644 THE ANIMAL PARASITES OF MAN 



with undoubted success, in so far that the haemorrhages became 

 considerably less in amount. As two patients in the course of enteric 

 fever lost their haematuria, Stock accordingly recommends subcu- 

 taneous injections of Wright's typhoid vaccine. In the early stages 

 of the rectal lesion suppositories of iodoform, ichthyol, or narcotics 

 might possibly be of use. In the case of urethral fistulae, division, 

 excision and scraping out of the granulation tissue are recommended ; 

 in cystitis with formation of tumours high resection with curetting 

 of the tumours or their destruction with the cautery ; in the case of 

 vesical calculi, high resection, curetting the bladder, and then 

 drainage. Tumours of the rectum must also be removed by 

 operation. 



Prophylaxis is important ; it should be extended to all modes of 

 using water, only filtered water being drunk, and only boiled water 

 being used for washing. This advice should be given to tourists who 

 travel through the infected districts, and is also recommended to 

 soldiers and officials who are despatched to the Colonies. The favour- 

 able influence of change of climate can only show itself where fresh 

 infections are avoided. 



CESTODES. 



GENERAL. 



It seems advisable to preface the section on the Cestodes with 

 some general observations on the symptoms of disease provoked by 

 tapeworms, especially so far as they relate to the question of toxic 

 effects, and to include the Nematodes in this discussion. After this 

 will follow a brief exposition of the most important intestinal lesions 

 causally connected with intestinal parasites. 



It is known to every experienced practitioner that the different 

 intestinal parasites can give rise to a series of nervous symptoms, 

 slight or severe, and produce, above all, blood changes anaemia of 

 the most varied nature, to the extent of severe progressive anaemia. 

 These symptoms are regarded by many authors as reflex, or, as in 

 the case of ancylostomiasis, the main feature from the loss of blood 

 caused by the habit of life of the intestinal parasites. More fre- 

 quently, however, they are regarded as toxic conditions produced by 

 the parasites. In view of this divergence of opinion there appears 

 to be some advantage in defining clearly the present position as to 

 the toxic action of parasites. Most interesting in this respect are 

 Dibothriocephdlus hi Ins and Ancvlostoina dnodcnale. 



We are indebted to the clinic at Helsingfors for our most detailed 

 knowledge of bothriocephalus anaemia. Reyher 1 was the first to 



Reyher, Deutsch. Arch. f. klin. Med., 1886, xxxix. 



