Habitat.—Adults in large intestine of man. Young forms in small intestine and often in the appendix.
The worm lives in the lower part of the small intestine, cæcum and vermiform appendix, and before becoming adult undergoes two or three moults (Heller). According to Wagener the worms at times live in the gut wall, giving rise to calcareous nodules. When the uterus of the fertilized females begins to fill with eggs they leave the cæcum and travel through the colon to the rectum. The uterus is now packed with eggs which contain a tadpole-shaped embryo. Egg-laying now takes place, partly in the rectum, partly outside, the mode of exit being not only passive through defecation but also an active one on the part of the worms when the patient is in bed. In this case the worms crawl out of the anus, producing a most intolerable itching as they scatter their eggs between the nates and the perinæum. From here in the case of girls they may get occasionally into the vulva and vagina, and even into the oviducts and so into the body cavity. The worms also may wander through the alimentary canal in the opposite direction, getting out occasionally through the mouth. Recently a rôle has been assigned to them, as to other gut parasites, in appendicitis and typhlitis.
It is stated that the males die after fertilizing the females, thus explaining why they are so rarely met with in fæces [but it is probable that they often escape notice from their small size.—J. W. W. S.].
Development.—The eggs, which often adhere together, contain a tadpole-like embryo, the thin tail of which is bent upwards ventrally; the embryo in a short time, given a sufficiently high temperature, passes into a second folded nematode-like embryonal stage, lying in the egg-shell, either in the fæces, with which also numerous females pass out, or in the moisture of the groove between the buttocks, and they there await the opportunity of being reintroduced into man per os. It is very improbable that infection takes place directly in the large intestine, as is occasionally stated, because although the harbourers of Oxyuris are frequently liable to auto-infection, this takes place exclusively through the mouth, and is conveyed by the fingers, on which the ova of Oxyuris, and occasionally the female worms, have clung.
Fig. 347.—Oxyuris vermicularis: egg freshly deposited, with tadpole-like embryo. × 640.
