anomalies and curiosities of medicine-第204部分

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e　baby　from　the　first；　and　the　administration　of　one…grain　doses　of　potassium　bromid　at　short　intervals。　The　infant　death…rate　on　the　island　of　St。　Kilda　has；　consequently；　been　much　reduced。　The　author　suggests　the　use　of　a　new　iodin…preparation　called　loretin　for　dressing　the　cord。　The　powder　is　free　from　odor　and　is　nonpoisonous。

Human　Parasites。Worms　in　the　human　body　are　of　interest　on　account　of　the　immense　length　some　species　attain；　the　anomalous　symptoms　which　they　cause；　or　because　of　their　anomalous　location　and　issue。　According　to　modern　writers　the　famous　Viennese　collection　of　helminths　contains　chains　of　tenia　saginata　24　feet　long。　The　older　reports；　according　to　which　the　taenia　solium　（i。e。；　generally　the　taenia　saginata）　grew　to　such　lengths　as　40；　50；　60；　and　even　as　much　as　800　yards；　are　generally　regarded　as　erroneous。　The　observers　have　apparently　taken　the　total　of　all　the　fragments　of　the　worm　or　worms　evacuated　at　any　time　and　added　them；　thus　obtaining　results　so　colossal　that　it　would　be　impossible　for　such　an　immense　mass　to　be　contained　in　any　human　intestine。

The　name　solium　has　no　relation　to　the　Latin　solus；　or　solium。　It　is　quite　possible　for　a　number　of　tapeworms　to　exist　simultaneously　in　the　human　body。　Palm　mentions　the　fact　of　four　tapeworms　existing　in　one　person；　and　Mongeal　has　made　observations　of　a　number　of　cases　in　which　several　teniae　existed　simultaneously　in　the　stomach。　David　speaks　of　the　expulsion　of　five　teniae　by　the　ingestion　of　a　quantity　of　sweet　wine。　Cobbold　reports　the　case　of　four　simultaneous　tapeworms；　and　Aguiel　describes　the　case　of　a　man　of　twenty…four　who　expelled　a　mass　weighing　a　kilogram；　34。5　meters　long；　consisting　of　several　different　worms。　Garfinkel　mentions　a　case　which　has　been　extensively　quoted；　of　a　peasant　who　voided　238　feet　of　tapeworms；　12　heads　being　found。　Laveran　reports　a　case　in　which　23　teniae　were　expelled　in　the　same　day。　Greenhow　mentions　the　occurrence　of　two　teniae　mediocanellata。

The　size　of　a　tapeworm　in　a　small　child　is　sometimes　quite　surprising。　Even　the　new…born　have　exhibited　signs　of　teniae；　and　Haussmann　has　discussed　this　subject。　Armor　speaks　of　a　fully…matured　tapeworm　being　expelled　from　a　child　five　days　old。　Kennedy　reports　cases　in　which　tapeworms　have　been　expelled　from　infants　five；　and　five　and　one…half　months　old。　Heisberg　gives　an　account　of　a　tapeworm　eight　feet　in　length　which　came　from　a　child　of　two。　Twiggs　describes　a　case　in　which　a　tapeworm　36　feet　long　was　expelled　from　a　child　of　four；　and　Fabre　mentions　the　expulsion　of　eight　teniae　from　a　child。　Occasionally　the　tapeworm　is　expelled　from　the　mouth。　Such　cases　are　mentioned　by　Hitch　and　Martel。　White　speaks　of　a　tapeworm　which　was　discharged　from　the　stomach　after　the　use　of　an　emetic。　Lile　mentions　the　removal　of　a　tapeworm　which　had　been　in　the　bowel　twenty…four　years。

The　peculiar　effects　of　a　tapeworm　are　exaggerated　appetite　and　thirst；　nausea；　headaches；　vertigo；　ocular　symptoms；　cardiac　palpitation；　and　Mursinna　has　even　observed　a　case　of　trismus；　or　lockjaw；　due　to　taenia　solium。　Fereol　speaks　of　a　case　of　vertigo；　accompanied　with　epileptic　convulsions；　which　was　caused　by　teniae。　On　the　administration　of　kousso　three　heads　were　expelled　simultaneously。　There　is　a　record　of　an　instance　of　cardiac　pulsation　rising　to　240　per　minute；　which　ceased　upon　the　expulsion　of　a　large　tapeworm。　It　is　quite　possible　for　the　presence　of　a　tapeworm　to　indirectly　produce　death。　Garroway　describes　a　case　in　which　death　was　apparently　imminent　from　the　presence　of　a　tapeworm。　Kisel　has　recorded　a　fatal　case　of　anemia；　in　a　child　of　six；　dependent　on　teniae。

