THREADWORM.
Once these parasites have gained admission to the intestinal canal their ova, which are invisible, get under the finger-nails in scratching, and are conveyed to the patient's mouth again, so that reinfection is constantly occurring. Absolute cleanliness is, therefore, an essential, and children should be made to sleep in garments which render this method of infection impossible. It is also probable that as the worms wander about the anus and vagina they may be communicated from one person to another sleeping in the same bed. Their origin in the human subject arises from eating uncooked vegetables and fruits, and from drinking water containing their ova. They chiefly infest the lower end of the great intestine, but Cobbold insists that their presence here is accidental, their real locality being as high up as the cwcum. The males and young embryos are found in the lower part of the small intestine, whilst the impregnated females are found in the cmcum, and descend to the rectum to lay their eggs there, after which tt.,y pass out of the body in the faeces.
The worms can be reached by enemata, and the addition of r oz. Chloride of Sodium to each pint of water effectually destroys the parasite. The injections should he repeated every second night for at least a month or until the worms and their ova disappear from the motions. Infusion of Quassia (I in 4o) is also very efficient, the B.P. infusion (I in ioo) is too weak, and the i in 20 infusion often recommended is not free from danger; the best result probably follows a combination of the salt and infusion in one enema. Lime Water, solutions of Alum, of Aloes, of Ether
(in water), of Eucalyptus Oil, of Tincture of Iron, of weak Carbolic Acid, of Turpentine, of Vinegar, of Tansy, of Olive Oil, of Chloride of Am monium, and many other substances, are useful, and, in the case of children, are generally successful after a few repetitions of the enema.
A little weak Mercurial or White Precipitate Ointment just placed within the sphincter keeps them from migrating at night.
CobboId attaches most importance to internal remedies, and lie advises Iron in tonic doses, with Aloes and Asafoetida occasionally, followed b) repeated Saline cathartics, as the Friedrichshall and IIunyadi waters. Others recommend large draughts of Quassia or Gentian in infusion, swallowed fasting, and followed by a Saline; 2-gr. pills of Extract of Quassia coated with Keratin and administered 3 times a day after a smart aloetic purge have been extolled in chronic intractable cases.
Two Sulphur Lozenges thrice daily or a teaspoonful of the Confection at bed-time may be tried. Naphthaline has been given by the mouth. A child two years old may get 3 grs., and a child of ten may get 5 to 6 grs. with sugar four times a day for two days between meals.
Santonin is not be to relied upon, as the drug is absorbed before reaching the (=cum.
The salt injections have never failed in the hands of the writer when persistently employed.