The delicate balance: When an internal guest becomes a pathological assassin

“ The male of the Syngami is so obliterated, that when compared with the other males of its order it is only a testicle living on the female.
Should an organ infested with worms be considered diseased, simply on account of their presence? We hesitate not to say that, as long as these guests cause no disorders, there is no pathological condition. The child which has Ascarides lumbricoides in its stomach is not necessarily ill. All animals in a wild state always have their parasites; they lose them rapidly when in captivity. ”

“ Ancylostoma duodenale (Ancylostomiasis) .
Whilst up to quite modern times it has been generally maintained that the great majority of worm diseases cause more or less marked symptoms, the exact investigations of the last few years have made it plain that the great majority of people with worms are not only perfectly healthy, but the most careful clinical observations show no single sign of any ill-effect of the intestinal parasites on the health of the host (Löbker and Bruns835) . ”

“ If infection has led to the development of only a few ancylostomes, then injury to the general health is, as a rule, scarcely noticeable. In order to produce severe illness the presence of several hundred worms in the intestine is necessary, and in general the intensity of illness varies in exact proportion to the number of worms. Then the duration of the infection comes into play: the longer the human organism is submitted to the injurious effect of the parasite, the clearer is the effect on the host. Besides, the resistance of the individual has to be considered. ”

“ Breton made the same observations in Cochin China and found that only 10·4 per cent. of cases of chronic dysentery, and 8·8 per cent. of chronic diarrhœa, show Strongyloides. Normand, moreover, found that only a few of the Europeans residing in Cochin China are exempt from S. intestinalis, yet the people exhibit no intestinal symptoms; if, however, from any cause a catarrhal condition of the intestine supervenes the condition is changed, the parasites appear in larger numbers, and the disorder is considerably intensified. ”

“ As every debilitating condition renders the already predisposed animal more open to attack, all causes of ill health should be guarded against, and especially for the young, and in the case of such as are inevitable, every effort should be made to curtail and lessen the evil influence. Food or water which contains the eggs and embryos of intestinal worms, must be avoided and parasites which have already invaded the system must be got rid of as far as possible. ”

“ In general, the frequency of occurrence of intestinal worms is proportioned to the extent of use of uncooked or insufficiently cooked meats, the drinking of unfiltered standing waters, uncleanly habits, and the intimacy of association with domestic animals. It therefore follows that important prophylactics against infection by parasites are properly-cooked food, the use of spring or freely-running water or filtered standing water, cleanly habits, and the avoidance of intimacy with domestic animals. ”

“ Petersburg, after determining the presence of scolices of Bothriocephalus in the muscles, liver, and organs of generation of the pike, trout, and eel-pout, by feeding these to cats and dogs succeeded in rearing worms which differed in no respect, except in being smaller, from the Bothriocephalus latus of man. Such being the case, it becomes evident that man may ordinarily become infested with the parasite by eating raw or insufficiently cooked fishes of the kind mentioned. ”

“ The infection is undoubtedly taken in with the food or water, infection being spread by the eggs of the parasite, and being expelled with the feces of an infected animal. The eggs being swallowed by insects, worms or snails, which act as an intermediate host, and which when swallowed accidentally by cattle while grazing or drinking carry with them into the animal’s stomach the infectious stage of the tapeworm. Aged cattle do not seem to suffer much from tapeworms, but in calves these parasites cause scours and rapid emaciation. ”

“ They have in reality come from the bodies of insects in which they pass their young or larval stages as parasites. The hair-worms all live as parasites during their larval stage, and as free independent animals in their adult stage. Some of them require two distinct hosts for the completion of their larval life, living for a while in the body of one, and later in the body of another. The first host is usually a kind of insect which is eaten by the second host. The eggs are deposited by the free adult female in slender strings twisted around the stems of water-plants. ”

“ The greater part of parasites, especially of fish, are introduced with the first nourishment. As soon as they issue from the egg, young rays, like young turbots, are already stuffed with worms which afterward obstruct the digestive organs. The stomach of each of these fishes is like a filter which allows every thing which is food to pass, but detains on its passage and without any change all that is living. ”

“ Some years since, no one suspected that a parasite could live in any other animal than that in which it was discovered. All helminthologists, with few exceptions, looked upon worms in the interior of the body as formed without parents in the same organs which they occupy. Worms which are parasites of fish, had been seen a long time before this in the intestines of various birds: experiments had even been made to satisfy observers of the possibility of these creatures passing from one body to another ”

“ Think of hog cholera, a germ disease; of tuberculosis, a germ disease; of stomach worms, parasites; of staggers, a mold disease; of abortion, a germ disease; and hundreds of like nature, all due to parasites and germs, disease agents that disturb and destroy [86] the delicate organs or exposed regions, as the case may be, regardless of age, value, or breed.
Of course, remedies and treatment are being worked out to meet these individual diseases as they occur. Nevertheless, the best treatment is prevention. It is far better to prevent than to cure ”

