T^NIA SOLIUM 239 



During the last decades, however, these cases have also become 

 less common ; thus, according to Virchow, since the introduction 

 of official inspection of meat, the number of cases of cysticercus 

 of the brain has fallen from i in every 31 post mor terns to i in 

 every 280 ; Hirschberg between 1869 and 1885 discovered cysticerci 

 in the eye seventy times in 60,000 ophthalmic cases, but during 

 the following six years the parasite was only present twice amongst 

 a total of 46,000 cases of ophthalmic diseases. 



The infection of human beings with cysticerci can only take 

 place by the introduction of the oncospheres of Tcenia solium into 

 the stomach with vegetable foods, salads that have been washed 

 in impure water containing oncospheres, also by drinking con- 

 taminated water ; the carriers of Tcenia solium, moreover, infect 

 themselves still more frequently through uncleanliness in defaeca- 

 tion, the privies in public localities and many private houses 

 contributing to this cause. The minute oncospheres can thus 

 easily reach the fingers and thence the mouth (as in twirling 

 the moustache, biting the nails). More rarely a third manner of 

 transmission or internal auto-infection may possibly take place, 

 as, when in the act of vomiting, mature proglottides near the 

 stomach are drawn into it ; the oncospheres or segments there 

 retained are then in the same position as if they had been intro- 

 duced through the mouth. 



On account of these dangers of internal or external auto-infection, it 

 is therefore the duty of the medical attendant, after recognising the presence 

 of tapeworms, to expel them/ and in doing so to employ every possible means 

 to prevent vomiting setting in ; it is, however, equally important to take 

 the necessary steps to destroy the parasites evacuated. It may be inci- 

 dentally mentioned that in using certain remedies the scolex not rarely remains 

 in the intestine ; the cure in such cases has not been accomplished, as the 

 scolex again produces new proglottides, and after about eleven weeks the 

 x first formed ones are again mature and appear in the faeces. 



Amongst the Cysticerci also many malformations appear ; thus absence 

 of the rostellum and the hooks ; or double formation with six suckers, or 

 abnormalities of growth on account of the surroundings, and which have 

 had a particular name given to them : Cysticercus racemosus, Zenk. 

 ( = C. botryoides, Hell.; C. multilocularis , Kuchenm.) ; these forms are more 



1 The diagnosis as a rule is not difficult ; the patients themselves frequently 

 observe the pumpkin-seed-like segments in the faeces. But in such cases the diagnosis 

 must still be confirmed. In other cases the discovery of tne oncospheres in their 

 shells, which cannot be confounded with the other constituents of the faeces, gives 

 complete certainty, although the differential diagnosis between T. solium and T. 

 saginata is hardly possible from the oncospheres ; but, if evacuated segments are placed 

 between two slides and lightly pressed, the species is easily recognisable by the shape 

 of the utuers. 



