OXYUEIS VEKMICULAEIS. 373 



itching is laid to the account of the Molimina heemorrhoidalia, 



whilst it is a purely mechanical phenomenon. If the worms be 

 not disquieted by any particular cause, the annoyances cease 

 during the day but come on all the more violently when the 

 patient goes to bed. For this reason I am inclined to regard 

 the Oxyurides as nocturnal animals. Then they wander out of 

 the anus, keep off sleep, and make it restless, especially in 

 irritable children ; although adults, and even old people, are also 

 troubled in their sleep by this cause. The consequences of the 

 constant itching are not only a general disturbance of the nutri- 

 tion by the prevention of sleep, but it leads, after the age of 

 puberty, to increased sexual irritation, onanism, &c, in both 

 sexes. The latter phenomena occur especially when we have to 

 do with the female sex, and the worms wander into the vagina, 

 which takes place not very unfrequently, and give l'ise to mecha- 

 nical irritation of the vagina, leucorrhcea, pruritus, &c. 



The diagnosis can only be established with certainty when 

 worms are observed in the evacuated fasces. The quickest way 

 of getting a clear diagnosis is by a clyster and the examina- 

 tion of the fasces. 



The prognosis is unfavorable, as although the disorder may 

 certainly be relieved, it is only got rid of with difficulty, even 

 with age. 



Treatment. — I mav be excused from enumerating here all the 

 remedies which have been recommended for these worms. In- 

 ternal remedies are in general but little to be recommended. 

 Whoever has had to do with the expulsion of Tceni<e will, how- 

 ever, have had the opportunity of seeing that when the anthel- 

 mintics administered have been carried rapidly through the 

 bowels by the addition of purgatives, they frequently remove a great 

 number of Oxyurides. This applies especially to those which are 

 administered in the form of powder, or in that of a difficultly 

 soluble extract ; for example, my extract of pomegranate-root, 

 the powder of Kousso, Panna, Filix mas, &c. Thus Dr. Pockels, 

 of Holzminden, gives Filix powder and Jalap in some sweet 

 juice. With me, the long-continued use of a tea made from 

 Flores Verbasci proved to be of good service. The flowers are 

 left in the infusion, and used with it. The fine hairs of the 

 flowers appear to irritate and disturb the worms mechanically. 

 Violent diarrhoeas, as well as violent purgatives, only diminish 

 the numbers of the worms, but never entirely destroy them. 



