22 PARASITES OF MAN 



expulsion of some of the parasites had occurred. Accord- 

 ing to the patient's statements this result, so far, was entirely 

 due to his having been placed on a milk diet ; this course 

 of treatment having been recommended by Dr Henderson, 

 of Shanghae. The patient himself always suspected the pre- 

 sence of intestinal worms of some sort or other, although a 

 Japanese doctor laughed at the idea of such a thing. Some 

 other doctor treated this missionary for parasites, administering 

 both male-fern and santonine without effect. 



It was not until several months had elapsed that his wife 

 was attacked with diarrhoea. In both cases there was more or 

 less flatus. The motions were white, and there were other indica- 

 tions implying that the liver was affected. Later on, symptoms 

 of indigestion, with heartburn, set in and became very severe. 

 Streaks of blood appeared in the faeces, but there was no 

 dysentery. For the most part these symptoms were attributed 

 to the effects of climate. 



When, in the month of February, 1875, I saw the missionary 

 a second time, professionally, I found that all the old sym- 

 ptoms had returned. He had a foul tongue, the surface of the 

 body was cold, he felt chills, and the pulse, though regular, 

 registered ninety-six to the minute. Indigestion, nausea, head- 

 ache, and diarrhoea had reappeared. Notwithstanding these 

 febrile symptoms, so satisfied was the patient himself that all 

 his ailments were entirely due to the presence of parasites, that 

 I felt inclined to take the same view of his case. Accordingly 

 my attention was principally directed to an effort for their expul- 

 sion ; and in this view I ordered an aloetic pill followed by a 

 castor-oil emulsion. This having no effect, I subsequently 

 prescribed aloes and assafretida pills, followed by scammony 

 mixture. The action of the latter drug did not occasion griping, 

 but, although efficient, led only to negative results. I should 

 mention that in the patient's judgment none of the vermifuges 

 administered to him at any time had exerted any influence in 

 the expulsion of the flukes. He was still thoroughly impressed 

 with the notion that the milk diet, ordered by Dr Henderson, 

 was the sole cause of their expulsion. 



As even a missionary could not live by milk alone I insisted 

 upon a more substantial diet. The milk, indeed, had occasion- 

 ally been supplemented by Liebig's extract of meat and by light 

 farinaceous food. When I last saw him neither he nor his wife 

 had passed any more flukes, but they did not feel satisfied that no 



