Ascaris lumbricoides, the largest nematode, has a worldwide distribution and is most common in underdeveloped countries and areas with poor sanitation. Symptoms usually occur in the presence of large worm burdens and include intestinal obstruction; volvulus; obstructive jaundice; cholangitis; cholecystitis; pancreatitis; and bleeding, be it occult, obscure, or massive, from the small bowel, the colon, and even the esophagus. Alice of Wonderland would be curious why the double-balloon enteroscopy was negative, whereas the capsule test was positive, although it is possible that the answer is in highly specific worm locations. Finally, I can see the use of Weber's scales to quantify human response to physical stimuli, personality traits regarding risk taking, and also lengths of octaves in mandolins but not to quantify the degree of melena. In one regard (only one regard), melena is like pregnancy: positive is positive without the need to define how much.
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