A SC ARIA SIS 



1775 



Summary of Preventive Measures. 



Educational : — 



Instruction of rich and poor with regard to the methods of infection, 

 symptoms, treatment, and prophylaxis. 

 Personal Prophylaxis : — 



1. Protection of the feet. 



2. Protection of the hands. 



3. Immediate treatment of the eruption on feet or hands. 



4. Necessity of early treatment. 

 Public Prophylaxis : — 



1. Search for and treatment of carriers. 



2. Search for cases of the skin eruption and treatment of the same, 



3. Search for cases of anaemia and treatment of same. 



4. Provision of sanitary conveniences kept in good condition, and 



associated with a good system of conservancy. 



Ascariasis. 



Definition. — Ascariasis is infection with Ascaris lumbricoides 

 Linnaeus, 1758; Toxascaris canis Werner, 1782; or Belascaris mystax 

 Zeder, 1800, the first named being much the most common. 



Symptomatology. — ^The symptoms may be nil, or may resemble 

 those of cestode infections, being partly gastro-intestinal, partly 

 reflex, while skin irritation and eruptions may also be present. If, 

 however, the number of parasites be very considerable, signs of 

 toxic poisoning, or even of intestinal obstruction from interlacing 

 of the worms, may develop, but the great danger is from the 

 wandering of the parasites. If they wander up the bile-duct and 

 into the liver, they may cause abscesses in the liver. We have 

 found as many as eleven worms in the bile-duct, with a large 

 number in the liver, three of which lay in abscess cavities. They 

 may also enter the duct of Wirsung, and cause slight inflammation 

 of the pancreas, or go into the appendix, and cause appendicitis. 

 Further, they may pierce the bowel in cases of ulcerative conditions 

 of the bowels, and enter the peritoneum or the bladder, or enter the 

 lung, the nose, or the ear by the Eustachian tube — in fact, they may 

 wander all over the body. The observer must, however, be careful 

 to distinguish between the post-mortem and ante-mortem wander- 

 ings of these worms; in the former case the worms are generally 

 found alive. The most important reflex symptoms are the con- 

 vulsions so commonly met with in children, and attacks of so-called 

 ' wormy ' cough are not rare. We have seen cases of fever re- 

 sembling typhoid (typho-lumbricosis) which on post-mortem ex- 

 amination have shown no lesions of typhoid, but enormous numbers 

 of ascaris. 



Diagnosis. — ^The diagnosis will depend upon the discovery of the 

 eggs in the faeces. 



Treatment. — The best treatment is santonin, with some form of 

 purgative. Usually santonin is mixed with an equal quantity of 

 calomel, and given in doses of i to 3 grains for an adult, and ^ grain 

 for every year of life for a child. The dose is given every morning 

 for two or three days, and repeated again in a week if eggs still 



