\\Then male fern has failed after a couple of trials, any of the following anthelmintic drugs may be employed.
Oil of Turpentine has long enjoyed the reputation of being a valuable agent in killing tapeworm, but to be of any use it must he given in doses of at least 4 fluid drs. (This quantity may excite strangury and serious symptoms.) Moreover, it is most objectionable as to taste and smell, and now it is seldom employed for these reasons. If selected after the failure of male fern, it should always be given with about r fluid oz. of Castor Oil after fasting. The parasite is expelled (lead.
Thymol, found so effectual in the destruction of ankylostoma, has recently been extolled in the treatment of Tania salient. The drug, to be of any use, must be administered in doses far beyond the usual limit 20 grs. should be administered every 2 hours for four times, after which a strong dose of a saline cathartic as 2 oz. Black Draught must be given; Castor Oil might act as a solvent for the drug and cause poisoning by allowing the thymol to be absorbed; for the same reason all oleaginous substances should he avoided, and Oil of Turpentine should never be combined with the drug.
Kousso may be given in doses of 4 drs. infused in boiling water, which is swallowed without straining as soon as the infusion is cold. This dose generally not only kills the worm, but causes its expulsion in fragments without any further purgative; 4o grs. Koussin may be given.
Kamala acts in the same manner as kousso; 2 drs. kill and generally expel the worm when given suspended in syrup, mucilage or gruel. Anderson's Tincture is made by macerating 9 oz. of Kamala in 21 oz. strong Alcohol, the dose of which is a large teaspoonful. Large doses may purge very severely.
Punica Granatum is one of the most certain vermicides, and is used in preference to male fern in the East. It may be administered in the ordinary decoction (4 to 20 oz.). Of this r to 2 oz. may be swallowed every hour for three doses after fasting. As the crude drug deteriorates by keeping, the following preparation is now generally employed: Pelletierine—the alkaloid in the form of Sulphate or Tannate--is given in doses of 5 to S grs., followed inside a couple of hours by a large dose of Castor Oil. Manson points out that the alkaloid should never be administered to children under so years of age. Schroder has demon strated that the one ten-thousandth part of this subtance, when added to the fluid in which a living tapeworm is placed outside the body, causes its death in a few minutes.
The dried fruit of Embelia Ribes in doses of r to 4 drs. is a favourite remedy in India and the East Indies. The seeds of the common yellow pumpkin, Pepo, are employed in similar doses and are safe for children.
Areca has been long prized in veterinary practice. The alkaloid Arecoline in the form of the Hydrobromide is given in a dose of gr., followed by a brisk purge.
Ether, Chloroform and Chloral Hydrate have been administered with the intention of killing the worm before its expulsion by a purgative, but in the doses capable of accomplishing this effect these agents are dangerous and should not be employed.
Papain in so to 15 gr. doses has been given with the view of causing digestion or disintegration of the parasite, but this result is very doubtful, if, indeed, it is desirable.
Myrtol in doses of 5 to 15 mins. in capsules appears to act like Thymol, but it is not reliable.
Naphthaline in 15-gr. cachets has sometimes proved efficacious, and is practically free from danger.
Prophylaxis of Tapeworm.—The measures to be employed for the prevention of txnia are obvious from a knowledge of the etiology and life-history of the parasites. The pork tapeworm is the variety most commonly to be met with; the introduction of this parasite will be effectually prevented by a thorough cooking (p. 98o) of all food supplied by the flesh of this animal—pork, bacon, hams, etc. The mere " curing " or smoking of bacon and ham is not sufficient to destroy the bladder worms or cysticercus cellulosai which constitute the disease known as " measles " in the pig. The close inspection of all pork before curing should be carried out by every municipal authority; the cysticercus is easily detected in the dead animal by its visible presence in the tissues under the tongue. Rigid personal cleanliness in every individual infested with these parasites is essential for the prevention of cysticercus in the human tissues. When this latter form of infection has been detected by brain or eye symptoms, Renzi has shown that it also may be combated by the administration of Male Fern by the mouth.
Similar precautions regarding the thorough cooking of beef and fish are essential in the prophylaxis against the beef and fish parasites.