On the Influence of Intestinal Worms in the Causation and Modification of Disease

The important part played by intestinal worms in the causation and modification of disease does not appear to me to be generally appreciated. I was first induced to turn my attention to the subject wlien treating a bad case of remittent fever in the bazaar. Quinine had been administered with very little effect, and the patient still continued to have fever, and was gradually but surely sinking. Latterly, when unable to take nourishment, ho complained of a gnawing pain in the epigastrium. Being rather in difficulty as to the true nature of the case, there being no organic lesion of any important viscera, I casually asked if he had ever passed worms ; I was informed that he had voided an ascaris lumbricoides a few days before. I then suspected that the persistent nature of the fever, together with the gnawing pain in the epigastrium, might be connected with the presence of more worms, and, with the view of dislodging them, I gave four grains of santonine on alternate evenings ; after the first dose the patient