SUPPLEMENT 669 



rightly desires the abolition of the custom of manuring fruit-plants 

 such as strawberries, vegetables and salad with the contents of privies, 

 and would extend the use of privies in the country. 



Symptomatic treatment consists, in the case of those Tseniae which 

 resist radical attempts at expulsion, of repeated use of drugs injurious 

 to the worm as soon as ever new proglottides are formed, or in 

 special cases, as in the case of persons weakened by diseases or 

 operations, or frail old people, or patients with severe heart failure, 

 gastric or intestinal carcinoma, or in pregnancy, in effecting the 

 expulsion of a large chain of proglottides by the mildest measures 

 possible. 



Radical treatment of the Taenia is not always equally easy in all 

 three species, even when the means used are the same ; the easiest to 

 expel is T. solium, then D. latus, and the most difficult T. saginata. 

 That as yet no certain cure exists for Cestodes is clear from the large 

 number of drugs recommended from time to time, and the increase 

 of bungling treatment in this respect ; in addition, there is no depart- 

 ment in which there is so much quackery as in vermifuges. The 

 treatment proper should always be preceded by thorough preparatory 

 treatment, the purpose of which is to render the gut as empty as 

 possible once for all, and on the other hand to put the worms them- 

 selves into a diseased condition. How far the host himself has been 

 made ill by such preliminary cures (herring, pickle, garlic, onions, 

 preserved strawberries), many a person who has had to do with such 

 things can recount. In the opinion of Fischer 1 strict preparatory 

 treatment appears to favour the development of toxic substances, or 

 else it disposes to vomiting ; as a rule it causes the patient far more 

 discomfort than the treatment itself. In recent times far less weight 

 is attached to these preparatory treatments than to carefully prepared 

 and correctly dosed drugs ; the preparation is generally limited to 

 relieving the intestine in a simple way, the day before the treatment, 

 of the densest faecal masses, by a simple aperient or water enema. 



We recommend the following, which has always proved itself to 

 be the best and simplest remedy against T. saginata. The patitfnt 

 takes early in the evening before the treatment nothing but a plate of 

 soup or a glass of milk, and then takes a laxative (electuar. lenit or 

 infus. sennas compos, or an enema), so that later in the evening one 

 to two stools are passed. In this connection we fail to agree with 

 Grawitz 2 and Boas, 3 who consider that at least preliminary evacua- 

 tion of the intestines can be dispensed with. On the following 



1 Fischer, Stockholm, Nordin and Josephson, 1904. 



2 Grawitz, Munch, wed. Woclienschr., 1899. 



3 Boas, Dtutsch. med. Wochemchr., 1889. 



