Treatment.—The most efficient remedy for removing round-worms is Santonin. The quantity necessary for the various ages is as follows:
| Two to four years | 2 | grains. |
| Four to six years | 3 | grains. |
| Six to ten years | 3-1/2 | grains. |
The best way to give it is in divided doses, with an equal quantity of sugar of milk. For a child of six years the formula would therefore be, 3-1/2 grains of Santonin, mixed with the same quantity of sugar of milk divided into three powders. These powders are given four hours apart in the following way. The child is given a light supper the evening before and one-half glass citrate of magnesia the following morning and the first powder one-half hour later; no breakfast being given. A light lunch, of milk and crackers, may be taken about noon. The second powder is given four hours after the first, and the third four hours after the second. Half an hour after the last powder, a dose of castor oil (one tablespoonful) is given. In a few moments the bowels will move; usually there are no worms in this movement. A little later they will move freely again and if worms are present they will be discharged in this movement.
Thread-Worm, or Pin-Worm.—A thread-worm looks just like a little piece of white thread. They are found in the lower part of the bowel and in the rectum. They are usually present, if present at all, in large numbers.
Symptoms.—The chief symptom is itching. It may be limited to the anus or it may involve the neighboring parts. Thread-worms may find their way out of the anus and in female children may find their way into the vagina. In these instances the child is tormented with itching of the privates and may establish the habit of self-abuse as a result of the constant itching and scratching. The itching is more intense at night soon after the child goes to bed. As a result of the local irritation in the lower part of the bowel and rectum there is set up a catarrh of the bowel which produces large quantities of mucus.
Treatment.—The only medication by the mouth that is of any use is turpentine in one drop doses after meals, given in a teaspoonful of sugar. The best treatment, and in most cases the only treatment that is effective, is the use of rectal injections. The procedure is as follows:—The child first gets a cleaning injection of two quarts of warm water into which a teaspoonful of borax has been put. This will wash away any mucus or fecal matter that may have collected. This injection is best given with a No. 18 rectal catheter which is pushed into the rectum for about 10 inches, the water being allowed to run away as it enters. From six to eight ounces of the infusion of quassia is then passed, as high up as the catheter will reach. It is intended that the quassia will remain in as long as possible, for at least half an hour. In order to assure this there are two features that should be kept in mind: first, the water should be allowed to flow in slowly, consequently hold the bag low, not higher than two feet above the level of the bed on which the patient lies; second, after the water is all in remove the catheter very slowly and keep the child absolutely quiet. This treatment is repeated every second night for a week, then twice a week for four weeks.
A solution of garlic is a very effective remedy and may be tried if the quassia fails, which is not likely if the treatment is carried out effectively and if the parts are kept scrupulously clean.
Tape Worms.—Tape worms are obtained from eating raw meat, pork or sausage, rarely from fish, and from playing with cats and dogs.
Symptoms.—No definite symptoms accompany the presence of tape worm. The children may have pains in the abdomen, diarrhea, a capricious appetite, foul breath, and they may suffer from anemia, sometimes quite severely. The only positive symptoms is the presence of links of the worm in the stools.
Treatment.—Give a dose of castor oil at bed time. Two hours after breakfast next morning give one-half dram of the oleoresin of male-fern in emulsion or capsule. Very light nourishment should be taken during the day, composed of gruels and soups. When the worm is passed it should be examined to find if the head is present; if not, the treatment should be repeated in twenty-four hours.