Treatment. —A very generally employed specific against round worms is the chenopodium, the blossom of Artemisia maritima, popu larly called worm-seed. The dose is 0.5 to 1 gram (7-15 grains), two or three times a day, in syrup or honey, as an electuary. The officinal preparation from this plant is the santonie acid, santonin, of which tablets may be obtained containing from one-half to one grain.
Several weeks after the cure, the stools must be again examined for the eggs of the asearides.
Prophylaxis consists in absolute cleanliness of the person, and especially of the food. Santonin must never be given on an empty stomach, and never in large doses; since, otherwise, poisoning is easily produced, with the following symptoms: general malaise, headache, vertigo, vomiting, dilated pupils, yellow vision, and convulsions. Fatal cases of santonin poisoning have been observed. After the administra tion of santonin, the urine becomes dark yellow and orange yellow. When dilute alkalies, caustic soda, carbonate of soda, or ammonia, are added, the urine will become a beautiful red. The treatment of santonin poisoning has for its object the removal of any unabsorbed part of the drug, by washing out the stomach and intestines and giving laxatives and emetics; and the combating of shock with black coffee, brandy, and injections of camphorated oil.
2. Oxyaris verinicularis (thread-worm).—The spindle-shaped body is white. The male is three to four 111111. long and 0.1 to 0.2 ntm. thick. The hinder end of the body is eurve.d forward; the penis projects from the cloaca. The female is eight to twelve iffin. long and 0.5 mm. thick. Its body is usually straight. The sexual opening is in the an terior third of the body (Fig. 40). The uterus of an adult female con tains, according to Leuckart, from ten to twelve thousand eggs. These have a white color; are elongated, oval, and asymmetrical; and measure 0.05 min. long and 0.02 to 0.03 mm. broad. Within a triple outer membrane is a finely granular yolk with a clear nucleus J.ig. 41, a). Often, also, they contain an embryo (Fig. 41, b). The oxyuris does not require an intermediate host. The embryos, after their escape from the eggs, accumulate in the small intestine, where the males and fe males are present in about the same number. The favorite locality for
the female is the cecurn, colon, and rectum. Here n-e find the females predominating, the males being in the ratio of only 1:10 and 1:20. The migrating female, which may be evacuated with the feces, con tains many eggs and soon dies. The eggs again enter the human body by direct inoculation.
Thread-worms are distributed over the whole earth, and are met with in the best social circles. _investigation of the feces for the eggs of the oxyuris is usually, if not always, as some authors say, negative, in spite of the presence of many parasites. Only the superficial layers of the formed stool are suitable for investigating for eggs, especially the particles of mucus that adhere to it. One frequently thick:, also, the oxyuris eggs in the clirt under the finger-nails.
Our diagnosis is most readily made from the visible demonstration of the oxyurides in the folds of the anus and in the genitoerural fold, or on the sound used for irrigation or for removing the feces. The evacua tion after an enema usually contains several female oxyurides, which are easy to find against, a black background—for example, a black rub ber saucer—on account of their mobility. By giving an enema, we can nearly always make sure of our diagnosis.
Catarrhal processes in the small intestine—but more particularly in the large intestine and reetum—are set up by these parasites, if present in considerable number. Their presence in the rectum usually gives rise to intense itching and smarting, which prevents the child's falling asleep and leads to scratching and boring with the fingers.,—where by frequently, pruritis ani and secondary eezemas are produced. Oxytt ris eggs have been frequently found in the scratch-marks and eczematous lesions. The irritation about the anus, and more especially the migration of the oxyurides into the vagina, can cause onanism in boys and girls and give rise to diurnal and nocturnal eneuresis. Recently encapsu lated, calcified oxyurides have been found more than once in the folds of the peritoneum in women (Kolb), probably having penetrated there from the vagina. Whether a single oxyuris, Baginsky observes, can be the real cause of appendicitis, must still be left open to question.