each morning the bowel is to be well washed out with cool water and Castile soap, being sure to raise the hips of the child high on a pillow when giving the injection, in order that the water may flow as far back into the bowel as possible. An ointment containing sixty grains of boric acid in an ounce of vaseline should be frequently applied to the skin about the back passage, after the latter has been thoroughly washed with soap and water to remove the eggs of the parasites. It is well at the same time to give children a teaspoonful of Epsom salt dissolved in fruit sirup, and half a teaspoonful of fluid extract of spigelia every morning for several days to expel the worms from the higher parts of the bowel which are not reached by the injections.

Whenever the bowels move, the parts thereabout should be thoroughly washed, and the towels and all articles coming in contact with the patient should be boiled or treated as advised in the beginning of this article to prevent the contamination of other children. When the pinworms are not readily expelled by soapsuds injections, these may be followed by injection of half a pint of strong solution of common salt and water, which should be retained in the bowel as long as possible, a folded towel being pressed against the back passage to keep the injection in. These injections should be repeated each day for ten days. The application of belladonna ointment to the parts will relieve the itching.

Tapeworms.-The common tapeworms are of two varieties: beef and pork tapeworms, caused by the eating of the raw or imperfectly cooked meat of these animals. If raw beef is very finely minced, or if the juice is squeezed out of raw beef and strained, the danger of tapeworm is averted. There is great danger of children with tapeworm conveying some of the eggs from the parts about the bowel to their mouths, in sucking their fingers; in this event the immature tapeworms penetrate the body and attack other organs, thus endangering the life of the patient. The ordinary tapeworm is from twenty to fifty feet long, made up of flattened joints or segments of a white color. The head is of the size of a pinhead, and the neck is not much thicker than a thread, but the middle and lower part of the body is from a quarter to half an inch wide. The presence of the worm is recognized by the escape of pieces in the excrement every few days. After fasting, as in the treatment of roundworms, pumpkin seed, from which the outer coverings are removed by crushing, are soaked overnight in water and taken on an empty stomach in the morning; a child takes one to two ounces thoroughly mashed mixed with sirup or honey, and an adult four ounces. An hour later, one to two teaspoonfuls of castor oil should be given children; a tablespoonful of oil, five grains of calomel, a tablespoonful of Epsom salt, or some other cathartic may be taken by adults. The head of the tapeworm should always be removed with the body to prevent the

later growth of the worm. The worm should never be dragged from the bowel if hanging from it, but an injection of soapsuds should be given to dislodge it. It is well to receive the bowel passages in a vessel of warm water, in order to ascertain the presence of the worm and prevent its breaking.

There are many other efficient and more powerful drugs for destroying worms, but they are not safely employed except under a physician's directions, and for this reason, and because mucus and other matter in the excrement are often taken for worms, it is always best to consult a doctor. Measures for preventing tapeworm include the destruction of all segments, meat inspection, and sufficient cooking of meats to kill the parasites.

CHAPTER III

Common Abdominal Pains

Remedies for Colic-Neuralgia of the Stomach-PeritonitisAppendicitis-Gallstone-Renal Disorders-Stoppage of the

Bowels.

COLIC; STOMACHACHE; BELLYACHE; INTENSE PAIN IN THE BELLY.-There are many diseases causing colic, or intense pain in the abdomen, which are considered in detail below, but in such conditions the first endeavor must be to relieve the suffering, and the following measures will be appropriate in all cases.

Treatment. Opium in some form is usually essential. Among its various preparations, morphine sulphate (grain one-sixth), laudanum or the tincture of opium 1 (ten drops), and paregoric1 (one and one-half tablespoonfuls), one should be given hourly in a little water, until the pain abates or three doses have been given, or, if the drug is immediately vomited, the dose may be repeated at once. Morphine injected under the skin with a hypodermic syringe acts more certainly and rapidly, but this can rarely be done except by a physician. Suppositories containing each one-quarter grain 2 Use only on physician's orders.

2

1 Caution. Dangerous.

of morphine and one-quarter grain of extract of belladonna are useful, because they are made to be introduced into the bowel and cannot be expelled by vomiting. One should be greased and inserted into the bowel and repeated in an hour, if necessary, but opium must not be given at the same time, in any form, by the mouth. The inhalation of ether from a towel, folded into a cone and held over the nose and mouth, is harmless, providing the patient is not rendered wholly unconscious, and also the use of chloroform, if given with the same purpose. They may relieve severe pain until the preparation of opium has begun to act. Ether should be poured on the towel, about one tablespoonful at a time, and repeated every three to five minutes, the towel being kept close over the face. In very extreme cases chloroform should be given only in single drops on a handkerchief, held an inch or so from the patient's mouth, a fresh drop being allowed to fall on the handkerchief as soon as the previous one has evaporated. Twenty drops of chloroform, if swallowed on a little sugar, will sometimes give relief from pain, but chloroform should not at the same time be inhaled. The application of cloths, wrung out of very hot water and, if possible, sprinkled with turpentine and applied frequently to the belly, will prove of much service. Also a bag containing hot water-not more than half full to avoid weight-or large, hot poultices made of bread, Indian meal, flaxseed, or any of the cereals, may be employed. Rubbing the belly in the direction