gastric and perhaps nervous troubles—capricious appetite, foul breath, restless sleep, peevishness, vague abdominal pains, nausea, and so forth. Sometimes the worms get into the stomach and are vomited, their appearance giving rise to no inconsiderable alarm. They may even creep up the œsophagus and into the mouth, or out by the nostrils. Cases are on record in which they caused suffocation by wandering into the rima glottidis. They have been
Fig. 174.—Trichiuris trichiura. (Magnified.)
a, Male partly embedded in the mucous membrane of the intestine; b, female.
known to enter the bile-ducts and give rise to jaundice; to penetrate the intestinal wall and escape into the peritoneum, causing peritonitis; or to burrow into the abdominal walls and cause abscess. Fortunately these accidents are of rare occurrence; their possibility, however, should be borne in mind, and, apart from other obvious considerations, ought to make us endeavour to rid patients of these troublesome guests as soon as possible. With this object in view, it was my practice in China to give my little patients, as a matter of routine, a few doses of santonin twice a year; very often the precaution re-
