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knowledge of the presence of this worm may cause great nervousness or depression. The presence of the segment in the stools proves their presence in the bowels.

Treatment, preventive.—This is most important. Careful attention should be given to three points: First, all tapeworm segments should be burned. They should never be thrown into the water-closet or outside; secondly, special inspection of all meat; and, thirdly, cooking the meat sufficiently to kill the parasites.

MOTHERS' REMEDIES.—1. Tape Worms, Pumpkin Seed Tea for.—"One pint pumpkin seeds skinned and steeped. Add water enough to make three tumblers. Take one tumbler every half hour, then a good dose of castor oil. The worm will come with oil. My mother helped prepare the seeds and saw the tapeworm which came from a woman as a result of this dose."

2. Tape Worms, Another good Remedy for.—

    "Powdered Kamala 3 drams
    Syrup simple 3 ounces

Two doses of this mixture hardly ever fails to bring the worm. Give oil and turpentine two hours after the last dose." Of the oil and turpentine an average dose would be a half ounce of castor oil and fifteen drops of turpentine.

3. Tape Worm, Ontario Mother's Remedy for.—"Don't eat until very hungry (extremely so), then eat one-half pint of pumpkin seeds. This is good and will remove the worm every time." This remedy is different from the above in that you eat the seeds instead of making a tea.

4. Tape Worm, Successful Remedy for Children or Adult.—

    "Turpentine 15 drops
    Castor Oil 1 teaspoonful
    Milk 1 teacupful

Mix and for adult take at one dose. If not successful repeat the next day.
For child under ten years, one-half the quantity."

[50 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT.—Preparing the Patient; Giving the Remedy, and Receiving the Worm.—Whenever a round or tape worm is to be attacked, the patient must be starved for at least twelve to twenty-four hours, in order that no food in the intestinal (bowel) tract may protect the worm from the action of the drug. During this time a little milk can be given, and after a night of fasting, before breakfast, the worm medicine (anthelmintic) must be swallowed. In addition, nearly all the drugs must be followed by purges in order to dislodge the intruder while he is paralyzed and has lost his hold; and in many it is well to have a basin of salt and water ready so that when a passage occurs a rectal injection may be given to wash out the segments of the worm which remain in the rectum. I am giving many remedies and the different ways of administering them. Not every one can be cured with the same remedy. One will act better in some people than in others. So I give a variety and they are all good.

1. For two days prior to the administration of the remedies the patient should take a very light, diet and have the bowels moved by a saline (salts) cathartic. As a rule the male fern acts promptly and well. The etheral extract of male fern in two dram doses may be given; fast, and follow in the course of a couple of hours by a brisk purgative; that is, calomel followed by salts.

Fasting means this: Light diet for a day or two and a cathartic at night, no supper except a glass of milk before the worm medicine is given. Then at bed-time take two to three grains of calomel with ten grains of bicarbonate of sodium; rochelle salts, one-half to one ounce, upon awakening. As soon as the bowels have moved give oleorisin of aspidium, one dram in capsules. A saline cathartic should be given one-half to one hour later. Never give castor oil or any oil after this remedy, When calomel is given it should be given about one hour after taking the worm medicine and followed in one or one and one-half hours by a half to one ounce of salts.

2. Pelletierine Remedy for.—This comes in bottles of the proper dose. It is dear, but effective. It must be taken lying down, and followed by some cathartic or a dose of epsom salts in two hours after taking.

3. Infusion and Emulsion for.—An infusion of

      Pomegranate root 1/2 ounce
      Pumpkin seeds 1 ounce
      Powdered ergot 1 dram
      Boiling water 10 ounces

To an emulsion of the male fern (a dram of the ethereal extract) made with acacia powders, two drops of croton oil are added. The patient should have had a low diet on the previous day and have taken a dose of salts in the evening.

The emulsion and infusion are mixed and taken at nine in the morning. If the bowels do not move in two hours, salts should be taken.

4. An Old Remedy.—Chew freely of slippery elm bark. This, it is stated, is very effective and as it is cheap and will not injure, it is worth a thorough trial. I am often surprised at the value of the seemingly simple remedies.

[ANIMAL PARASITES 51]

TRICHINIASIS (Trichinosis).—The disease is caused by the trichina spiratis, a parasite introduced into the body by eating imperfectly cooked flesh of infected hogs. The "embryos" pass from the bowel and reach the voluntary muscles, where they finally become "encapsulated larvae,"—muscle trichinae. It is in the migration of these embryos that the group of symptoms known as trichiniasis is produced.

