72 TROPICAL MEDICINE AND HYGIENE 



Aspiration with an exploring needle or a large hypo- 

 dermic syringe is often conclusive, but should not be 

 done unless all preparations for the completed operations 

 have been made. The proofs obtained are : (i) frag- 

 ments of the laminated membrane may be found ; (2) 

 detached booklets or even a complete scolex may be 

 obtained; (3) if clear fluid be drawn off, free from 

 albumin and of low specific gravity, 1010, it is highly 

 suggestive. The proceeding is not free from risk, as 

 sudden death may occur. The puncture in some cases 

 leads to rupture of the cyst, if in the liver into the peri- 

 toneum, or if in the lungs into the bronchi. Smart 

 attacks of urticaria may follow such explorations, or even 

 death, due to the absorption of the toxins in the fluid 

 within the cysts or in fluid that has escaped from the cysts. 

 Possibly the grave results are essentially anaphylactic. 



The use of X-rays has greatly facilitated the diagnosis 

 of these cysts, so that such exploratory measures are 

 rarely needed now for diagnosis and should not be made. 



Prophylaxis includes registration of dogs, destruction 

 of butchers' offal, and prohibition of dogs in any slaughter- 

 house. It is important to thoroughly cleanse such veget- 

 ables as are eaten raw, and it is advisable to drink only 

 boiled water, as the oncospheres may be blown into 

 drinking water. 



TABLE OF TAPEWORMS FOUND IN MAN. 



Dibothriocephaloidea I I I I 



| Dipylidiuni Hymenolepis Davainea Tania 



I ~T~ till! 



Dilothrio- Diplo- Sparga- D. caninum H. nana D. mada- T. sohum 



(Cphalus gonoporus num (?) H.dimimita gascariensis 7\ sa^inata 



IJj T. africana 



D. latus D.grandis S. man- 7. confusa 



' soni T. echino- 



