THREADWORMS. 95 



troubled with threadworms from childhood, and 

 had undergone all sorts of treatment without any 

 manifest advantage. She appeared to be as it 

 were " eaten up with worms/' and in addition to 

 the ordinary symptoms superinduced by these crea- 

 tures they had brought on severe chlorotic symp- 

 toms, ansemia, asthenia, and utter prostration, 

 accompanied with complete deafness. In fact, I 

 found her in an apparently moribund condition. 

 Naturally it was difficult to say what was the best 

 treatment to advise, as the system required every 

 kind of support, while at the same time the para- 

 sites were the true cause of her ruined health. At 

 some risk I ordered a brisk purgative containing 

 spigelia, but the action was too powerful to allow 

 of her taking a second dose. I subsequently en- 

 couraged the use of enemata ; but the patient's 

 previous experiences seemed only to induce despair 

 as to any good results being obtainable from this 

 source. The case is instructive, as showing the 

 necessity of treatment before the time arrives when 

 active anthelmintics can no longer be borne. 



CASE LIV. H. H. T., a surveyolr, of middle age, 

 requested advice on the 12th July, 1869. With 

 a foul tongue, depressed look, and remarkable dul- 

 ness about the eye, there was continual trembling 

 of the upper limbs, especially of the right limb, 

 attended with general restlessness, hemicrania, and 

 anxiety. He could not even hold a pen to write. 



