68 LECTURES. 



worms, it is always worth while ascertaining the 

 presence or absence of threadworm in any case 

 that may present itself for treatment. Here is an 

 instance in which I prescribed for the two kinds of 

 entozoa : 



CASE XXXVII. B. V. H., about thirty-five years 

 of age, an officer in her Majesty's Hidian army, 

 sought my advice on the 13th of May, 1871. He 

 has been infested by tapeworm for a period of ten 

 months. He is quite sure that he contracted the 

 disorder in the Punjaub, where measly beef is 

 unusually prevalent. He has been treated with 

 kousso and male-fern ; but with such feeble results 

 that hitherto only a few inches of the worm 

 have come away. Proglottides, nevertheless, are 

 passed daily. His general health is good; but 

 he is sometimes troubled with slight hemicrania, 

 vertigo, and singing noises in the head. At 

 once adopting the male -fern method I expelled a 

 very fine specimen of the beef-tapeworm, measuring 

 fifteen feet in length, including the finest neck- 

 segments close up to the head. Observing a solitary 

 threadworm in the faeces I advised some further 

 treatment in view of ascertaining whether any 

 more were left behind. I administered areca-nut 

 powder and santonin, followed by a brisk saline 

 purgative ; but this combination was adopted not 

 alone for the purpose of testing for oxyurides, 

 seeing that the head of the tapeworm might still 



