THREADWORMS. 85 



the margin of the anus. These symptoms in 

 bad cases become distressing and almost in- 

 tolerable, especially when the itching extends to 

 the genito-urinary passages, in consequence of the 

 escape and migration of the parasites about these 

 parts. By-and-by the local inflammatory action 

 thus superinduced sets up various sympathetic 

 phenomena, such as restlessness, general nervous- 

 ness, itchings at the nose, involuntary twitchings, 

 grinding of the teeth during sleep, chorea, convul- 

 sions, and epileptiform seizures. At the age of 

 puberty special local disorders arise, the nature of 

 which will be readily understood when merely 

 spoken of as the morbid phenomena of sexual 

 irritation. In the female the occurrence of pruritus 

 and leucorrhoea is not uncommon, accompanied or 

 not, as the case may be, with hysteria in various 

 forms. In the ordinary run of cases you merely 

 encounter general asthenia, with more or less 

 emaciation. The anaemia is sometimes remarkable; 

 but in place of anorexia, which is however an 

 occasional concomitant, you frequently find a most 

 voracious appetite, especially in the younger patients. 

 Sometimes one meets with all sorts of obscure 

 symptoms simulating those of local organic disease. 



