CESTODES 525 



contact with fecal masses, the possessor of a tenia solium may spread the 

 infection. 



THERAPY 



Prophylactic measures are based on the history of the development of these 

 parasites. In the first place the spread of cystieercus disease among animals 

 used for food must be prevented, and not only the tape-worms which are 

 voided, but also the feces of the patient with tape-worm disease should be 

 effectually destroyed, best by fire. All who harbor the parasites should be 

 placed under treatment as soon as possible, particularly such persons as come 

 in contact with animals used for food. The patients must be instructed 

 never to defecate in the open air. 



The dissemination of tape-worm is actively combated by the erection of 

 abattoirs and the introduction of compulsory meat inspection. It is true this 

 protection is not absolute, for even with experienced meat inspectors some 

 cysticerci which are deeply hidden in the muscles may be overlooked. I refer 

 particularly to the small cysticerci which are few in number, as in the case 

 of the tenia saginata. Cleanliness in the kitchen and in the household, espe- 

 cially in handling raw meat, is absolutely necessary. Vessels in which raw 

 meat is kept should not be used for other food substances. Thorough boiling 

 kills the cystieercus as well as corning, with or without subsequent smoking. 

 The process of smoking, alone, by no means prevents the development of the 

 cysticerci. The heat in the inner parts of the meat to be smoked certainly 

 does not reach 50° C. and an absolute protection is therefore not obtained. 



The removal of the tape-worm in delicate children, in the aged, during the 

 course of acute diseases, particularly severe intestinal diseases, and during 

 menstruation and pregnancy, is usually contraindicated. 



I carry out the treatment in the course of a day in which I may personally 

 superintend it. For a long time the actual treatment is preceded by a prepara- 

 tory one. I have been unable to convince myself of the value of a prolonged 

 preparation. On the day before the treatment is begun, I give milk, and 

 prohibit food containing sugar, so that the worm will have no favorable nutri- 

 tive material. After the midday meal, if at all possible, I give only coffee; 

 in the evening, bouillon, eggs, a little wheat bread, perhaps some red wine 

 diluted with water. At night the patient is given a tablespoonful of castor 

 oil or an enema. 



Among numerous vermifuges, which I do not intend to enumerate here, 

 I prefer radix filices or the ethereal extract of male fern, and order extr. 

 fil. mar. sth. 5.0-6.0-7.5-10.0, syr. simpl. 40.0, M.D.S., to be taken within 

 ten minutes. Children receive a correspondingly smaller dose. The tape-worm 

 is to be stupefied by the remedy, and to be subsequently exposed to its action. 

 If nausea or vomiting occur, I give small pellets of ice, some brandy, or a 

 little lemonade. I am also quite fond of employing Helfenberg's Tape-worm 

 Remedy, which consists in the administration of eight capsules that contain 

 one gram of fil. mar. and 2 grams of castor oil. According to the patient, 

 I give 6 or 8 capsules at once, and, after an hour, 7 capsules which contain the 

 castor oil. I will briefiy describe my method of treatment. 



