INFECTION BY WHOLE PROGLOTTIDES. 545 



tremities, which seemed almost "stuffed" with them.' Similarly 

 Gubain reports^ a case where the muscles and internal organs (heart, 

 brain, and viscera) were so full of bladder-worms " that had one not 

 seen the resulting disorganization one would not have believed it." 



Such occurrences cannot, of course, be referred to the introduction 

 of isolated eggs ; it must have taken place en masse, either by a large 

 number of newly expelled eggs,^ or of eggs still within the proglottis. 

 In other words, whole proglottides or series of them may be trans- 

 ferred to the stomach of their host, and there liberate the eggs. 



We can hardly bring ourselves to suppose that it can ever happen 

 that man should infect himself with a whole brood as the swine do. 

 One must, however, face the facts, apart from any aesthetic prejudice, 

 and there are several disgusting possibilities of this sort. 



First, we must remember that there are among men coprophagous 

 persons even besides the insane, and such an one may easily become 

 infected like a pig.* The only question is as to the real existence of 

 such a habit. On this point we have suspicion rather than fact to go 

 upon. But at any rate this does not exhaust the possibilities of in- 

 fection en masse, for the proglottides may also by themselves find their 

 way to the mouth. 



We cannot suppose that any one would wittingly swallow a tape- 

 worm joint. But apart from the possibilities open to children and 

 the insane, the tape-worm patient may readily infect himself with 

 the proglottides during sleep by lifting the hand to the mouth. The 

 transference is, however, more frequent when, by shrivelling and 

 drying up, the proglottides become indistinguishable, are then car- 

 ried by chance in various directions, which distribution sometimes 

 not unnaturally results in their being swallowed. Disorder and un- 

 cleanliuess in the room and house are fertile sources of increased risk. 



When an inmate of the house or a member of the family suffers 

 from Tcenia solium, there is obviously special necessity for cleanli- 

 ness and care. The linen of the patient should be frequently changed, 

 the buttocks and hands should be frequently washed, the excrement 

 carefully removed, and the voided proglottides destroyed, if possible, 

 by burning, without touching the hands. The patient is himself in 

 greatest danger of self-infection. 



' Onymua, Gaz. des hSp., p. 237, 1865. 



' Quoted by Stioh, foe. cit., p. 176. 



° We may also note that even after an abundant introduction, only one bladder- worm, 

 or but a few, may develop. 



* In fact Wendt and Birch-Hirsohfeld have found numerous Cyslicerci in the brain of 

 a coprophagous tape-worm patient. Wendt, Allgem, Zeitschr. f. Psychiatrie, Bd. iii., 

 1872 ; and Biroh-Hirschfeld, Jahrb. d. pathol. Anal., p. 203, 1876. 



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