524 THE ANIMAL PARASITES OF MAN 



In conclusion I must mention the fact that persons who have previously 

 been the hosts of parasites, and even persons who have never been affected 

 by tape-worm, but who have read or heard of the symptoms of helminthiasis, 

 occasionally suffer from hypochondria verminosa or teniaphobia. Ifervous 

 disturbances which appear incidentally are referred to the presence of a tape- 

 worm. That hysterical or hypochondriacal individuals are particularly pre- 

 disposed to these conditions is so obvious that it need not be especially dwelt 

 upon. 



On account of the great number of local and general symptoms caused by 

 the presence of this parasite, considerable experience must have been acquired 

 to make one suspect the presence of a tape-worm. Certain symptoms which 

 are occasionally present in helminthiasis arouse this suspicion. Among these 

 are the complaints that the symptoms are most distressing when the stomach 

 is empty, and that the disturbances are less on taking sweet food, but are 

 increased by salty or acid food. However, I never begin a tape- worm treat- 

 ment until after the presence of the parasite has been proven by the passage 

 of proglottides or the eggs in the feces. In examining these the physician 

 must be careful not to confound remnants of undigested food, mucus casts, 

 and shreds of tendons, often mistaken by the laity for proglottides, and thus 

 make an erroneous diagnosis. Dry proglottides after being soaked in water 

 soon assume their characteristic form. As a rule, the microscopic determina- 

 tion of the eggs of the tenia enable us to make the diagnosis earlier and 

 with greater certainty than by the macroscopic proglottides. The encapsulated 

 eggs of the bothriocephalus are readily recognized, but, as has already been 

 mentioned, the differentiation between the eggs of tenia solium and tenia 

 saginata is more difficult. 



To recognize from the shape of the proglottid which variety is present 

 it is advisable to fix this between two glass slides. The proglottid of the 

 tenia solium is more delicate and more transparent than the tougher segments 

 of the tenia saginata. In the former the structure of the branching uterus 

 is more plump, the number of lateral twigs only amounts to from 7 to 10, 

 while the uterus of the tenia saginata shows from 20 to 50 and more lateral 

 twigs. For the recognition of the less frequent parasites special text-books 

 on the subject must be consulted. 



PROGNOSIS 



The prognosis is generally favorable. Even in cases of severe bothrioceph- 

 alus anemia cure has generally taken place after the removal of the parasite. 

 Parasitism with the tenia solium necessitates special care on account of the 

 danger of autoinfection with the booklets. It is particularly apt to occur 

 from the appearance of ripe proglottides in the stomach as the result of anti- 

 peristaltic movements. Prolonged presence of the proglottides in the stomach 

 explains why, in some persons, the cysticercus is found with such extraordi- 

 nary frequency in the brain and in the musculature. Even in the eye occa- 

 sionally more than one cysticercus is found. The host of the tenia solium 

 is also a certain menace to those about him. By insufficient cleanliness, 

 by careless handling of the proglottides which have been passed, and by 



