ASCAE.IS LUMBRICOIDES. 313 



have paid little regard to cases where the authors have propounded 

 some palpably untenable theory, such, for example, as that 

 advanced by Rumsey, who, because he found lumbrici occurring 

 in two patients who were troubled with spitting of blood, imme- 

 diately drew the conclusion that the worms in question were the 

 cause of the haemoptysis. A reference to his cases will be found 

 in the Bibliography, as well as to each of the other cases above 

 quoted. Many other references are also separately given to 

 various other papers of interest bearing on this subject. 



From the observations of Dyer it would seem that lumbrici are 

 extremely common in the Mauritius, but, as happens with most of 

 the other species of Entozoa, they are comparatively rare along 

 the sea border. In all situations where there is an abundant 

 water supply, these parasites are more particularly common ; and 

 it is well known that the lowlands of Holland and the lake 

 districts of Sweden are eminently favourable to their existence. 

 All this is explicable enough from what we now know respecting 

 the conditions which are essential for the rearing of the larvse ; 

 but, as I have before observed, it is almost certain that the human 

 body becomes infested, not by the drinking of water which may 

 contain the sexually immature embryos, but by feeding upon the 

 flesh of some quadruped, fish, or fowl which happens to represent 

 the so-caUed intermediate host. 



Treatment. — As regards the treatment of Ascaris lumhricoides 

 by the internal administration of medicines, I can only very briefly 

 notice the principal remedies. Foremost among these is santonine, 

 which may be given to children in the form of a simple powder, 

 two or three grains being sprinkled over a slice of bread and 

 butter. It is better still if they can be induced to take it along with 

 castor oil, or, if preferred, a little honey is a very good substitute 

 for the oil. An adult may take as much as five grains twice a day, 

 which may be repeated every second day for a week, but not oftener 

 at the commencement. In all cases the effects of the drug should 

 be carefully watched, as tenesmus, spasms, and even hoemorrhiagic 



s s 



