16,1 Haughwout ayid Ho^Tilleno: Intestinal Parasites 49 
pulsion of worms cannot be said to have been spontaneous in all 
cases, as was the case with the others. 
Ascaris, in recent years, has been steadily losing its reputa- 
tion for harmlessness. Unfortunately, much of the evidence 
against it has been accumulated on the operating table and at 
autopsy. We now know it as a not infrequent cause of intes- 
tinal obstruction. Perforation of the intestine has been traced 
to it in some cases, and invasion of the bile ducts, the liver, and 
the appendix are not uncommon. More than one foreign phy- 
sician we have known has received a shock during his early 
days in the Philippines by witnessing “vermiform movements” 
of an appendix he has been called upon to remove. Degorce(l4) 
has recently reported the formation of calculi in the bile ducts 
about the eggs of Ascaris. 
A new phase of the mischievous activities of Ascaris has re- 
cently been suggested as a result of the brilliant work of Stew- 
art and others on the life history of this nematode. It Vv^ould 
be out of place here to go into details regarding the complex, 
devious, and seemingly anomalous developmental cycle of this 
organism described by Stewart and apparently sustained by 
other workers. As we have said, Ascaris is a nomad and there 
seems at present no reason to doubt that in its larval stages 
Ascaris penetrates the intestinal wall, travels through the blood 
stream to the lung, remains there for a while, and ultimately 
regains the intestine via the trachea, mouth, and oesophagus. 
The thing that interests us most at this time, is the possibility 
that in its peregrinations the worm, small as it is in this stage 
of its development, may cause serious trouble en route. This 
is a problem that is worth the most careful investigation, but 
it is a problem that it seems to us will be extremely difficult to 
handle on anatomical grounds alone. 
Several investigators have observed lung symptoms in exper- 
imental animals following the ingestion of developed Ascaris 
eggs and they are exceedingly suggestive. These observations, 
however, have not been confined to lower animals. Hosier (44) 
and Lutz (37) have reported the observation of symptoms refer- 
able to the lungs in human beings a few days after the inges- 
tion of the eggs of Ascaris. Lutz’s experiment is of particular 
interest. He administered ripe eggs of Ascaris lumbricoides 
to a woman aged 32 years following which the woman suffered 
an unusually severe bronchitis accompanied by a slight remittent 
fever. 
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