THE ASCARIS LUMBRICOIDES. 93 



duction of lumbrici in the air passages, the compli- 

 cation occurred in children between the age of four 

 and ten years. 



When a lumbricus has found its way into the 

 larynx, it may remain entangled there, or it may 

 pass beyond the glottis, and penetrate as far as the 

 trachea or even the bronchi. 



If it be only entangled at the upper part of the 

 larynx, violent paroxysms of coughing, great anxiety, 

 screaming, and pains at the situation of the larynx 

 come on ; the suJSbcation becomes rapidly worse, and 

 death occurs at the end of a short period, unless the 

 worm be expelled during a fit of coughing. 



When it has passed beyond the glottis similar 

 symptoms are produced, but, as soon as the worm has 

 completely entered the trachea or the bronchi, and 

 has left the opening of the glottis free, the cough 

 becomes less violent, and the sense of suffocation is 

 less severe. The disorder continues, however ; the 

 voice is stifled or suppressed, as well as the cough ; 

 the patient places his hand up to his neck, as if to 

 indicate or to attempt to remove the obstacle which 

 opposes the free entrance of air into the lungs ; the 

 dyspnoea recurs at intervals, and is accompanied by 

 great mental agitation, vomiting, convulsions, and occa- 

 sional involuntary discharge of urine. Death finally 

 supervenes at a period which varies, according to 

 published observations, from a few hours to three 

 days, unless the worm be fortunately dislodged and 

 ejected during the coughing. The sjrmptoms cease 

 almost immediately after the removal of the worm, 

 either accidentally or by surgical means. 



The diagnosis of the existence of a lumbricus in 