“ The worms which inhabit the intestines have a sharp biting mouth by which they fasten themselves to the mucous membrane and devour the blood. The most prominent symptom of the disease is anæmia, or loss of blood, due not only to the direct eating of the parasite, but to bleeding from the small wounds caused by its bite. Large numbers of eggs are produced by the parasite which are passed out with the feces, which becomes the only infectious material. In a city provided with water-closets and a system of sewerage there would be no means of extension of infection. ”

“ The rapid running-down pulse, paleness of the eyes, nose, and mouth, sighing, stertorous breathing, tottering gait, etc., are symptoms by which we know that the animal is dying from internal hemorrhage. ”

“ If raw pork containing these worms is eaten by man, the cyst is dissolved off by the action of the digestive fluids, and the living trichina becomes free in the intestine of man. Here it reproduces and the young bore their way through the intestine walls and enter the muscles, causing inflammation there. This causes a painful and often fatal disease known as trichinosis.
The Hookworm.—The discovery by Dr. C. W. Stiles of the Bureau of Animal Industry, that the laziness and shiftlessness of the "poor whites" of the South is partly due to a parasite called the hookworm, reads like a fairy tale. ”

“ Practically, it is important to inform the persons most interested that an active “drench” may be serviceable in dislodging the free intestinal worms, but the administration of purgatives must not be persevered in. As in the somewhat parallel case of Trichinosis in the human subject, the fatality of the disorder depends not upon the free and mature worms, but upon the migrating and sexually-immature forms. All attempts by means of active drugs to poison the entozoa, when once they have gained access to the tissues (whether actually capsuled or not) , are worse than useless. ”

“ According to Kurlow,789 in Siberia there is a form of sporadic bloody diarrhœa which has its origin in the presence of Strongyloides stercoralis. The parasite does not live only in the intestinal lumen, but also in the intestinal wall, where it causes abscesses, fistulæ and effusions of blood.
Diagnosis is easily made by the detection of the actively moving larvæ in the stools.
Treatment is rather difficult, as it is not always successful in getting rid of the parasites. Authors differ as to the effectiveness of extr. ”

“ If the parasites have gained admission to the muscles all hope of destroying them is at an end; but if a person suspects himself to have eaten diseased or trichinised meat he should lose no time in seeking professional assistance, seeing that the administration of suitable anthelmintics might be the means of saving his life, whereas a few days’ delay would probably prove fatal. So long as the worms remain in the stomach or intestinal canal they can be got rid of, but when once the trichinal brood have invaded the flesh then they cannot be expelled. ”

“ The first symptoms show in November or December, the disease being in a latent stage during the development of the worms. The first symptoms are diarrhea, loss of appetite, and emaciation. The animal becomes anemic. Secondary symptoms are edema and such complications as joint infection, colic due to embolism, and accidents from falls, hemorrhage from ruptured aneurisms, or perforation at the site of abscess. The animal may die, recover, or become a chronic sufferer, the internal injuries failing to make a satisfactory recovery even with the removal of the worms in chronic cases. ”

“ This illiteracy is one cause of their poverty, but not the only cause: a part of it is moral, involving a lack of steadfast purpose, and a part is physical. The researches conducted by the United States Government, the state boards of health, and the Rockefeller Foundation show clearly that much of the indolence charged to the less prosperous Southern rural whites is due to the effect of the hookworm, a tiny intestinal parasite common in most tropical and subtropical regions and probably brought 74 from Africa or the West Indies by the negro. ”

“ Little tins are given out for feces specimens, and their contents examined. If you want worms you choose the people who have been found positive through examination; positive because hookworm eggs have been found in their specimens. You dose them with the drug, say tetrachloride, then you give them a “jerry,” which is usually a five-gallon benzine tin, and tell them that all their bowel motions for die day must be deposited in the big container. A purge has been given after the tetrachloride, to hurry things up. ”

“ It is only when the physician has seen the head of the parasite that he can reasonably ensure his patient a permanent cure.
TREATMENT.—To get rid of tape-worms many remedies have been employed, though comparatively few retain a reputation for positive success. Some act by powerfully operating on both bowels and worms, producing the detachment and discharge of the latter without killing them, as is often indicated in the lively movements they exhibit after their expulsion. Others poison and kill the worms, and also cause their detachment and expulsion from the bowel. ”

“ That worms exist in the human body there can be no doubt; and that they must sometimes be considered as a disease, is equally certain: but this is not the case so often as people imagine. The idea that worms occasion many diseases, gives an opportunity to the professed worm-doctors of imposing on the credulity of mankind, and doing much mischief. They find worms in every case, and liberally throw in their antidotes, which generally consist of strong, drastic purges. ”