The　number　of　ascarides　or　round…worms　in　one　subject　is　sometimes　enormous。　Victor　speaks　of　129　round…worms　being　discharged　from　a　child　in　the　short　space　of　five　days。　Pole　mentions　the　expulsion　of　441　lumbricoid　worms　in　thirty…four　days；　and　Fauconneau…Dufresne　has　reported　a　most　remarkable　case　in　which　5000　ascarides　were　discharged　in　less　than　three　years；　mostly　by　vomiting。　The　patient　made　an　ultimate　recovery。

There　are　many　instances　in　which　the　lumbricoid　worms　have　pierced　the　intestinal　tract　and　made　their　way　to　other　viscera；　sometimes　leading　to　an　anomalous　exit。　There　are　several　cases　on　record　in　which　the　lumbricoid　worms　have　been　found　in　the　bladder。　Pare　speaks　of　a　case　of　this　kind　during　a　long　illness；　and　there　is　mention　of　a　man　who　voided　a　worm　half　a　yard　long　from　his　bladder　after　suppression　of　urine。　The　Ephemerides　contains　a　curious　case　in　which　a　stone　was　formed　in　the　bladder；　having　for　its　nucleus　a　worm。　Fontanelle　presented　to　the　Royal　Academy　of　Medicine　of　Paris　several　yards　of　tapeworm　passed　from　the　urethra　of　a　man　of　fifty…three。　The　following　is　a　quotation　from　the　British　Medical　Journal：　〃　I　have　at　present　a　patient　passing　in　his　urine　a　worm…like　body；　not　unlike　a　tapeworm　as　far　as　the　segments　and　general　appearance　are　concerned；　the　length　of　each　segment　being　about　1/4　inch；　the　breadth　rather　less；　sometimes　1　1/2　segments　are　joined　together。　The　worm　is　serrated　on　the　one　side；　each　segment　having　1　1/2　cusps。　The　urine　pale；　faintly　acid　at　first；　within　the　last　week　became　almost　neutral。　There　was　considerable　vesical　irritation　for　the　first　week；　with　abundant　mucus　in　the　urine；　specific　gravity　was　1010；　there　were　no　albumin　nor　tube…casts　nor　uric　acid　in　the　urinary　sediments。　Later　there　were　pus…cells　and　abundant　pus。　Tenderness　existed　behind　the　prostate　and　along　the　course　of　left　ureter。　Temperature　of　patient　oscillated　from　97。5　degrees　to　103。2　degrees　F。　There　was　no　history　at　any　time　of　recto…vesical　fistula。　Can　anyone　suggest　the　name；　etc。；　of　this　helminth？〃

Other　cases　of　worms　in　the　bladder　are　mentioned　in　Chapter　XIII

Mitra　speaks　of　the　passage　of　round…worms　through　the　umbilicus　of　an　adult；　and　there　is　a　case　mentioned　in　which　round…worms　about　seven　inches　long　were　voided　from　the　navel　of　a　young　child。　Borgeois　speaks　of　a　lumbricoid　worm　found　in　the　biliary　passages；　and　another　in　the　air　passages。

Turnbull　has　recorded　two　cases　of　perforation　of　the　tympanic　membrane　from　lumbricoides。　Dagan　speaks　of　the　issue　of　a　lumbricoid　from　the　external　auditory　meatus。　Laughton　reports　an　instance　of　lumbricoid　in　the　nose。　Rake　speaks　of　asphyxia　from　a　round…worm。　Morland　mentions　the　ejection　of　numerous　lumbricoid　worms　from　the　mouth。

Worms　have　been　found　in　the　heart；　and　it　is　quite　possible　that　in　cases　of　trichinosis；　specimens　of　the　trichinae　may　be　discovered　anywhere　in　the　line　of　cardiac　or　lymphatic　circulation。　Quoted　by　Fournier；　Lapeyronnie　has　seen　worms　in　the　pericardial　sac；　and　also　in　the　ventricle。　There　is　an　old　record　of　a　person　dying　of　intestinal　worms；　one　of　which　was　found　in　the　left　ventricle。　a　Castro　and　Vidal　speak　of　worms　in　the　aorta。　Rake　reports　a　case　of　sudden　death　from　round…worm；　and　Brown　has　noted　a　similar　instance。

