SUPPLEMENT 675 



(Brims, 1 Leichtenstern 2 ). According to Kurlow/ 1 in Siberia there is a 

 form of sporadic bloody diarrhoea which has its origin in the presence 

 of Strongy hides stcrcoralis. The parasite does not live only in the 

 intestinal lumen, but also in the intestinal wall, where it causes 

 abscesses, fistulae and effusions of blood. 



Diagnosis is easily made by the detection of the actively moving 

 larvae in the stools. 



Treatment is rather difficult, as it is not always successful in 

 getting rid of the parasites. Authors differ as to the effectiveness of 

 extr. fil. maris. Goldmann 4 still considers this preparation as the most 

 effective ; he recommends preliminary treatment with calomel o'2 grm. 

 and tuber, jalapae 0-5 grm. a day before the special treatment, which 

 consists of gelatine capsules of 15-0 grm. extr. fil. maris (to be taken 

 in the course of four hours) ; afterwards rectified oil of turpentine 

 in gelatine capsules. The thymol treatment (vide Ancylostomiasis, 

 p. 682), thymol alone or in combination with calomel (Schluter, 5 Valdes, G 

 Soussino, 7 Goldmann 8 ), has often caused diminution of the number 

 of larvae, but also often remains resultless. Teissier 9 maintains that by 

 degrees he procured complete cure by the administration of mercury 

 in the form of blue pill. In our case neither thymol nor calomel, 

 santonin, extr. fil. maris, decoct, rad. granat., had any result whatever. 

 Davaine 10 believes he attained decrease and final disappearance of 

 the Iarva3 by protracted milk-cure. Santonin, tannalbin and other 

 preparations seem ineffectual. Tannin enemata (Mildner 11 ), high 

 injections with starch enemata (Schliiter 12 ), may alleviate in persistent 

 diarrhoea. Travellers who are visiting regions the native home of 

 Strongyloides must exercise the most extreme care and scrupulous 

 cleanliness, and these are also necessary in patients already suffering 

 from Strongyloides, to prevent auto-reinfection (Trappe 13 ). 



Dracunculus medinensis (Dracontiasis). 



The guinea worm develops in the dermis of human beings with- 

 out any symptoms ; only when it is completely grown does it form 

 boil-like, extremely painful abscesses, in the greater majority of cases 

 in the legs, in the region of the ankle, and is accompanied by general 

 disturbance and a feeling of heaviness, dragging and pricking of the 



1 Bruns, Munch, med. Wochenschr., 1907, xix. 



- Leichtenstern, Deutsch. med. Wochenschr., 1898. 



3 Kurlow, Centralbl.f. Bat.,iqo2. * Goldmann, Deutsch. Aerzte-Zeitg., 1903. 



3 Schliiter, " Diss. Kiel," 1905. 6 Valdes, loc. cit. 7 Soussino, see Schliiter he. cit. 



s Goldmann, loc. cit. 9 Teissier, Arch. d. Med. exp., 1895. 



10 Davaine, see Seifert, Deutsch. med. Zeitg., 1885. 



11 Mildner, Berl. med. Ges., July 24, 1907. 



12 Schliiter, loc. cit. > 3 Trappe, loc. cit. 



