INFECTION WITH T^NI^ 67 



convenience from an infection with this worm, it is very 

 different in the case of a chronic invalid, and it will 

 invariably be found that as the tapeworm matures the 

 patient will lose weight. The preliminary fasting and 

 the purgation required to remove the worm are not 

 well borne by such patients. 



Varied opinions have been held as to the import- 

 ance as causes of ill-health of infection with Taeniidae. 

 To many people the presence of such worms is a source 

 of annoyance, and such persons will refer any ill-health 

 or dyspeptic symptoms to these worms. Whether the 

 disease is really caused by the worms or whether their 

 presence merely leads to morbid feelings, the expulsion 

 of the worm is equally imperative. In other cases the 

 ill-health precedes the knowledge of the presence of the 

 worm ; and in invalids fed on raw meat, if they become 

 infected, loss of weight certainly occurs. 



Expulsion of the worm is strongly indicated where 

 the condition of the patient admits of the treatment. 

 Any purgative will cause the expulsion of immature as 

 well as of mature segments ; but as long as the scolex 

 remains new proglottides are formed and after an interval, 

 dependent on the length still remaining, segments will 

 again be passed. After an abortive attempt at treatment 

 there is usually a period of two months before mature 

 segments are passed. The expulsion of the scolex is 

 therefore necessary. 



Treatment. In many cases the worm is easily expelled, 

 in others several attempts may have to be made. 

 Probably the amount of mucus influences the result. 

 Treatment may be divided into three stages : (i) pre- 

 liminary, starving and purgation ; (2) anthelmintic, oil of 

 male fern in full doses, combined with or followed by 

 (3) a purgative such as castor oil. (i) In many cases it 

 is sufficient to keep the patient without food for twelve 

 hours, and give a brisk salient aperient so as to act freely 

 in the early morning, but it is better for light diet only 

 to be taken for two or three days previously. (2) Follow 



