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XLV] ceived its justification by the appearance of one or more ascarides in the stools.

Adults, especially young adults, although to a much smaller degree than children, are liable to entertain these verminous visitors. Sometimes certain obscure dyspeptic symptoms in grown-up people will resist all treatment until three or four grains of santonin and a purgative have been administered. I had a patient once who for a long time had been troubled with unaccountable nausea. One day, while he was sitting at breakfast, the feeling of sickness came on with unusual intensity. He had to leave the table, and, after one or two retching efforts, brought up an Ascaris lumbricoides. After this he was no more troubled with nausea. It is well, therefore, when puzzled over some obscure dyspeptic condition in tropical patients, to bear the ascaris in mind. If, for some reason, it is undesirable to give santonin unnecessarily, the stools ought first to be examined with the microscope. If ova (Fig. 168, f, g) are found, a dose or two of santonin may clear up the diagnosis and cure the patient; if no ova are found, the drug may be withheld and the idea of ascarides abandoned.

Treatment.— The ascaris is readily expelled by a few grains of santonin. The dose is from ½ to 1 gr. for a child, 3 to 5 gr. for an adult. A good plan of giving the drug is to prescribe three such doses on successive nights, the first and the last dose to be followed by castor oil next morning. Patients, or mothers, ought to be warned about the peculiar effect santonin has on the urine and sometimes on the vision. I have only once seen any bad effect; in this instance a peculiar sort of intoxication, attended with delirium, which did not quite pass away for several days, followed its exhibition. Lagochilascaris minor (Leiper, 1909) was removed from an abscess in a native of Trinidad. This species is normally an intestinal parasite, and its occurrence under the skin of man undoubtedly indicates an abnormal infection. L. major (Leiper, 1909) is found in the lion in East Africa. The male is 5 mm. by 2 mm., the female 15 mm. in length. There are three cuticular lips, separated from the body by a