78 
which contained eggs of H. nana^ but also in feces in which the pres- 
ence of eggs could not he established, he was inclined to discard his 
former interpretation. It is possible, in those cases in which the 
spherical bodies but no eggs w^ere present, that there were in reality 
worms in the intestine, which, however, had not attained their full 
growth; consequently the eggs had only partially developed and were 
found in the feces only in their immature stages. 
TREATMEXT. 
Male fern is the only remedy which has met with any degree of suc- 
cess in the treatment of Ilyinenolepis nana. Kousso, kainala, santonin, 
thymol, or pomegranate proved ineffective in the cases in which any 
of these were tried (Nos. -t, 5, T, 8, 38, 43, 48, 53, 89). 
The usual prec'autions should be taken in the treatment with male 
fern, namely, taking care to have the patient in the best possible phys- 
ical condition, and preceding the administration of the t^eniacide by a 
preparatory treatment of mild laxatives and a light diet in which the 
amount of starchy foods is reduced to a minimum (Eichhorst, 1901a, 
p. 298). In the technic of tapeworm treatment some authors recommend 
a salad of dried herring, garlic, and onions, the evening before the 
administration of the male fern; this procedure was followed in a num- 
ber of cases of Ilymenolepis nana. but to what advantage does not 
appear. The preparation of male fern to be emplo^^ed is the olhcial 
oleo-resin (Oleo-resina aspidii, U. S. P.), or ethereal extract of European 
pharmacy, which must be fresh to be effective. The dose for adults 
is 2 to 4 cc. (d. - There is some danger attending iis use; a num- 
ber of cases are on record in which poisoning occurred, several result- 
ing fatally. Six drams and even less have caused death. The symp- 
toms of poisoning were vomiting, vertigo, headache, diarrhea, severe 
pains in the abdomen, d}’spnea, cold sweat, coma, convulsions, mania, 
and temporary or permanent blindness. 
After the preliminary treatment the male fern is given in the morn- 
ing upon an empty stomach. In its administration various methods 
have been used; it has been given in pills, mucilage, syrup, electuary 
with calomel, etc. Eichhorst (1901a, p. 299) has obtained satisfactoiy 
results with gelatin capsules. A number of small doses at intervals, 
or one, two, or three larger doses, may be given; Mertens (1892) found 
the latter procedure preferable. 
One treatment may not suffice for a cure; in at least 20 of the cases 
of II. nana the eggs were found in the feces after treatment, usually 
after an interval of about fifteen da}"s, and in several instances 4 or 5 
repetitions of the treatment were necessary. 
