552 MUSGRAVE, CLEGG, AND POLK. 



in accepting the hypothesis of Askanazy, explains his failure to secure the worms 

 when his patient was treated with benzine, by stating that the worms were killed 

 in place and so remained attached to the mucosa. 



Morsasca(62) reports one case of severe progressive anaemia accompanied by 

 abdominal pains, nervous symptoms, and diarrhoea and considers that Trichuris, 

 which were present, to be the cause of the condition. 



Federolf ( 27 ) , a Russian military surgeon, notes that Russian authors have 

 repeatedly called attention to the serious symptoms which may be produced by 

 Trichuris infections. He reports one case in which the prominent symptoms were 

 psychic depression, slight diarrhoea, retention of urine, fever of intermittent 

 character, nausea, and palpitation of the heart. Treatment by santonin was 

 followed by the disappearance of the eggs from the stools and the complete 

 recovery of the patient. 



Heine (43) encountered Trichuris in many sick deer and in two of the animals 

 which he found dead the presence of these parasites was the only condition 

 which could explain the result. Hausmann(42) believes that certain of the 

 symptoms of infection with this parasite point to the production of some form of 

 toxin. Guinard(41) reports finding nematode worms in the caecum at operations 

 for appendicitis. 



Metchnikoff (57) considers both the clinical and pathologic facts to be con- 

 vincing of the important role of eelworms and whip-worms in appendicitis. 

 Guiart(39, 40) insists upon the important pathogenic role of Trichuris in human 

 pathology. The parasite fixes itself on the mucous membrane of the caecum or 

 appendix and becomes an inoculating agent of bacteria. In one case of appendec- 

 tomy an adult Trichuris was found attached to the mucosa of the appendix and 

 the author believes it to have been the cause of the disease. 



Girard(33) reports a case of appendicitis with general peritonitis due to 

 infection with Trichuris {TrichocephaJus hominis) . The patient was a girl; 8 

 years old, who was recently convalescent from typhoid fever. She was re-admitted 

 to the hospital suffering from diphtheria and a vaginal discharge. Under anti- 

 toxin treatment there was recovery from the diphtheria. Symptoms of acute, 

 severe appendicitis developed and the appendix was resected on the fourth day. 

 At operation a general peritonitis was encountered and after resection of the 

 appendix and drainage, complete recovery resulted. The appendix was fixed en 

 masse and sectioned. In general the organ showed but slight pathologic change 

 except in the distal third where there was rather severe inflammation. Section 

 in this area showed partial occlusion of the lumen caused by two of the adult 

 Trichuris which were firmly attached to the mucosa. The author describes and 

 illustrates the inflammatory zone around the attachment of the worms to the 

 mucosa and, although no perforation is mentioned, he considers the peritonitis 

 to be due to the condition of the appendix. Finally, Girard believes he has 

 demonstrated the penetrating powers of the whip- worm; he states that the 

 parasites play a septic r61e at least by transmission of pathogenic bacteria and 

 he believes with Metchnikoff, that these parasites may cause inflammatory lesions 

 which may lead to grave consequences. 



Schiller ( 75 ) reports a case of heavy infection with Trichuris in which high 

 fever was a symptom. Hemmeter (46) considers that single specimens of the 

 parasite do not cause S3 7 mptoms, but if larger numbers occur in the colon, diarrhoea 

 and nervous symptoms may appear. 



Becker (5) reports two cases of Trichuris infection. In the first the patient 

 was a woman suffering from chronic progressive anaemia with dizziness, cramps 

 in the muscles, abdominal pain, and palpitation of the heart and the stools 

 contained many Trichuris eggs. Physical examination was negative. At the 





