248 DISEASES DUE TO HELMINTHS 



Bilharzial tissue may form in any part of the urinary tract. 

 It may spread to the rectum and abdominal wall with sinuses, and 

 may affect the prostate. 



SYMPTOMATOLOGY. 



After the Transvaal War, many of the soldiers took it with them to 

 England, India, and to other places. 



Incubation (?) from three to six months (Sandwith). 



The symptoms may be absent or considerable, according to the 

 amount of the infection. 



There are : frequency of micturition, burning pain about the 

 urethra and perin^eum, straining after micturition. Haematuria at the 

 end of micturition at first (endemic hcematuria). 



The urine centrifuged shows the ova. 



There may be pain in the back, gluteal region, and down the legs. 



The urine is foul-smelling, decomposes, is alkaline, turbid, and 

 contains pus, phosphates, blood and ova. 



Cystitis sets in and the other symptoms increase. 



There is no rest dav or night. 



A calculus may form to add to the misery. The prostate enlarges. 



A urinary fistula may form above the pubis. 



Pyonephrosis may develop, the kidneys enlarge, and septicaemia 

 set in. Prostatic inflammation predisposes to new growths. 



Stricture is not uncommon. In females there is vaginitis with 

 papillomatous masses about the vulva. The uterus and ovaries have 

 been found infected. 



Severe haemorrhage may ensue from the large vessels. 



There may be cirrhosis of the kidneys with high blood-pressure. 



When the spinal cord is attacked the symptoms may imitate tabes 

 dorsalis or disserninated sclerosis. 



TREATMENT. 



Most cases cease to discharge eggs within five years of leaving the 

 endemic area. 



There is no specific drug for the parent worm. 



Give male fern, u^ v, t.d.s. for a long time. 



Give bladder washes of silver nitrate i in 10,000 at first, or quinine 

 4 per cent., or adrenalin in saline. 



Helminthol, grm. i, t.d.s. may be tried. 



Urotropin, salol, benzoic acid, buchu, and hvoscyamus all have 

 their advocates. Good results are claimed for emetine. 



Christopherson claims that antimony tartrate intravenously will 

 cure. In vesicle infections inject along the dorsal vein of the penis. 



Much water and fluids should be given to act mechanically. 



