ANIMAL PARASITES
Tape Worms
Varieties.—Taenia solium; taenia saginata; bothriocephalus latus.
The larvæ of tape-worms are introduced into the intestinal canal by food and drink. The parasite reaches adult growth in the intestines. The larval forms are then found again in the muscles and solid organs.
Taenia Solium.—This is derived from the hog, and is the most common form in this country. When mature it is from two to four yards in length. The head is small, about the size of a pin, and provided with four cup-like suckers surrounded by a double row of hooklets, hence it is called the armed tape-worm. The head is fastened to the body by a thread-like neck, and following the neck, the body occurs in segments. The sexual organs, both male and female, occur in the center of the broad surface of the segment. The segments are about one millimeter in length and seven or eight millimeters in breadth. There are thousands of ova in each mature segment. The worm attains its growth in about twelve to fifteen weeks, after which time the segments are shed and passed. For further development the ova must gain entrance to the stomach of a pig or of man, and passing from the stomach they may reach the muscles and organs and develop into larvæ or cysticerci.
Taenia Saginata.—This is derived from beef, and is much longer and larger than the taenia solium. It is from five to six yards in length; the head is over two millimeters in breadth, is square shaped, and has four large sucking discs, without hooklets; hence it is called the unarmed tape-worm, in contra-distinction to the hooked variety. The segments are thicker and the ova larger, and they are passed and ingested in the same manner as the taenia solium.
Bothriocephalus Latus.—This is found especially in Europe and is very long, measuring from eight to ten yards; it is derived from fish, is not provided with hooklets, but has two lateral grooves. The segments are short and wide, the sexual organs being on the narrow side of the segment.
Etiology.—Unhealthy condition of the stomach and intestines is the predisposing, and uncleanliness an important, factor in the occurrence of tape-worm. Those eating imperfectly cooked beef, pork, fish or other meats, and those handling fresh meats, are liable to be affected with tape-worm.
When the ovum is taken into the stomach the capsule is dissolved and the embryo passes into the small intestines, fastening itself into the mucous membrane, by its hooklets and suckers and grooves.
Symptoms.—Tape-worms occur in the human being at all ages. Oftentimes symptoms are absent, the expulsion of segments being noticed and thus the worms accidentally discovered. The tape-worm is seldom dangerous, but if a worm is known to exist it is always a source of considerable anxiety on the part of the patient. Severe anemia may result and be wrongly diagnosed.
There are dyspeptic symptoms, colicky pains, nausea and occasionally diarrhea. The appetite is variable, sometimes ravenous. This condition is followed by loss of flesh and various reflex phenomena, as vertigo, headache, convulsions, palpitation, choreic movements, itching of the nose and anus, paralysis, and rarely, insanity. In addition to these symptoms there may be a wrinkled countenance, sensation of a cold stream winding itself toward the back immediately after a meal, pain in various parts of the body and ringing in the ears. The decisive diagnostic symptom is to find segments of the worm in the stools.
Diagnosis.—Discovery of the ova or segments in the passages of the bowels is the only proof of the presence of a tape-worm.
Prognosis.—Favorable in all cases.
Treatment.—Prophylactic treatment is necessary. Meats should be thoroughly cooked so that the larvæ will be destroyed; and all segments of tape-worms passed in the stools should be burned—by no means should they be thrown outside or in the water-closet.
The immediate expulsion of a tape-worm is not a necessity. First of all the mode of living, and then the general state of health should be corrected. Tape-worms invariably result from a general state of unhealthiness, and with improved health and corrected digestive processes the worms cannot exist, and in a short time will be expelled. Expulsion of the head is necessary before the case will be cured, for if the head is not expelled new segments will continue to grow.
Stimulating the liver to increase the amount of bile, and increasing the activity of the digestive glands of the stomach and intestines, by a thorough treatment of the splanchnic region and direct treatment over the abdomen, will usually be sufficient for the cure of intestinal parasites. The treatment will probably have to be repeated several times, in order that the intestines may regain a healthy tone, so that the parasite will not find favorable conditions for its existence within the intestines, and that the bile may be secreted in sufficient quantities to dislodge the worm.
