100 ENTOZOA FOUND IN MAN. 



either at once or at successive intervals. The wound 

 degenerates into a fistulous opening which allows of 

 the escape of foecal matter ; in some cases the fistula 

 has been made permanent by the entanglement of 

 lumbrici in it from time to time ; the opening often 

 heals spontaneously, and especially after the com- 

 plete expulsion of the worms, according to some 

 writers. In other cases closure of the fistula cannot 

 be obtained ; and death may result from the primary 

 effects of the tumour, or in consequence of the pro- 

 tracted and exhaustive discharge from the chronic 

 fistulous opening. 



The treatment is that which is appropriate to 

 abscesses of the abdominal walls ; the application 

 of poultices, incision with a bistoury, and simple dress- 

 ings will be found most useful. If the wound has 

 become fistulous, and still gives passage to worms, it is 

 advisable to free the intestine from entozoa by purga- 

 tives and anthelmintics, as the lumbrici may, through 

 their becoming entangled in the opening, keep up the 

 irritation, and thus retard the cure. If notwith- 

 standing the adoption of these measures the passage 

 does not become closed, we must have recourse to the 

 ordinary treatment of intestinal fistulae. 



The cases in which lumbrici which have had no 

 share in the production of the tumour occasionally 

 issue from the opening do not differ essentially from 

 those which have been just described ; and, fre- 

 quently, the only distmction between them consists 

 in the period at which the worms make their appear- 

 ance externally. 



