550 MTJSGRAVE, CLEGG, AND POLK. 



outer surface of left lobe shows a hemorrhagic infarct about 4 centimeters in 

 diameter, penetrating about 3 centimeters into the lung substance. Lower edge 

 of right lower lobe has a large infarct about 11 centimeters in length and about 

 centimeters broad. On section no embolism could be found in the arteries. 



Heart: Very slight atheromatous patches in arch of aorta. The left coronary 

 artery contains an adult Trichuris trichiura, with about one-third of the posterior 

 portion remaining free in the aorta. 



Liver: The liver is friable, dark red in color (slight post-mortem change). 

 The spleen is dark red, slightly mottled, and of firm consistency. Kidneys 

 congested. 



Moderate injection^of the mucous membrane of the large intestine, which 

 contains a small amount of mucus; a number of Trich/wris were found in the 

 cecum. 



Anatomic diagnosis: Embolism of the left coronary artery due to adult Tri- 

 churis; hemorrhagic infarcts of the lower lobe of either lung. 



Numerous other cases of Trichuris infection much, less severe, but 

 with suggestive sjonptoms, could be mentioned, but in them the diag- 

 nosis is not so clear and the}' will only be considered in the general 

 discussion in the second part of this paper. 



GENERAL EEVIEW OF THE LITERATURE. 



The first description of the parasite which we now recognize as Trichuris 

 trichiura (Linnaeus 1761) was that of Morgagni(61) who found the worms in 

 the cecum of a man at autopsy. Rbderer (73), in collaboration with his students, 

 made additional contributions to the description of the parasite, and Biittner 

 (1761) examining their specimens and mistaking the posterior for the anterior 

 end of the parasite named it Trichuris. Linneus (1771) introduced the name 

 Ascaris trichiura. Goeze(34) recognized Biittner's error in thinking the smaller 

 end to be the head of the parasite and changed the name from Trichuris to 

 Trichocephalos. According to Blanchard(S) Morgagni, Eoderer, YVagler, Happ, 

 and Wristberg thought there were two species of these worms, but Miiller (1778) 

 showed the two kinds to be male and female; Schrank (1788) recognized the 

 parasite under the name of Trichocephalus hominis, and the same name was used 

 by Gmelin (1789); Rudolphi (1801) described the parasite under the name of 

 Trichocephalus dispar and this name has been the one in most common use until 

 within the last few years. 



Owing to the adoption of different rules of nomenclature there is at present 

 considerable difference of opinion among zoologists as to the correct name of the 

 parasite. Stiles maintains Trichuris trichiura. while most of the European 

 authors adopt Trichocephalus trichuris. 



Without entering into the discussion, we have decided in this report to use 

 the name recommended by Stiles. 



Barth(4) reports a case of severe infection with Trichuris as the only explana- 

 tion of severe meningitis-like symptoms in a patient. This is perhaps the first 

 report in which a pathogenic role in human beings has been attributed to this 

 parasite. 



Davaine(19) examined a large series of stools in Paris and concluded that 

 probably one-half the people of that city harbor this parasite. 



Gibson (32) reports an interesting case of severe nervous symptoms with 

 paralysis in a girl who had a very severe Trichuris infection. Calomel 0.065 

 gram and rhubarb powder 0.65 gram were given night and morning for some days. 

 "On two occasions the child passed a small chamber vesselful of worms; species, 



