_Treatment._—Efficient treatment can only be carried out in association
with microscopic examination of the stools, and hence all that need
here be said is that various worm medicines are employed, of which
the most effectual are thymol and oil of chenopodium. These should be
administered only under careful medical supervision. The anæmia has to
be treated, and in the case of natives a nutritious and easily-digested
diet is indicated; for example, for native coolies the following has been
recommended: bread 1 pound, milk 2 pints, sugar 2 ounces, 2 eggs, and 4
bananas daily. Ground itch should be treated by an ointment containing
zinc oxide and salicylic acid.
_The Bilharzia Worm._—This worm, of which there are two species, produces
the disease known as Bilharziasis or Schistosomiasis, which occurs in one
or other, or both forms, in various parts of the world, but is specially
prevalent in Egypt.
_Cause._—The worms, which produce either urinary or rectal bilharziasis,
live in parts of the human vascular system, where they produce their
eggs. These eggs are furnished with spines, and hence cause irritation
when lodged in the tissues. In the urinary form the eggs have a terminal
spine, in the intestinal form the spine is lateral. These eggs are passed
either in the urine or in the excreta and reach water, where they develop
into larvæ. The larvæ enter special species of water snails, in which
they develop, producing eventually tiny forms known as cercariæ. These
cercariæ escape into the water and can penetrate the unbroken skin or
intact mucous membrane. They thus get access to the bodies of persons who
are bathing in the infected water, or who may drink it. Once in the human
body, the blood carries them to the place where they develop into the
adult worms, which eventually unite, and then the females begin producing
the spined eggs.
_Symptoms._—In the urinary form the chief symptom is the passage of
bloody urine, which usually shows itself about three months after
infection, and is often associated with a good deal of irritation of the
bladder and the pipe. The intestinal form may produce various symptoms.
Sometimes a condition resembling enteric fever occurs, sometimes one
like dysentery. Diarrhœa is common. The condition is chronic and, if
untreated, sets up all kinds of secondary effects, which need not be
discussed.
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