noticed shortly as a disease liable in careless hands to be confounded
with irritant poisoning. This is far from being a common accident, and
very rarely takes place during life. In most of the cases in which it
has been witnessed the symptoms antecedent to death were those not of
irritant, but of narcotic poisoning, and were then owing simply to the
great accumulation of worms in the alimentary canal. On this subject the
reader is referred to the article Epilepsy in the introductory remarks
on the effects of the narcotic class of poisons. But at times the
symptoms have been like those of irritant poisoning. Thus the following
is a case of perforation by worms during life giving rise to all the
phenomena and symptoms of peritonæal inflammation. A soldier at
Mauritius was seized with slight general fever and severe pain, at first
in the pit of the stomach, and afterwards over the whole belly, which on
the third day began to enlarge. A tendency to suppression of urine and
costiveness ensued, then bilious vomiting; and he died on the fourth
day, the belly having continued to increase to the end. On dissection,
several quarts of muddy fluid were found in the sac of the peritonæum,
the viscera were agglutinated by lymph, a round worm was discovered
among the intestines between the navel and pubes, and the ileum was
perforated six inches from the colon by a hole corresponding in size
with the worm.[189]—A singular case, not however fatal, but which
confirms the fact, that worms may make their way through the intestines
and other textures during life, is mentioned in Rust’s journal. A woman
after a tedious illness first vomited several lumbrici, and was then
seized with a painful swelling in the left side, which in the process of
time suppurated, and discharged along with the purulent matter three
other worms of the same species.[190] Another instance of the same kind,
where the perforation of the gut succeeded strangulated hernia, and was
followed by the discharge of two lumbrici and ultimate recovery, is
detailed in the Revue Médicale.[191]
Symptoms like those of narcotico-acrid poisoning may be caused by worms
without perforation. A girl, eight years old and in excellent health,
was suddenly seized with violent colic pains, vomiting, bloody stools,
tenderness and swelling of the belly, followed by convulsions and coma,
and proving fatal in seven hours. No other explanation of the case could
be discovered on dissection except the presence of several hundred
ascarides in the intestines and thirteen in the stomach.[192]