Hahnemann claimed, “that during a period of comparative health tape-worms do not inhabit the intestines proper, but rather the remnants of food and fecal matter contained in the intestines, living quietly as in a world of their own without the least inconvenience to the patient and finding their sustenance in the contents of the bowels. During this state they do not come in contact with intestinal walls, and remain harmless. But when from any cause a person is attacked by an acute disease the contents of the bowels become offensive to the parasite, which in its writhing and distress touches and irritates the sensitive intestinal lining, thus increasing the complaints of the patient considerably by a peculiar kind of cramp-like colic. (In similar manner the human foetus in the womb becomes restless, twists its body and moves whenever the mother is sick, but floats quietly in the liquor amnii, without distressing her while she is well.)” This but harmonizes with the osteopathic theory and practice with regard to tape-worm, that there is an unhealthy condition of the intestines which predisposes to the affection, and consequently the cure must be a correction of such a disordered state.
During the treatment, if a light diet of milk and broths is given, it will favor an earlier removal of the parasite, by helping to remove the mucus in which the head is embedded. If this fails extract of male fern is suggested.
Ascaris Lumbricoides (Round Worm)
This is the most common parasite, and is found principally in children; it is also found in cattle and hogs. It is of a yellowish brown color and in form resembles earth worms. The worm is cylindrical, pointed at both ends; the female is from seven to twelve inches in length, and the male from four to eight inches. They are probably introduced into the stomach by food and drink. They occupy the upper part of the small intestine, and are usually one or two in number, though they may be numerous. Occasionally they migrate into the stomach and are ejected by vomiting, or into the trachea and produce suffocation, or into the larynx or Eustachian tube, or they may pass downward to the anus, or into the bile ducts.
Symptoms.—Oftentimes symptoms are absent. There may be dyspepsia, colicky pains, mucous stools, meteorism, vertigo, fretfulness, voracious appetite, anemia, sallow complexion, headache, chorea and convulsions. Other symptoms may be present, as grinding of the teeth and itching of the nose and anus. Obstruction of the bowels has occurred. If a worm enters the bile duct obstructive jaundice occurs. A decisive diagnosis can be given only when the worm is seen.
Treatment.—Particular attention should be paid the liver, for it is here that we must seek the natural remedy in the form of bile, in order to eject and cleanse the system from nematodes.
Modes of improper living should be corrected; cleanliness is essential, and there should be attention to the general health of the patient. Thorough correction of all defects of the spinal column in the region of the splanchnics, and careful direct treatment of the bowels is indicated. The child may be put to bed and fasted twenty-four hours, then the liver strongly stimulated to increase flow of bile.
If the above treatment is not successful oil of wormwood may be employed.
Oxyuris Vermicularis
(Thread-worm; Pin-worm)
This small parasite, commonly seen in children, is from three to five millimeters long in the male and about twenty millimeters in the female, is blunt at one end and sharp at the other, and occupies the colon and rectum. They are probably introduced into the intestines in the ova, by uncooked fruits and vegetables, or by the dirty hands of mothers and nurses of the infants. They vary greatly in number; migrate to the rectum where they deposit their eggs, and are often discharged in the feces, where they appear like pieces of ordinary white thread.
Symptoms.—Loss of appetite, anemia, restlessness and irritability are marked. The itching becomes intolerable when the worms come down in the rectum to the anus and within the folds about the anal orifice. In the female the worms may wander into the vagina where they become particularly distressing, and thus may produce excessive sexual excitement and cause nymphomania and masturbation.
Treatment.—Cleanliness of the most scrupulous kind should be demanded in every instance. Injections of cold salt water (repeated for at least ten days) and other agents within the rectum will destroy the eggs as soon as they are deposited, besides relieving the terrible itching. In obstinate cases use quassia decoction.
Attention to the general health of the patient and great care of the intestines and other digestive organs are absolutely necessary. The spinal treatment to the intestines and other digestive organs, as well as thorough direct treatment over the abdomen, is indicated.
