A. E. Siiipley 
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many more which merit discussion, but these three are, from my point 
of view, the most important. Two of these, the Oxyuris and the 
Trichocephalus, are comparatively common, and the latter is probably 
much more common than is usually recognized. I have given some 
figures above as to its prevalence. The family Doctor knows how 
common Oxyuris is. Comparatively few children escajoe it and it 
attacks the rich and the poor, the apparently well cared for and the 
neglected, with complete indifference. Only a couple of months ago 
I found three specimens of Oxyuris in the extirpated appendix of 
a patient who was quite ignorant as were her parents that she 
harboured these worms. Further I have confined my attention largely 
to appendicitis, there are, however, many other diseases whose presence 
is associated with entozoa in the alimentary canal, e.g. certain forms 
of diarrhoea; some of these have been described by Weinberg who 
has investigated the relations of many more parasites to the intestinal 
wall than are considered here. All tell the same tale. 
With the discovery of bacteria and the important work which has 
been done during the last forty or fifty years the grosser human parasites 
have been rather left in the shade. Before that time it was much more 
usual to administer vermifuges from time to time. Many of the 
numerous ailments of children were treated by our medical grand¬ 
fathers with antihelminthics, and even to-day Sir Patrick Manson 
recommends that in the tropics and in other places where the intestinal 
parasites are common a course of santonin should be administered to 
children every six months. In spite of the great increase in our 
knowledge and practice of Hygiene, care in our meat supply, etc. which 
has so materially lessened the number of cases suffering for instance 
from the pork- or beef-tapeworm, I am not sure that, as regards 
other entozoa, whose entrance into the body is less easily controlled, we 
keep the inside of our digestive system as clean as our ancestors kept 
theirs. But times are changing, and increasing attention is being paid 
to what I am convinced is a serious factor in certain diseases. The 
matter is one which in England has received so far but little attention. 
Looking through the list of my “ cloud of witnesses ” hardly an Anglo- 
Saxon name occurs. Our knowledge of the relations of the parasite to 
the intestinal wall is derived mostly from Italian, French and German 
sources. In the United States however there is at least one voice 
crying in the wilderness. In Professor H. B. Ward’s (1907) careful 
consideration of entozoa as germ carriers and germ inoculators, he says 
