62 LECTURES. 



one month he wrote to the effect that the pro- 

 glottides had reappeared, and thus my suspicions 

 proved to be correct. In the following June he 

 returned to town, and placed himself under my 

 immediate care, when accordingly I adopted the 

 male-fern method of treatment. The first two 

 administrations produced no result, but on doubling 

 the dose of the extract and increasing its action by 

 cathartics and plenty of coffee, the desired effect 

 was accomplished. The parasite measured sixteen 

 feet in length. 



This case is particularly instructive, as showing 

 the correctness of the diagnosis, the propriety of 

 delaying to give anthelmintics, and the possibility 

 of the parasites resisting one drachm doses of the 

 ethereal extract of male-fern. Though the head of 

 the entozoon was not found at the time, it pro- 

 bably came away with a subsequent movement of 

 the bowels. If it had returned I should have been 

 informed in view of a repetition of treatment. It 

 is not often, however, that you will find patients 

 occupying a lower sphere of life who will accept 

 with good grace this kind of advice; but our 

 endeavour should be to do the best we can for 

 them, notwithstanding that they are utterly dis- 

 satisfied with our opinion. The late Professor Syme, 

 of Edinburgh, once told me of a patient who came 

 to him with the intention of having his leg cut off; 

 and on being informed by that distinguished 



