68 TROPICAL MEDICINE AND HYGIENE 



this action by the administration of one drachm of 

 freshly prepared oil of male fern in gelatine capsule or 

 emulsion with a half-an-ounce dose of castor oil ; some 

 prefer to the castor oil one minim of croton oil. If, 

 however, this treatment fails and the segments are again 

 passed after about two months, much more careful pre- 

 paration of the patient is required. 



The diet for three or four days should be light milk 

 puddings, beef tea, milk and soda, or milk and barley 

 water, with only a little fish or meat should be taken. 

 Vegetables and fruit that do not leave too hard a residue 

 may be taken. The bowels should be kept freely open 

 each morning with a salient aperient and small doses 

 (J^ gr.) of calomel taken three times a day. Some 

 American authorities recommend podophyllin in the 

 belief that this drug tends to remove the mucus surround- 

 ing the head of the worm. Some prefer, in addition, 

 to give doses of ammonium chloride, 5 to 10 gr. in a 

 wineglassful of water three times a day. By these means 

 the mucus in which the scolex is embedded will be to a 

 large extent removed. 



On the day before the treatment is commenced the 

 patient must be kept in bed and take very little food, 

 and none at all after 4 p.m. The bowels must be kept 

 freely open with salines. 



On the following morning at 7, 8, and 9 a.m., half a 

 drachm of the fresh oil of male fern should be given, and 

 in addition, at 8 or 9 a.m., 5 drachms of the mixture 

 so much used for ankylostomes (eucalyptus oil or 

 eucalyptol rrixxx, chloroform rrixl, ol.ricini, 5x). 



.The patient must be kept absolutely at rest and not 

 allowed to sit up or raise his head. No food of any kind 

 should be allowed till a motion has been passed, and 

 only fluid nourishment throughout the day. 



Unless the scolex be passed the treatment has probably 

 failed. In addition to examining the motions for the 

 scolex, and straining the stool if necessary, it is advisable 

 to make sure that there is not more than one tapeworm. 



