Taeniae or Tape-Worms.
Taenia Soleum (Pork Tape-worm).—This variety of flat worms is not so often seen in our country as in Europe. It is from six to fifteen feet long. Its habitat is the small intestine—the ileum—and though usually found alone, there may be two or more in the same bowel.
It is divided into three parts, a head, neck, and a number of segments. The head is round and smaller than a pin-head. It has four suction disks and a double row of hooks, about twenty-six, hence it is called the armed tape-worm. A small, slender neck, about an inch long, is attached to the head, and then follow the segments or joints, proglottides, progressively increasing in length and breadth.
The segments contain both male and female organs of generation. The uterus runs through the middle of each segment. Here the thick-shelled eggs develop, each containing an embryo with its booklets.
The worm requires from three to four months for its development, and upon maturity sheds one or more segments, which, with their ova, pass with the feces info the world. For their further development, the ova must be taken into the stomach of the hog, where the shell is dissolved and the embryo set free. These penetrate the walls of the stomach and intestines, enter the blood-current, and are carried to the muscles where in two or three months they develop into cysts, from whose walls a newly developed taenia head—scolex—arises.
These cysts are known as measles or cysticerci. When taken into the stomach through eating rare pork, a new taenia develops in from three to four months.
Taenia Saginata or Mediocanellata (Beef Tape-worm).—This is the variety commonly found in this country. It is longer than the pork tape-worm, being from fifteen to forty or more feet long. The head is larger than that of the taenia soleum, is square-shaped, has four large sucking disks, but has no booklets, hence is known as the unarmed tape-worm. The segments are thicker, broader, and longer than those of the taenia soleum, and when segments are expelled exhibit a crawling motion in contradistinction from the taenia soleum, which are non-motile.
The life history of this worm is about the same as the pork-worm, with this difference, the cysticerci do not inhabit pork, but are found in beef; hence the infection in man comes from eating rare or raw beef.
Symptoms.—The symptoms of the presence of a tape-worm are not constant. One of the largest specimens I ever saw was not suspected till the patient noticed a number of segments passed in the stool, his health being unusually good. At other times there will be colicky pains and diarrhea, alternated with constipation. There may or may not be a voracious appetite.
After the patient discovers the passing of one or more segments, nervous symptoms are apt to develop, the patient becoming melancholy or hysterical. Chorea, convulsions, and even epilepsy, have occurred; but this may have been a coincident rather than a result.
Though in most cases the health is but little impaired, we must admit that they may occasion severe illness.
Diagnosis.—This can only be positively made by the presence of segments of the worm or the ova in the stool.
Prognosis.—This is always favorable, no matter how long the worm has been present in the intestine.
Treatment.—The prophylactic treatment will consist in eating only thoroughly cooked pork and beef, and drinking pure water. Care should be taken to destroy the stools containing segments of the worms, so that animals may not take them into their digestive tract to further propagate them.
There are a number of reliable anthelmintics, though some are so nauseating, that they are rarely used, especially since we have at least two that rarely ever fail to bring good results, and yet are free from disagreeable sensations. The most prominent anthelmintics are male fern, pomegranate bark, pumpkin-seed, kousso, turpentine, chloroform, and thymol.
Before administering the selected drug, the patient should undergo preparatory treatment for twenty-four or forty-eight hours, which consists of fasting, or restricting the diet to two or three glasses of milk, and thoroughly emptying the bowels with salts or antibilious physic.
The agent that has never yet failed me, and I have used it a great many times, is "granatum." It is not unpleasant, children taking it without the least trouble. It should be given in bed, early in the morning, on an empty stomach, and the patient instructed not to get out of bed for at least two hours; this precaution must be insisted upon, as the remedy often produces dizziness if the patient assumes the erect position too soon after the ingestion of the agent.
One hour and a half after the administration of the remedy, give a full dose of Epsom salts and await results. As soon as the bowels move, the parasite will appear.
Dr. Webster speaks equally positive of thymol. After a similar preparation of the patient, he administers thirty grains of the powdered drug, to be followed in two hours by a second dose if the first fails to bring about the desired results. No matter what agent is used, it should be followed by a cathartic about an hour after its administration.