— 340 
and entrance through the points of attachfnents of the whipworm 
in the large bowel, particularly the caecum, by amoebae. Amoe- 
bic infections of the intestinal tract are always confined to the 
large bowel and appendix, and frequently the only lésions noted 
at autopsy are a few ulcers in the caecum in the exact location 
of the point of attachment of the whipworm to the mucosa. 
These points of attachment are sometimes the seat of inflamma¬ 
tion and I hâve seen the association of amoebic colitis and of 
whipworms in the same bowel a number of times. 
The srpall number of infections by Ascaris lumbricoides is pro- 
bably due to the following reasons*: Ascaris infections usually 
yield readily to treatment and they are more commonly met with 
during adolescence. The patients in the insane division are mostlv 
in the third and fourth décades of life and they hâve ail been un- 
der anthelmintic treatment. 
Strongyloides stercoralis in cultures was found to develop in 
both modes : the direct filariform and also the indirect mode. The 
latter is much more commonly encountered among natives of the 
tropics than the former. 
The proportion of infections by this nematode is higher among 
the insane than among other individuals to judge from the lite- 
rature on this subject, but it must be said that the cultural me- 
thod has not been carried out in other examinations reported in 
the literature. 
The infection is probably a very persistent one for it has been 
found in several insane patients between 60 and 70 years of âge. 
With regard to the question of the relation of Strongyloides 
to diarrhoea, I was informed by Drs. Lawler and Drennan, 
who bave charge of the patients, that in not one of the 57 cases 
of Strongyloides infections detected was there a case of diarrhoea, 
thus confirming the view of Grassi and others that this nema¬ 
tode does not cause diarrhoea. 
The infections by Oxyuris vermicularis are peculilarly interes- 
ing on account of their relative infrequency among natives and 
also that by the differential density method it is necessary to look 
for adult worms in the supernatant fluid of the centrifuge tube, 
as well as for ova, for the latter may be absent and the former pré¬ 
sent. . . j 
Three of the seven males infected with Oxyuris vermicularis 
were Spanish laborers, and six.of the seven are sodomists or hâve 
