Fig. 342.—Ovum of Ascaris lumbricoides, with shell and albuminous envelope. 400/1.
The ova are elliptical with a thick (4 µ) transparent shell (fig. 342) and an external albuminous coating which forms protuberances; the ova measure 50 µ to 70 µ in length, 40 µ to 50 µ in breadth; they are deposited before segmentation; the albuminous coating is stained yellow by the colouring matter of the fæces, but is sometimes absent. The egg cell is unsegmented, it almost completely fills the shell, and its nucleus is concealed by the large amount of coarse yolk granules.
Abnormal or unfertilized eggs also occur in fæces. They are distinguished by their elongated form (80 µ by 45 µ), irregularly cylindrical, its contents consisting of refractive granules.
Ascaris lumbricoides is one of the most frequent parasites of man; it is distributed all over the inhabited parts of the world, and though it is particularly frequent in the warmer regions, yet it also occurs in Finland, Greenland, etc. In temperate climates A. lumbricoides occurs most frequently in young children; it is, moreover, more common amongst country dwellers than amongst the inhabitants of towns, but is not lacking in infants, adults and aged persons. As a rule only a few specimens are present in the intestine, but many cases are known in temperate zones in which several hundreds of worms have been found in the same patient. This species is particularly numerous in the negroes of Africa and America. It occurs also in the monkey, dog and pig (? A. suilla).
The parasite was known in ancient times; the Greeks called it ἐλμινς στρογγύλη, Plinius termed it Tinea rotunda, later on it was named Lumbricus teres. The ἄσκαρις of the Greeks is our Oxyuris.
The small intestine is the normal habitat of Ascaris lumbricoides; the worms, however, often leave this part of the intestine and wander into the stomach, whence they are frequently evacuated by vomiting, or they may creep through the œsophagus into the pharynx and crawl out through the nose or mouth; very rarely they may find their way into the Eustachian tube or into the naso-lachrymal duct, or into the excretory ducts of the liver and pancreas; exceptionally they may gain the trachea, and they have also been found in the abdominal cavity. They may bore through adhesions between the intestinal wall and the omentum (worm abscess); they occasionally penetrate the urinary apparatus and are passed with the urine; in febrile diseases A. lumbricoides usually leaves the intestine spontaneously. It is obvious that these wanderings may be accompanied by the most serious symptoms, but in sensitive persons the invasion of even only a few intestinal Ascarides gives rise to a series of almost inexplicable symptoms (hysterical, epileptiform attacks, cerebral congestion, aphonia, etc.), which cease with the expulsion of the worms, so that many authors are driven to the conclusion that these Ascarides secrete a toxin. Fortunately, the presence of A. lumbricoides in the intestine is easily demonstrated by the microscopical examination of the fæces.
Development.—Several authors (Gros, Schubart, Richter, Leuckart and Davaine) have demonstrated that the ova of Ascaris develop in water or moist earth after a long period of incubation. Freezing and desiccation (if not too long) do not injure their powers of development; the duration of the development depends on the degree of the surrounding temperature. At a medium temperature, after a varying period of incubation, it takes from thirty to forty days for the embryo to become formed. The spirally rolled up embryo, with its so-called “tooth,” formed by three papillæ close together, never leaves the egg-shell in the open, even if the eggs are kept for years under favourable conditions. Davaine proved that the larvæ hatch out in the intestine of the rat, but are again expelled with the fæces; he therefore concluded that the hatching likewise takes place within the intestine of man, but is followed by the invasion of the larvæ. In the meantime Leuckart had sought to infect himself by swallowing embryo-containing eggs, but without results; he therefore conjectured that there must be an intermediary host, and v. Linstow thought he had found it in myriapods (Julus guttulatus). Subsequently, Davaine’s opinion proved correct. First of all Grassi succeeded in infecting himself by swallowing 100 embryo-containing eggs of Ascaris lumbricoides; five weeks after ingestion the worms had attained maturity and their ova appeared in the fæces. Calandruccio also sought to infect himself, but failed, yet he succeeded in infecting a little boy aged 7. Lutz also reports a successful experiment which must have been positive, as young worms 5·5 to 18 mm. long were expelled. Lutz proved that the eggs lost their albuminous shell by long lying in water and then died when introduced into the stomach; this would explain the failure of Leuckart’s experiment; in moist earth the albuminous shell is retained. Finally, Epstein conducted unimpeachable experiments on three children which place direct infection with embryo-containing eggs beyond doubt; he, moreover, proved that the development of the eggs takes place more rapidly in the fæces when there is free admission of air, sun, and a sufficiency of moisture.
Accordingly, infection occurs partly through water, but principally direct from the soil.
Ascaris, sp.
Wellmann states that yet another species of Ascaris in man occurs in the highlands of Angola: up to the present nothing certain is known about it (Welland, “Critical Notes on Tropical Diseases of the Angola Highlands,” New York Med. Journ. and Philadelphia Med. Journ., August 12 to September 2, 1905.)