Uncinariasis
(European hook-worm disease; Miner’s anemia; Ankylostomiasis; Hook-worm disease)
This disease results from infection by the hook-worm of any of the various types. In Europe it is found in Italy, Belgium, Germany, France and Switzerland. In America it seems to be of Africo-Asiatic origin but was first discovered in the Southern states and abounds chiefly in Texas, Florida, Georgia, North and South Carolina as well as in the West Indies. Infection comes from unprotected feces that are allowed to be spread where the feet or hands may come in contact as it is without doubt that the contagion occurs through the skin. One authority states that hook-worm is rarely found except in cases where ground itch has occurred within a period of eight years. Negroes harbor the parasite and transmit it but seem immune to its effects while the poorer whites are afflicted to a large degree. The worms are carried from some abrasion of the skin, by the blood to the heart and lungs, thence to the pharynx and swallowed, thence to the duodenum and jejunum where they attach themselves to the lining walls. Here they not only feed upon the blood but develop a toxin. The female worm is about twice the size of the male, 10 to 18 mm. as against 6 to 11 mm. and there is slight difference between the old and new world varieties. The head is provided with four hook shaped teeth which form the attachment to the intestine and it is very secure.
Diagnosis.—For years the languid, dull, expressionless, lack-luster of eye and general unambitious characteristics of the inhabitants of the great sand belt of the United States attracted attention and was attributed to laziness but the discovery of the hook-worm explained the cause. Children are stunted in mind and body and have a muddy, dirty white complexion.
At the beginning there must be a very considerable colony of the parasites to cause symptoms but as the disease advances there is a distention of the abdomen from enlargement of the spleen and liver and from flatulency. There is palpitation, shortness of breath, cardiac bruits from the severe anemia while edema of the feet and legs is rather common. The blood shows a severe secondary anemia with its coagulation time much increased. Leucocytosis is not common; hemoglobin is from one-tenth to one-half normal with erythrocytes about half normal.
Treatment.—The removal of the worms with the least possible harm to the body is indicated. Thymol is a poison which is not absorbed by the body, when carefully given, and which is very toxic to the parasite. The dose varies from eight grains for a child under five years of age, to forty-five for an adult. Thymol is soluble in fats and in alcohol, so that for a day or so before the thymol is given, and from one to four days after, no fats or alcohol should be taken. The best way to avoid poisoning by thymol is to give the patient charcoal, then no fats or alcohol is permitted until the treatment is completed. When the stools become black, the thymol is given on an empty stomach. A purgative is given a few hours later. Enemas should be used very freely in order to facilitate the removal of the injured or poisoned worms. Another dose of charcoal is given, and when the stools are black again, the patient may return to his ordinary diet. The denial of fats to the person so thoroughly accustomed to bacon three times a day is a factor met with difficulty in dealing with patients of the ordinary class with the disease. (Clinical Osteopathy.)
Prophylaxis.—After treatment it is imperative to prevent reinfection and to do that the most rigorous sanitary measures must be instituted. All feces must be disposed of and habits of cleanliness in defecation insisted upon while negroes, who harbor the worm without showing symptoms, must be looked after as well as the actual victims. Care of the feet is important and shoes should be worn in infected regions and all abrasions of the skin protected. Drinking water must be uncontaminated which presents a problem as wells and springs are usually unprotected. Absolute and persistent cleanliness is the answer to the question of prevention.
Trichiniasis
Trichiniasis is a name given to a disease produced by the embryos of the trichina spiralis. In the adult condition the trichina spiralis lives in the small intestines. The embryos migrate into the muscles where they finally become encapsulated. Man is infected by eating insufficiently cooked pork containing the encapsulated worm, which is set free during the digestive process. About the third day they attain their full growth and become sexually mature. Each one discharges large numbers of embryos. As soon as born the young brood is carried away from the bowel and invade the muscles through various channels—principally by means of the blood stream and along the connective tissue routes. The female trichina may bring forth several broods of embryos in succession. In nine or ten days after infection the first brood reaches its destination. They attain to maturity in about two weeks after entering the muscular tissue. In this process an interstitial myositis is excited and a fibrous capsule is formed in four to six weeks. The capsule gradually becomes thicker and finally calcareous infiltration may take place.
Thorough cooking destroys the parasite. The disease is most frequent among the Germans who eat raw ham and sausages.