The　echinococcus　is　a　tiny　cestode　which　is　the　factor　in　the　production　of　the　well…known　hydatid　cysts　which　may　be　found　in　any　part　of　the　body。　Delafield　and　Prudden　report　the　only　instance　of　multilocular　echinococcus　seen　in　this　country。　Their　patient　was　a　German　who　had　been　in　this　country　five　years。　There　are　only　about　100　of　these　cases　on　record；　most　of　them　being　in　Bavaria　and　Switzerland。

The　filaria　sanguinis　hominis　is　a　small　worm　of　the　nematode　species；　the　adult　form　of　which　lives　in　the　lymphatics；　and　either　the　adult　or　the　prematurely　discharged　ova　（Manson）　block　the　lymph…channels；　producing　the　conditions　of　hematochyluria；　elephantiasis；　and　lymph…scrotum。　The　Dracunculus　medinensis　or　Guinea…worm　is　a　widely…spread　parasite　in　parts　of　Africa　and　the　West　Indies。　According　to　Osler　several　cases　have　occurred　in　the　United　States。　Jarvis　reports　a　case　in　a　post…chaplain　who　had　lived　at　Fortress　Monroe；　Va。；　for　thirty　years。　Van　Harlingen's　patient；　a　man　of　forty…seven；　had　never　lived　out　of　Philadelphia；　so　that　the　worm　must　be　included　among　the　parasites　infesting　this　country。

In　February；　1896；　Henry　of　Philadelphia　showed　microscopic　slides　containing　blood　which　was　infested　with　numbers　of　living　and　active　filaria　embryos。　The　blood　was　taken　from　a　colored　woman　at　the　Woman's　Hospital；　who　developed　hematochyluria　after　labor。　Henry　believed　that　the　woman　had　contracted　the　disease　during　her　residence　in　the　Southern　States。

Curran　gives　quite　an　exhaustive　article　on　the　disease　called　in　olden　times　〃eaten　of　worms；〃a　most　loathsome　malady。　Herod　the　Great；　the　Emperor　Galerius；　and　Philip　II　of　Spain　perished　from　it。　In　speaking　of　the　Emperor　Galerius；　Dean　Milman；　in　his　〃History　of　Latin　Christianity；〃　says；　〃a　deep　and　fetid　ulcer　preyed　on　the　lower　parts　of　his　body　and　ate　them　away　into　a　mass　of　living　corruption。〃　Gibbon；　in　his　〃Decline　and　Fall；〃　also　says　that　〃his　（Galerius's）　death　was　caused　by　a　very　painful　and　lingering　disorder。　His　body；　swelled　by　an　intemperate　course　of　life　to　an　unwieldy　corpulence；　was　covered　with　ulcers　and　devoured　by　immense　swarms　of　those　insects　who　have　given　their　names　to　this　most　loathsome　disease。〃　It　is　also　said　that　the　African　Vandal　King；　the　Arian　Huneric；　died　of　the　disease。　Antiochus；　surnamed　the　〃Madman；〃　was　also　afflicted　with　it；　and　Josephus　makes　mention　of　it　as　afflicting　the　body　of　Herod　the　Great。　The　so…called　〃King　Pym〃　died　of　this　〃morbus　pedicularis；〃　but　as　prejudice　and　passion　militated　against　him　during　his　life　and　after　his　death；　this　fact　is　probably　more　rumor　than　verity。　A　case　is　spoken　of　by　Curran；　which　was　seen　by　an　army…surgeon　in　a　very　aged　woman　in　the　remote　parts　of　Ireland；　and　another　in　a　female　in　a　dissecting…room　in　Dublin。　The　tissues　were　permeated　with　lice　which　emerged　through　rents　and　fissures　in　the　body。

Instances　of　the　larvae　of　the　estrus　or　the　bot…fly　in　the　skin　are　not　uncommon。　In　this　country　Allen　removed　such　larvae　from　the　skin　of　the　neck；　head；　and　arm　of　a　boy　of　twelve。　Bethune；　Delavigne；　Howship；　Jacobs；　Jannuzzi　and　others；　report　similar　cases。　These　flesh…flies　are　called　creophilae；　and