1907, Charles Wardell Stiles in Modern Medicine, Chapter XXVI., page 601:One of the most constant symptoms is an intense itching and burning at the anus, due to the wandering of the female, especially shortly after the patient retires; the anus appears red, irritated, sometimes bloody; reaching the perineum the worms may pass to the vagina if the skin is moist, and may here cause hyperæmia, increased secretion of mucus, and sometimes hyperæsthesia and leukorrhœa; sexual excitement may result.