Symptoms.—These are sometimes absent, especially when only a few are eaten. If large numbers have been ingested, gastro-intestinal symptoms develop in the course of a few days. Vomiting, diarrhea, and pain in the abdomen may be present.
In from one to two weeks muscular symptoms develop. There is fever, muscular pain, especially during motion, and the muscles are stiff, tense and sometimes swollen. When the respiratory muscles are involved dyspnea is produced, which may prove fatal. Eosinophilia is a helpful diagnostic point. Edema, especially of the face, is an important symptom. Profuse sweats, itching and tingling of the skin have been observed.
Diagnosis.—Epidemics of this disease are more easily diagnosed than an isolated case. Among the Germans, if cases of apparent typhoid fever occur after a picnic or other feasting occasion, where raw ham or sausages have been indulged in, this disease should be suspected. Examination of the stools and of the muscles will be of aid. The worms may be discovered in the pork, a portion of which has been eaten by the patient.
Prognosis.—This depends upon the number of worms ingested. The prognosis should always be guarded. Early, marked diarrhea is favorable.
Treatment.—Prophylactic treatment is of great importance in trichiniasis. Inspection of the meat supply, is doing much to prevent trichiniasis; although the most practical way to prevent the disease is to thoroughly cook all pork and sausages. The central portions of the meat should be well cooked.
In the feeding of hogs care should be taken that they do not receive any offal, but only milk, grain, vegetables, etc.
When a person is infected with trichiniasis, thorough and prompt evacuation of the bowels should be performed at once, so that the embryos will not have time to pass into the muscles, but will be ejected from the body. This should be followed by a thorough and persistent treatment for several days of the liver and intestines; treat both the liver and intestines directly and through the spine. The object of this treatment is to render all the digestive juices active, so that they may dislodge the animal parasite, and to prevent their passing into the muscles. Also keep the bowels active for several days.
When the larval parasites have entered the muscles, a treatment cannot be applied to affect them directly, but the health of the body should be maintained if possible, and the severer symptoms, as the muscular pains, weakness and insomnia combated. Thorough manipulation, massage and hot baths will be of special aid in relieving the stiffness and weakness of the muscles.
Filaria
(Filaria Sanguinis-Hominis)
There are two varieties. One is a thread-like worm with tapering, blunt ends, appearing in the blood at night, hence called nocturna, while the other is of slightly different form, appearing in the blood only by day and is called diurna.
The mosquito is the communicating host of the parasite. During the night, or should the patient sleep during the day, the nocturna appears in the peripheral circulation, while during the other interval they are probably in the other vessels, particularly the lungs.
After the mosquito has taken blood from an affected patient it requires from six to seven days for the metamorphosis of the minute filaria which are then lodged in the probosis of the mosquito and introduced into the blood of the next victim. The adult parasite is from three to four inches long and the thickness of a coarse hair, with clear sexual distinction.
Pathologically there are no distinct lesions, as the parent worm must establish one. Lymphatic engorgement may result from plugging of the thoracic duct or of a large lymphatic with consequent engorgement which may develop symptoms in the inguinal glands, pelvic and lumbar lymphatic trunks. As these varicosities develop rupture may occur; if into the genito-urinary tract chyluria or chylocele may result, or if in the abdominal cavity chylous ascites.
Lymphangitis follows a lymph stasis, which later results in elephantiasis. (Barbadoes leg.)
Symptoms.—Elephantiasis affects the legs, but the arms rarely; the labia of the female and scrotum of the male; occasionally the breasts and other parts of the body. Fever is present on account of the lymphangitis, accompanied by rigors and delirium and there is marked local inflammation. The attack terminates in a pronounced sweat. In deeper parts there is deep seated pain and signs of sepsis, while abscesses may develop over the inflamed area.
The varicose inguinal glands are doughy, soft and painless, with both sides affected alike. The scrotum is affected by the extension, and at times the testes.
Treatment is surgical, as the tumors must be removed. Unless the female worm is also removed this is, however, only palliative.
Methylene blue is said to be destructive to the filaria and it is practically harmless to the human body. The only treatment is one that will aid in building up the general health.