626 AFFECTIONS OF THE INTESTINAL CANAL. 



time to time, of severe pain in the abdomen, which they describe as 

 twisting and turning (but, perhaps, they may not do so until they 

 know they have a tape-worm) ; they double themselves up, or press 

 the abdomen against some hard substance, have nausea, and, occasion- 

 ally, vomiting. The secretion of saliva is almost always increased, so 

 that the sah'va flows out of the mouth. The attacks above described, 

 particularly when they occur after the use of herring, onions, horse- 

 radish, or large-grained fruits, are by the laity considered as a certain 

 sign of worms, and should excite in the physician also a suspicion of 

 tape-worm ; but there is no certainty about it till links of the tape- 

 worm have been passed, either spontaneously or after the use of laxa- 

 tive or anthelmintic remedies. In other cases, the presence of the 

 parasite is not so well borne ; occasionally, particularly after eating 

 salty or spiced food, there is diarrhoea; the patient becomes weak, 

 pale, and thin. This occurs particularly in persons previously debili- 

 tated, especially in children and young girls. Lastly, the irritation of 

 the intestines, caused by tape-worm, may be reflected to other nerves ; 

 but the frequency of nervous affections from this cause has been much 

 exaggerated, and this exaggeration has led to numerous errors. The 

 sensation of tickling in the nose, which induces the patient to rub and 

 pick that organ, the dilatation of the pupil, squinting, grating the 

 teeth, and other unimportant and more isolated disturbances of inner- 

 vation, are rather attributed to the round worm, while the tape-worm 

 is blamed with severer and more extensive nervous affections, particu- 

 larly epilepsy and St. Vitus's dance. We may entertain a faint hope 

 that epilepsy, occurring without any perceptible cause, depends on irri- 

 tation from worms, but we should avoid the belief that the passage of 

 links of tape-worm from an epileptic patient proves that the disease 

 depends on the presence of the worm, and will disappear with its re- 

 moval. Cases where this occurs are very rare, compared to those where 

 the epilepsy remains the same after the removal of the tape-worm as it 

 was before. 



As a rule, the presence of round worms in the intestines excites no 

 symptoms. They are so very common that, if the intestinal canal were 

 much irritated, and nutrition greatly impaired by their presence, there 

 would not be so many healthy and blooming children. If there be a 

 large number of them in the bowels, they may curl up together, and 

 form an obstruction, as hard faeces sometimes do, or cause colicky 

 pains ; if they do not again uncurl, or cannot be removed by cathartics, 

 they may induce the symptoms of ileus. In other cases, active move- 

 ments of the round worms seem to excite. abdominal pains, similar to 

 those caused by tape-worms. The causes of this disquiet of the worms 

 is unknown, and Jfiftchenmeister's suggestion, that perhaps the round 



