Pinworm.— The pinworm, threadworm, or seatworm (avynris venni colaris) is an inhabitant of the lower bowel, principally of the rectum and colon. It may, however, be found as high up as the appendix. The male worm is about one-sixth of au inch long, while the female may be as long as half an inch (see Fig. 446) The chief symptoms caused by this worm is local itching, which at times may be very severe. Restlessness and irritability are often present, and frequent urination is not uncommon. Picking at the nose may also be observed, and anaemia and loss of appetite are not infrequent symptoms.
The methods of treating pinworms are numerous. Examinations of the stools for eggs is desirable to establish the diagnosis in case no worms can be detected. Local irrigations by means of infusions of quassia, cinchona, etc., following a complete cleansing of the bowel by a saline cathartic, is the approved mode of treatment. In many patients it is a very difficult matter to get rid of these parasites, and continued treatment, even for years, may have to be carried on before recovery takes place.
In individuals who suffer from polypi of the lower bowel, infection by pinworms is very frequent, and their eradication is very difficult.
The so-called " tapeworms " are the most important worms found in human beings, and their life history is of considerable interest. Three of the most important forms are discussed in the article on TAPEWORM ; and it only remains to be added that, within recent years, a few more interesting worms have been discovered, which are of considerable importance. The most striking and wide spread of these is the Uncinaria, or hook-worm, which has been known for a long time in Europe. Until the work of Stiles and others, this parasite had more or less escaped observation in the United States. The disease was first described as occurring with greater frequency among miners in Europe ; and naturally, when it was looked for among the same class of workmen in America, it was found.
Furthermore, it has been learned that the hook-worm disease is by no means confined to miners, but is known to be comparatively widely distributed throughout the southern portion of the United States, contributing to the of the poor whites of the South.
The study of the spread of parasites is of great interest ; and, as countries grow more and more populous, and individuals are forced to live closer and closer together, it is found that parasites spread more widely. The most
important factor in the spread of parasitic diseases is the water supply ; and impure or contaminated water is responsible for the spread of the great majority of parasites here considered. The Bothriocephalus talus offers an excellent example. This parasite is found very commonly in places which are in close relation to large bodies of water where the sewage is not carefully disposed of, but allowed to flow into the water supply. The eggs of the parasite are discharged into the water, and fish serve as intermediate hosts. In them the worms develop a form of existence which can continue indefinitely. The fish may be caught, brought into market, sold and eaten, and the disease thus communicated.
The layman should, above all things, bear in mind that the diagnosis of intestinal worms is extremely easy. One need not rest on the physician's assurance that the patient has worms, but should insist on microscopical examination of the stools, when the eggs of the animal may be clearly shown. Not only is it possible to learn that the patient. has a worm or worms, but the microscope can show just what form of worms are inhabiting the intestinal canal, and thus appropriate treatment can be inaugurated. Guesswork in this respect loses a vast amount of valuable time, and is a reflection on the education of the physician.
Enlightened prophylaxis must not depend solely on national prejudice, but must have its roots in the education of the individual. So long as the mass of the population remains ignorant regarding the mode of spreading of these parasitic diseases, so long will they suffer from them. It is to be considered fortunate that the well-informed do not have to suffer from the ignorance of the masses in this respect, as they have to in the Matter of infectious diseases. There is no necessity for anyone to become infected if he follows out proper hygienic precautions. This cannot be said of the contagious diseases. Avoidance of eating raw meat, particularly raw pork and fish, as well as pickled meat and pickled fish ; absolute cleanliness in the preparation of vegetables, especially salads, which should be repeatedly washed in running water ; the restriction of the feeding of offal to pigs ; taking care of the finger-nails ; and the use of proper feeding-implements these are all individual modes of prophylaxis which cannot be too highly insisted upon as being essential if one would avoid infection.
WORMSEED.—See CHENOPODIUM.