TRICHOCEPHALIASIS. 551 



Trichocephalus dispar." More worms were passed on another date and following 

 this, the child rapidly recovered. 



Pascal ( 67 ) reports the case of a girl, 4 years old, who died of brain symptoms 

 simulating meningitis. Many Trichuris were found in the intestine at autopsy 

 and no pathologic changes were discovered. The author believed the parasites 

 to have been the cause of death. 



Burchardt ( 14) reports two eases in which he regarded Trichocephalus as the 

 causative agent. Vomiting, diarrhoea, headache, dizziness, and marked anaemia 

 were present in his first case. There was slight improvement upon treatment, 

 followed by relapse with icterus, bloody vomit, aphonia, and marked anaemia. 

 Complete recovery followed the expulsion of a large number of the worms. Bur- 

 chardt's second case was similar to the first, excepting that the symptoms includ- 

 ing the nervous ones were much less marked. 



Megnin ( 56 ) pointed out the fact that dogs which harbor large numbers of a 

 Trichuris sutler from a pernicious anaemia. 



Lutz(53) working in Brazil, found eggs in the stools of man, pigs, and cats. 

 In man, about one-third of the specimens examined contained the ova. 



Erni(24) believed the Trichuris to be one of the causes of beri-beri. 



Grassi(35) describes the swallowing of Trichuris eggs by a student who 28 

 days later found the first eggs in his stools. 



B. Blanchard ( 9 ) in a review of the subject of Trichuris infections states that 

 Vix, Leukart, and Brumpt all give observation of the transfixation of the mucosa 

 of the caecum by Trichuris and believes that this definite fastening of the worms 

 explains their constant absence from the fasces in infected cases. However, 

 Klebs(50), Heller (45) and Wichmann(89) do not believe that the worms attach 

 themselves to the mucosa, but state that they are maintained in place by a 

 mucus capsule resting upon the mucous membrane. 



Moosbrugger ( 59 ) reports three eases. The first was in a boy a year and a 

 half old who had a severe diarrhoea and with the usual symptoms accompanying 

 the latter. During an attack of bronchitis with fever the eggs of Trichuris, 

 which had been very numerous in the stools, disappeared. The author's second 

 case was in a three year old boy with symptoms similar to those in the first. 

 The patient died of croup and at the autopsy 442 male and 445 female worms 

 were removed from the bowel. The mucous membrane was pale in some places 

 and in others there were zones of congestion, with red spots and some erosions 

 and ulcerations in others. The third case was that of a girl three and half years old, 

 who had suffered for six months with severe diarrhoea of twenty or more stools 

 daily. The stools were tough in consistency and usually contained some blood. 

 There were 1,650 Trichuris eggs in one cubic centimeter of fluid stool. The child 

 was very anaemic, but recovered under treatment. Moosbrugger considers the 

 parasites to be the cause of the symptoms in his cases. 



Boas (11) considered the Trichuris to be the cause of severe chronic diarrhoea, 

 emaciation and anaemia in his patient, who was a man 71 years old. 



Huber ( 47 ) considers the clinical significance of this parasite to be generally 

 underestimated. He notes the presence of the worms in the caecum, appendix, 

 and occasionally in the ileum. The symptoms depend upon the severity of the 

 infection and are local (diarrhoea) and reflex (aphasia, etc.). 



Askanazy ( 3 ) demonstrated an iron-containing pigment in the intestinal 

 epithelial cells of Trichuris and concluded it to be a blood-sucking parasite. He 

 also showed that the parasite attached itself to the intestinal wall by piercing 

 a loop of mucosa or by inserting the head into the glandular tubules of the 

 mucosa. He believed that during certain diseases, or after death of the host, the 

 parasites disengage themselved from the mucous membrane and that this fact 

 explains why at autopsy they are usually found free in the intestine. Becker ( 5 ) 



