522 THE ANIMAL PARASITES OF MAN 



are often unaware of the presence of their guest until they note the discharge 

 of proglottides. The distressing thought of being the host of such a guest 

 causes the carriers of the parasite to seek medical aid. Strong, robust persons, 

 owing to their good constitution, are often uninjured by the parasite. A weak 

 constitution and sensibility, or other factors which are especially the cause of 

 disintegration of the blood leading to pernicious anemia, will produce symp- 

 toms in the affected individuals, sometimes even the most severe morbid 

 phenomena. 



There are patients who harbor the parasite for years without presenting 

 the slightest sign of helminthiasis. On the other hand, in sensitive persons 

 the symptoms may be numerous. In all cases the most positive indication is 

 the passage of segments of the worm, which occurs at times spontaneously, 

 at other times with the feces. With tenia saginata the spontaneous discharge 

 of proglottides appears to be more frequent than with tenia solium. In the 

 case of the bothriocephalus segments in chains amounting to several meters in 

 length are passed. 



Not infrequently the ingestion of very salty food, of blueberries, straw- 

 berries, salad, or of alcoholic drinks, causes the passage of segments. In very 

 rare cases, proglottides are vomited. By reason of abnormal protrusion of the 

 intestines or of the pelvic organs from the abdominal coverings, proglottides 

 occasionally appear externally. 



Besides these symptoms the microscopic examination of the feces is of 

 especial importance in the diagnosis. This should never be neglected if the 

 presence of tape-worm is suspected. Very frequently by careful, oft repeated 

 examinations of fecal masses indistinct symptoms on the part of the digestive 

 apparatus, of the nervous system, or of the general nutrition, have been ex- 

 plained, and treatment directed into the proper channels. As the uterus of 

 the tenia has no exit, the eggs can only find egress when the uterus of the 

 mature proglottid is injured. In the case of tenia saginata, discharge of 

 the eggs is almost the rule. The proglottides which are discharged are usually 

 without eggs. The ova of the bothriocephalus are extruded into the feces from 

 the uterus which has an external mouth. These may readily be differentiated 

 from the eggs of teniae, whereas the eggs of tenia saginata and tenia solium 

 only differ by their variation in size. 



Besides the ova, Charcot-Robin's crystals are found in the feces as in the 

 case of other helminthiases. 



Whereas the passage of ova and proglottides is the most positive, and 

 occasionally the only, symptom of an existing tape-worm, the other symptoms 

 of tenia permit us to recognize the presence of a tape-worm with but slight 

 probability. In some patients there are disturbances of the digestive apparatus. 

 I shall only mention here pyrosis, bulimia, nausea, a longing for spicy food, 

 etc., symptoms which, as is well known, are grossly exaggerated in the pam- 

 phlets of quacks to attract the attention of patients. In others there are 

 cohcliy pams which are occasionally more severe after taking sour food, and 

 better after fluids. It is evident that the tape-worm acts as a foreign body 

 in the intestinal canal, and may exert a powerful irritation in the region it 

 inhabits. Probably the booklets which some tenise possess may share in this 



