416 ANIMAL PARASITES. 



forward, without being carried upwards by watery vomitings, and 

 thus becoming more swelled, heavy, motionless, and inactive, 

 I have repeatedly seen it produce the most unpleasant disturbances, 

 such as constant retching, the most troublesome vomiting, irri- 

 tation in the throat, with fever, and even delirium, and, after the 

 evacuation of the worm, all disappear like a flash of lightning. 

 In doubtful and suspicious cases, therefore, it should never be 

 omitted to open the mouth of individuals suspected of worms 

 when suddenly attacked by fever, to see whether there is a worm 

 in the pharynx, which is immediately to be removed with the 

 finger or the forceps. If, however, the worm arrives in the 

 stomach, or in the portion of the alimentary canal between this 

 and the mouth or nose, in a dull and sickly state, without the 

 faculty of moving itself, and without strength to enable it to 

 adhere, the symptoms produced by it are much gentler and more 

 passive, as the worm is more easily removed as a dead foreign 

 body. Besides in these normal prolongations or appendages of 

 the intestinal canal, the worm can also pass to other regions 

 by pseudo-paths, through the external integument, or be met 

 with in closed serous cavities of the body. Such places the 

 worm reaches only when a breach (perforation) or an ulcer 

 yielding to the least force, for example to mere adhesion, 

 was ripe for perforation, occurred in the intestine, exactly 

 as we see Ascarides and Tcenice, with or without hooks, wander 

 through the shot-wounds in the intestines of animals killed 

 by sportsmen, into the abdominal cavity, the lungs, or out 

 of the body. The cause of such perforations, therefore, lies only 

 in morbid ulcerating processes of the mucous membranes of the 

 intestine, which are certainly mostly of a dyscratic nature 

 (tubercular, cancroid, typhoid). They can only be caused by the 

 worms, when these, being present in great numbers, have led to 

 ileus, inflammation of the intestine, and adhesion of the intestine 

 with partial mortification. The prognosis is the same as in all 

 perforating ulcers of the intestinal canal. At the same time it is a 

 further question, whether the perforation takes place before or 

 after the occurrence of adhesion with neighbouring organs. Thus 

 are produced the so-called worm-abscesses, in which the worm 

 passes out through the general integument. At the same time, 

 however, before this takes place the previous perforated wound 

 may be already covered by exudation, and the worm occur com- 

 pletely shut off from the intestinal canal in a sacculated cavity. 



