526 THE ANIMAL PARASITES OF MAN 



The patient is required to go to bed. A bed-pan, irrigator, lukewarm 

 water and a black pus basin are to be ready at hand. The remedy must be 

 given in the morning before food is taken. To prevent nausea and vomiting, 

 small pellets of ice, brandy, or lemonade are taken. After an hour, one or 

 two tablespoonfuls of castor oil are administered. If, after one or two hours/ 

 the worm has not been passed, an attempt should be made by the injection of 

 a large amount of lukewarm water into the rectum, to expel the parasite, which, 

 very frequently, has only been stunned. These injections are absolutely neces- 

 sary if large portions of the parasite are passed, as they readily break upon 

 manual extraction. If the head of the worm remain in the intestine, an 

 attempt must be made to expel this by the injection of a larger amount of 

 water. 



This treatment may be regarded as successful when the head, or, more cor- 

 rectly, the heads, have been found. The search for the head, which is often 

 detached, is facilitated by placing the worm which has been passed in the fiat 

 black basin. In spite of the greatest vigilance, it is occasionally impossible to 

 find the head. The result of the treatment is then questionable. It should, 

 however, only be repeated if, after eight to ten weeks, new proglottides are 

 passed, showing that the previous treatment has been unsuccessful. 



ECHINOCOCCUS DISEASE 



Echinococcus disease in the human subject is of increasing importance, 

 many cases having come under observation. I shall here consider the subject 

 as briefly as is consistent with accuracy. 



The echinococcus polymorphus is the encysted cysticercus of the tenia 

 echinococcus discovered by v. Siebold in 1853, and is found chiefly in the 

 small intestine of the dog, the Jackal and the wolf. The assumption that the 

 fox also may be a carrier and distributer of the tenia echinococcus has not yet 

 been proven. 



The tape-worm has a length of from 4 to 5 mm. The head is armed with 

 a rostellum and a double row of booklets. The number of Joints is only three; 

 immediately after the last Joint is desquamated a new portion forms. The 

 last Joint, which contains the mature eggs, comprises almost two-thirds of the 

 entire length of the worm; it is of extremely delicate texture, and is easily 

 lacerated. 



^ If parts of the infective proglottides reach the stomach of man and of cer- 

 tain animals, the tissue of these undergoes digestion by the gastric Juice, but 

 the eggs which have been set free are not digested, nor is the embryo. This 

 has six booklets which, emerging from the egg, penetrate the intestinal wall, 

 and thence in a more or less direct way reach the point where they later develop. 

 It IS quite probable that many of the eggs and embryos perish on account of 

 the digestive power of the gastric Juice, and are eliminated with the fecal 

 masses, for, otherwise, multiple echinococci would not be so exceedingly rare 

 —much rarer than the solitary form. According to van Beneden and Leuck- 

 ■art, the embryos forcibly penetrate the walls of the intestine, and finally reach 

 the blood and lymph-vessels, in which they are carried onward. The fact that 



