174 ANIMAL PARASITES. 



merit. The worm may even be expelled from pregnant women 

 without injury, in the fifth and sixth months. 



Schmidtmiiller's method. — After one day's fasting and the 

 administration at night of ^'j of castor oil, 3'U °f fresh bark, 

 after macerating for twelve hours in ^-xij °f water, are concen- 

 trated to 3 v j by a gentle heat, and this fluid is taken in three 

 doses within an hour. 



In ail these methods evacuation takes place without purga- 

 tives, as the fresh bark usually acts as an aperient itself; and in 

 this lies the great advantage of the fresh bark, and a principal 

 cause of the great uncertainty of most of the previous methods, 

 in which the dried bark was employed. To produce the aperient 

 action with certainty, the dried bark needs the addition of pur- 

 gatives. According to my experience, the neutral salts and the 

 true drastics, such as jalap, are greatly to be preferred to the 

 oils. But they all have something to be desired ; but I regard 

 it as the most natural plan to imitate the purgative action of 

 the fresh bark by the addition of some other a^ent which acts 

 as a purgative. To refer to particular methods here would 

 be superfluous, as they all agree. At the utmost they vary in 

 the dose of the bark and the preliminary treatment with castor 

 oil. 



As regards myself, I prefer the Extract. Radic. Punic. Granat., 

 prepared according to the prescription above given, to all other 

 remedies for tape-worm with which I am acquainted. As the cases 

 scattered through medical literature and my own experience have 

 shown me, the Kousso loses much of its value, because the worms 

 are expelled so much broken up in the region of the neck, 

 whilst in almost every case of expulsion effected by the pome- 

 granate bark we find it stated, " The worm was passed in one 

 piece with the head," or " The entire worm passed unbroken, and 

 in a single coil •" reason enough for our taking trouble to make 

 the administration of this remedy more agreeable, and by which 

 we can render its results still more certain. 



b. Combined methods with pomegranate bark and Filix mas. — 

 One of the first who combined the etherial extract of fern 

 roots (3ij) with the decoction of commercial pomegranate bark, 

 was Von Klein, of Stuttgart. 



I myself combine the aqueous extract of pomegranate bark, 

 prepared as above, with Extract. Filic. Mar. iEther., in the fol- 

 lowing manner : R Extracti Radic. Punic. Granat. aquosi, 



