670 ENTOZOA filaria medinemis, or Guinea thread worm. This is confined to certain localities in the tropical regions. It is seldom over 9 ft. long, and is found of all lesser sizes according to its age. The male has not yet been described, for either its small size prevents detection, or else it never occurs in man. In shape the female resembles a flattened cord, one line in diam- eter. Its color is pale yellow, and it is vivip- arous. Its head is circular and armed with four straight pointed spines, by which it prob- ably penetrates the tissues. It inhabits the subcutaneous areolar tissue, and chiefly that of the ankles, feet, and legs; but it has also been found in the abdominal parietes and arms. It often proves an endemic, attacking certain regiments in armies and sparing others. It ap- pears to follow the rainy seasons, and to occur mostly in low and marshy districts. There can be hardly any doubt that this animal is an in- habitant of wet places, and that man infects himself only by allowing it to come in contact with his skin. Those who take great precau- tion against wetting their feet, sleeping on the ground, and bathing in marshy pools, generally escape it. The worm may lie coiled up or ex- tended at full length be- neath the skin. As many as 50 individuals have been observed in one person, but usually one alone occurs. If super- ficial, its growth may be watched from day to day, and it has been seen to increase more than an inch in 24 hours. It often lies concealed for a long time without causing any symptoms of its presence, and may thus be borne from one country to another. When about to open ex- ternally, a little boil is found on the skin, which either bursts or is open- ed, and the anterior end of the worm protrudes. It is removed by seizing this and making gentle traction. All that readi- ly yields is wound about a compress, and bound down over the wound till the following day, when the process is repeated till it is wholly extracted. Great care is taken not to break the worm, for serious results often follow such accidents. It is probable that the young or germs inhabit wet soils, and enter the tissues of other animals to attain their full development after being impregnated out- side. The attempt of the mature female final- ly to escape seems to imply that, its end be- Fio. 13. Tricocephalus dispar. 1. Male, natural size. 2. Male, magnified. 8. Female, natural size. ing accomplished, it would return to its former home, and deposit its young, where new hosts may offer themselves for their reception. Many other less important varieties of these three classes of entozoa have been described. Medical Treatment. The administration of drugs in the encysted stages of tapeworm would of course be useless, and their diagnosis is often a most difficult problem. The following remarks apply then only to the intestinal forms. Nothing should be done until the passage of joints gives the infallible sign of the presence of the worm. All statements of patients re- garding their own symptoms must be received with much doubt. A long catalogue of fearful and frightful ills is ascribed to their presence, but probably in the majority of cases with- out any cause whatever. It is true that the worm feeds upon the nutriment of the pa- tient, but this has not yet formed a part of his organization, and is not assimilated. Whether epilepsy is ever caused by tape- worm is a matter of great doubt, and more valid proof is needed to show more than a coincidence between the presence of the two. Some species cling more firmly than others, and are more difficult to dislodge. Of course, unless we obtain the head we fail, for the scolex may go on producing new colonies in- definitely. The only way to effect their re- moval is to render their habitation disagreeable to them. Various drugs (called anthelmintics) are employed to drive out these intruders. A brisk cathartic may dislodge one or two ascari- des if present, or bring away a piece of tape- worm. Cowhage (mucuna pruriens) and tin filings are now seldom used. Santonine, the active principle of santonica or semen contra, is used in doses of 3 to 6 grains three times a day. The oil of wormseed (chenopodium) is used in doses of 5 to 10 drops. Spigelia or pinkroot, alone or with senna, is a favorite anthelmintic in the United States, and the bark of the pride of China (melia azedaracTi) in the south. Tansy and wormwood, though not fre- quently used, may be added to the list. The small worms in the rectum are best treated with injections, either of ice water, salt water, infusion of quassia, lime water, or decoction of aloes. The tapeworm is advantageously at- tacked with oil of turpentine, petroleum, the oleo-resin of male fern (aspidium filix-mas), pomegranate bark, kameela (from Rottlera tinctoria), or by kousso, the flower of Bray era, anthelmintica. An emulsion prepared from the seeds of the common pumpkin has been used with very good effect, and has the merit of causing no disagreeable symptoms. Some of these drugs, as male fern, santonine, pome- grante, and kousso, produce more or less in- testinal disturbance ; and some, as santonine, pomegranate, spigelia, and azedarach, produce nervous symptoms. Benzine and picric acid have been suggested for destroying the trichina spiralis; but unfortunately the presence of this dangerous parasite is not likely to be recognized
