Treatment
The most important matter is to avoid places where the infection is known to exist. If one must wade through infected waters the body should be protected by canvas or other closely woven garments.
Of various treatments, having in view the destruction of the worm, such as salvarsan, etc., none seem to have been of any value except antimony.
Robertson has reported relief of symptoms from the administration of 2 grains of thymol dissolved in half a drachm of benzine. The treatment is continued for a few weeks. Others have not had good results from this treatment. Local treatment is necessary in treating the cystitis and prolapse of rectum. Operative procedures are indicated where calculi exist.
The results obtained by treatment with tartrate of antimony during the past three years justify us in considering bilharziasis as a disease which has a specific for its cure. Almost all cases will yield to a course of intravenous injections of from one-half to two grains of the drug, commencing with the smaller dose. The drug should be well diluted (25 to 50 cc. sterile saline). Some use a 1% solution but the higher dilutions are safer from a standpoint of avoiding phlebitis. Intravenous injections are made twice weekly and the total amount of drug given during the course should rarely exceed 25 to 30 grains. For details see under treatment of leishmaniasis.
CHAPTER XXIV
MINOR HELMINTHIC INFECTIONS
Paragonimiasis
General Considerations
This is an infection with a trematode, Paragonimus westermanni (P. ringeri) (Distoma pulmonale). It is rather common in some parts of Japan and Formosa.