally and 

 physically, is greatly interfered with when the infection occurs at an 

 early age, so that these patients often appear to be many years younger 

 than they actually are. It is thought that when the disease occurs before 

 puberty, the endocrine glands may be disturbed. 



The other infections in this group are not associated with any meta- 

 bolic complications, unless it be in trichiniasis, which may cause a con- 

 siderable degree of cachexia in very severe cases. 



The Congenital Enteropathies 



(a.) Congenital Malposition of the Intestines. 



(6) Ilirschsprung's Disease, or Megacolon Congenitum. 



(c) Persistent Meckel's Diverticulum. 



In this group, only the curious malady megacolon congenitum 

 interests us. This condition is characterized by a high grade of dilata- . 

 tion of the colon, with thickening of all the tunics of the wall, especially 

 the muscularis, with retention of often enormous quantities of feces. In 

 long standing cases with progressively increasing retention of feces, a 

 considerable degree of emaciation occurs. The nutrition is greatly in- 

 terfered with and these patients present a remarkable clinical picture, 

 of general emaciation, with a tremendously distended abdomen, in which 



