274 
A Cause of Appendicitis 
intestine and contained many polynuclear leucocytes and coli bacilli. 
The same microbes were obtained in cultures made from the blood. 
Weinberg considers the monkey died of an infection produced by a 
pathogenic organism introduced by the whip-worm into the walls of the 
intestine. He cites a further instance of a Macacus sinicus which died 
of septicaemia caused by B. coli and in whose intestine but one 
specimen of T. trichiurus was found, and he considers this one worm 
sufficed to bring about the fatal inoculation. The grave cases of 
anaemia described by many observers in cases of Trichocephaliasis may 
be due to similar inflammatory ceutres which as a rule are not visible 
to the naked eye but which are readily revealed on microscopic investi¬ 
gation. 
Guiart and Grimbert (1906, p. 562) maintain that what they con¬ 
sider true of appendicitis (i.e. that the inflammation is set up by bacteria 
from the contents of the alimentary canal admitted to the tissues 
through punctures and perforations made by intestinal parasites) may 
also be true of Typhoid. They point out that if the bacillus of typhoid 
fever causes the disease entirely through its own efforts it is very 
difficult to understand why so small a percentage of people all drinking 
from the same water supply and all exposed to the same danger of wind 
or fly-borne infection suffer from the fever. If however the typhoid 
germs require a certain introduction to the walls of the alimentary 
canal one can understand its sporadic incidence and its association, 
formerly noticed, with the presence of Ascaris and Trichocephalus in the 
lumen of the intestine. An outbreak of typhoid occurred at Brest in 
the autumn of 1904. Investigating the dejecta of twelve patients 
suffering from the fever in the Hospital there Guiart found a constant 
passage of Trichocephalus eggs in ten of them. The number of eggs 
found in each case showed a strong infection. Of the two patients in 
whom there was not evidence that they were infected, one died and at 
the autopsy six specimens of Trichocephalus were found in his caecum. 
They may have been all males, or if females may have interrupted their 
oviposition ; either alternative would explain the absence of eggs in the 
faeces. There was no opportunity of examining the caecum of the 
twelfth patient who apparently happily recovered, but his case may 
have resembled that of the man who died in whom the worms were 
found but whose dejecta showed no eggs. These numbers are too small 
to be conclusive and there seem to have been no control experiments, 
still they are at least suggestive. Guiart further states that renewed 
observation at Paris confirms the statement that Trichocephalus is 