When the flesh containing the trichinae is eaten by man or by any animal in which the development can take place, the capsules are digested and the trichinae are set free. They pass into the small intestine and about the third day attain their full growth and become sexually mature. The young produced by each female trichina have been estimated at several hundred. The time from the eating of the flesh containing the muscle trichinae to the development of the brood of embryos in the intestines (bowels) is from seven to nine days. The female worm penetrates the intestinal wall and the embryos are probably discharged into the lymph spaces, thence into the venous system, and by the blood stream to the muscles, which constitutes their seat of election. After a preliminary migration in the inter-muscular connective tissue, they penetrate the primitive muscle- fibres and in about two weeks develop into the full grown muscle form. In this process interstitial inflammation of the muscle is excited, and gradually an ovoid capsule develops about the parasite. Two, and occasionally three or four, worms may be seen within a single capsule. This process of encapsulation has been estimated to take about six weeks. Within the muscles the parasites do not undergo further development. Gradually the capsule becomes thicker and ultimately lime salts are deposited within it. This change may take place in man within four or five months. The trichinae may live within the muscles for an indefinite period. They have been found alive and capable of developing as late as twenty or twenty-five years after their entrance into the system. These calcified capsules appear as white specks in the muscles. In many instances however these worms are completely calcified. In the hog the trichinae cause few if any symptoms. An animal, the muscles of which are swarming with living trichinae, may be well nourished and healthy looking. An important point also is the fact that in the hog the capsule does not readily become calcified, so that the parasites are not visible as in the human muscles.

Modes of Infection.—The danger of infection depends entirely upon the mode of preparation of the flesh. Thorough cooking, so that all parts of the meat reach the boiling point, destroys the parasites; but, in larger joints, the central portions are not often raised to this temperature. The frequency of the disease in different countries depends largely upon the habits of the people in the preparation of pork. In North Germany, where raw ham and wurst are freely eaten, the greatest number of instances have occurred. In South Germany, France, and England cases are rare. Salting and smoking the flesh are not always sufficient, and the Havre experiments showed that animals are readily infected when fed with portions of the pickled or the smoked meat as prepared in this country.

[52 MOTHERS' REMEDIES]

Symptoms.—The eating of trichinous flesh is not always followed by this disease.

In the course of a few days after eating the infected meat there are signs of disturbance of the stomach and bowels, and pain in the abdomen, loss of appetite, vomiting and sometimes diarrhea; and yet, these preliminary symptoms do not always occur, for in some of the large epidemics cases have been observed in which they have been absent. Pain in different parts of the body, general debility and weakness have been noted in some of the epidemics. In some instances the stomach and bowel disturbances have been so marked from the outset that the attack resembled our cholera. The invasion symptoms develop between the seventh and tenth day. Sometimes not until the end of the second week, and they are marked by fever, a chill in some cases and pain and swelling and tenderness along the muscles involved. The migration of the parasites into the muscles excites a more or less intense inflammation of these muscles, which is characterized by pain on pressure and movement, and by swelling and tension of the muscles, over which the skin may be swollen. The limbs are placed in some position in which these muscles are more at rest. Difficulty in chewing and swallowing is caused by the involvement of the muscles controlling these acts. In severe cases the involvement of the diaphragm and intercostal muscles may lead to difficult breathing (Dyspnoea) which sometimes proves fatal. Watery swelling, a feature of great importance, may be seen early in the face, particularly about the, eyes. Later it develops in the extremities when the swelling and stiffness of the muscles are at their height. Profuse sweats, tingling and itching of the skin and in some instances hives (Urticaria) have been described.

There are emaciation and anemia. In the severe cases the appearance may be like that in the third week of typhoid fever. In mild cases the fever and muscular symptoms subside in ten to fourteen days, in others only after two or three months. The mortality, from one to thirty per cent, seems to depend upon the virulence and number of parasites.

PHYSICIANS' TREATMENT.—If discovered within twenty-four to thirty-six hours, thoroughly empty the bowel with purgatives. Rhubarb and senna, or an occasional dose of calomel may be given. Relieve the pains afterwards and support the strength.

[SKIN DISEASES 53] DISEASES OF THE SKIN.

The skin is divided into three layers. Beginning with the outer one and naming inward, they are named as follows: The outer layer is called the epidermis or cuticle (near or upon the skin). The second layer is called the corium, derma cutis vera, or true skin. The third layer is called the sub-cutaneous (under the skin) (fatty or connective) tissue. This last layer contains the sweat glands, the lower end of the deep-seated hair follicles, (little sacs containing the roots of the hair) and larger branches of the lymphatics, blood vessels and nerves, and serves in general as a bed for the true skin to rest upon, and by which the true skin is connected with the deeper parts, muscles, etc. The appendages of the skin are the hair, nails, sebaceous and sweat-glands. The discharge from the sweat-glands form a little or larger tumor. The contents of a wen are from sebaceous glands—fat secretions—fat tumor. The following names are frequently mentioned in the skin diseases:

Macule. (Spots, patches). Skin is altered in color, but the skin is not raised or depressed; freckle, etc.

Papule. (Pimple). Elevated piece of skin, varying in size from a pin-head to a coffee bean.

Tubercle. (Node-lump). A solid elevation of the skin, varying in size from a pea to a cherry.

Tumors. These are soft or firm elevations of the skin, like a wen or hard lump. They are always deep-seated.

Wheel. A round flat, white or pink elevation of the skin; such as hives, mosquito bites, etc.

Vesicle. This is a pin-head or pea-sized elevation of the outer layer (epidermis) filled with a watery fluid.

Bleb. (Bulla). A circumscribed elevation of the skin and contains a watery fluid, such as a burn, etc.

Pustule. A rounded elevation of the outer layer (epidermis) of varying size, containing pus (matter).

A vesicle, bleb, and pustule are hollow; macule, papule, and tubercle are solid.

Scale. (Squama). This is a dry attached

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