256 DISEASES DUE TO HELMINTHS 



PATHOLOGY. 



The worms live in the puilal vein and capillaries of the bowel^ 

 where Uiey lay their eggs. The eggs burst the capillary, enter the 

 mucosa, cause cellular infiltration, thickening, mucus-covered papillo- 

 mata and ulcers. A dense fibrous infiltration of the peritoneum results. 



Large polypoid masses may protrude through the anus. 



A fistula may be caused in the subcutaneous tissue about the sacrum 

 and coccyx. 



The ova reach the liver by the blood-stream, and there form a patch 

 of fibrosis or an abscess. 



Gallstones may form around the ova of the bladder. 



The pancreas, spleen, urethra and vagina may be infected. 



A chronic interstitial pneumonia may be caused by ova reaching 

 the lungs, and from thence may enter the heart and the general 

 circulation. 



SYMPTOMATOLOGY. 



Sometimes nil in slight infections. 



There may be symptoms of chronic dysentery, abdominal pain, 

 blood, mucus, and ova in the stools. 



Prolapse of the rectum or of papillomatous growth is not un- 

 common, which is sometimes mistaken for hcemorrhoids. 



There is great agony from tenesmus when at stool. 



The prolapse, inflamed and painful, is the source of great discomfort. 



In cases where there is more fibrosis there is diarrhoea and consti- 

 pation. 



Tumours are sometimes found about the Ccecum or colon, which are 

 hard, movable, and are elongated in the long axis of the bowel. 



These may increase during the following months or years. 



Emaciation and attacks of colic are common. 



The liver may be enlarged and cirrhotic, also the spleen. 



The urine may be normal. 



PROGNOSIS. 



This is always unfavourable when the symptoms are marked. 

 The patient must be moved from the endemic area, if improvement 

 is to be expected. 



TREATMENT. 



Give male fern. 



Treat on general lines as for S. hjcmalobium. 



Whitehead's operation may be done for the treatment of many 

 rectal polypia. 



Irrigation of the intestine can be tried with sodium hypochlorite, 

 lo in 1,000, or of tannic acid, 3 in 1,000. 



