270 
A Cause of Appendicitis 
a small nematode—which proved to be a female Oxyuris —was found 
threaded through the mucosa and so firmly fixed that light traction at 
either end failed to dislodge it. The appendix was congested and the 
congestion was most pronounced in the neighbourhood of the parasite. 
Microscopic study of sections showed that the worm had pierced through 
the mucosa, traversed a gland, and reached the vascular layer in the sub¬ 
mucosa. These sections also showed a very inflamed condition of these 
parts, the parasite was surrounded by polynuclear leucocytes and amongst 
them a large number of bacilli. There were also signs of lymphangitis 
around the same spot extending into the sub-serous layer and here 
the blood vessels were very congested. All these disturbances had their 
centre in the impacted Oxyuris. 
Seiffert (1908) in his summary of the relation of entozoa to appen¬ 
dicitis quotes the following:—Still (1899) recognizes Oxyurids as the 
great cause of catarrhal affections in the appendix: Moty (1902) recog¬ 
nized Oxyurids as the cause of three of his cases of appendicitis : in 
Morkowitin’s (1902) cases numerous Oxyurids were obviously the 
disposing factors to appendicitis: Ramstedt (1902) found a regular 
tangle of Oxyuris in an extirpated appendix and believed that they had 
set up the inflammation: Oppe (1903) found Oxyuris in six appendices 
and thought that a “Wurmkur” should be considered in cases of 
appendicitis—this is especially indicated when examination of the faeces 
reveals the ova of Oxyuris or Ascaris ; Trichocephalus is much less affected 
by antihelminthics:—Hanau (1903) communicates a case where with¬ 
out doubt Oxyuris set up appendicitis : von Begonin (1902) a case in 
which in an extirpated appendix he found the mucosa ulcerated and 
15 Oxyuris in the lumen and Putnam (cited by Spieler (1904)) one in 
which 20 specimens were found: finally Schoppler (1906) holds that the 
danger of appendicitis is not removed when an Oxyuris which has 
wandered into the appendix dies; this is obvious if before death the worm 
has pierced the linings of the part and given exit to bacteria which may 
then exert a pathogenic action. 
Ascaris lumbricoides (Linnaeus, 1758). 
This, one of the commonest—as it is one of the largest—of the 
nematode human entozoa, normally inhabits the small intestine, but it 
is a little apt to wander and has in fact been found all over the body. 
It occurs at all ages, but is as a rule commoner in children about half 
