Saturday, 14 April 2018

Worms

Ft By There are many parasitic worms as many as about 135 which infest man. These worms mainly infest various sections of the intestinal tract, sometimes only the rectum, certain worms infest muscular tissues, the liver, the lungs and the brain. Infants or children are often the victims of different types of worms, mainly the following four types, which are common.
Round worms (ascaris lumbricoides)
Hook worms (ankylostoma duodnale
Thread worms (Oxyuris vermicularis)
Tape worms  (Taenias) 
Some of the characteristics for identification of these worms are disused here so that the treatment of any type of worms can be more specific and successful.
Round worms
This worm is similar to an earthworm, but is comparatively paler in colour. The adult male and female of these worms measure about 15 to 20 cm and 20 to 40 cm in length respectively and 3 to 5 mm in thickness. The Ascaride eggs are excreted in faeces and are yellow and elliptical in shape possessing a thick outer cell. These worms exist in the small intestine but often come up to stomach or go downwards and are excreted with the stools. In the intestine, larvae emerge from the eggs and penetrate through the mucous membrane of the intestine into the blood stream and then they are carried into the lungs, bronchi, trachea, larynx etc. The entire cycle of development takes approximately 75 days. Children aquire these worms due to poor hygiene, impure water and contaminated fruits and vegetables. Some children get the infection through the habit of mud eating. A round worm eats about 0-1 g of protein per day from the intestine. A child suffering from this type of worms often develops loss of appetite, nausea vomiting and at times dizziness and faintness, abdominal pain and constipation or diarrhoea. The child becomes listless and generally develops a protruberant abdomen. In certain cases, if number of worms is too large, it can lead to intestinal obstruction and acute colicky pains.
In some nervous children, the symptoms of irritability, hysterical or apoplectic attack may occur. When these worms migrates to the respiratory tract, these cause bronchitis and eosinophilia. The diagnosis of these worms can be established by examination of eggs in the faeces.
Hook worms
These worms enter in to the body of a person through skin and the infection is mainly acquired when a child walks bare footed. The adult male and female measure 8 to 10 mm and 12 to 18 mm in length respectively and 0.5 to 1mm in thickness. The egg is elliptical and thick shelled, and segmented in to 2 to 8 spherules.
On contact with the skin, the larvae bore their way into the blood vessels and many times pass to the right heart and lungs. When in the upper intestine,  they suck the blood and cause iron deficiency anaemia. Sometimes, the worms may cause local bleeding.
In the beginning, the larvae may cause ground itching or ankylostome dermatitis. Later, microcytic and the hypochromic anaemia may ensue. Children who are already malnourished and poor in iron and protein may suffer heavily due to the worm infestation. The children who are moderately infested may suffer from lethargy, hyper acidity and shortness of breath while the severe cases may show earthy colour skin, pallor of mucous membrane, mental sluggishness, constipation, cough, dyspnoea, oedema of the feet etc..
The diagnosis of this type of worm can be established by the examination of the stools for Ova and anaemia, especially if associated with eosinophilia.
Thread worms
These worms habitats the small and large intestines, the females descend into the rectum to lay their eggs in the creases of the anus. These worms measures about 10 mm in length and exist in clusters and rolled up masses. These look like threads and are white fusiform in shape and move swiftly. The female worms taper to a finer point and the males have a blunt and curved tails.
The chief symptoms caused due to infestation in children are itching in the area of the anus and genitals,  redness round the anus that may later change into abscess formation Anorexia, nausea, diarrhoea, abdominal pain, disturbed sleep,  offensive breath etc, . In girls, the worm infestation may cause itching in vulva. In severe cases of infestation,  inflammation of the caecum and the appendix may occur. In certain children, frequent micturition prolapsus ani may be observed. Long standing infestation may result from auto infection through the infected fingers of the child as it scratches the anus violently at night.
The diagnosis of this type of worms can be established by inspection of swabs made from the perianal skin. Sometimes female worms outside the anal canal may be observed at night immediately after the itching commence in the child.
Tape worms
Mainly there are two types of this worms, namely, measly pork tape worm and beef tape worm encountered in children. These are acquired by eating uncooked measly pork or beef. The tape worm measures 2 to 8 cm in length and is white in colour, articulated and flattened. The worms grow by formation of new segments below the head. The tape worm has slender neck and the body, its head being globular with four suckers, a b rostellum and a double row of hooks unless the head is destroyed and expelled, the worm grown Again and again. The following common species of tape worms are found infesting in children.
Taenia solium (pork tape worm)
Taenia saginata (beef tape worm) 
Taenia armata
Taenia cucumina
Hymenolepis nana ( dwarf tape worm) and
Diphylobothrium latum  (broad fish tape worm)
The cattle and swine ingest the eggs or the segments of tape worms with grass or water, or gets infested with the larvae which are carried to all the parts of the animal body with the blood where they become encysted (the form in which they can exist for years)  in the tissues of their intermediate hosts. The child becomes infested by consuming raw or poorly cooked Cysticercus beef or pork, the Cysticerci mature into the tape worm in the human intestine 2/3 months after ingestion. Some by the symptoms caused in the children due to infestation by the tape worm are gastro intestinal disturbances,  such as loss of appetite or voracious appetite, colicky pains and diarrhoea some children develop convulsions and strabismus. Occasionally, diphyllobothrium latum can cause megalocystic anaemia.. The diagnosis may be established by identifying the appropriate segments or Ova of the worm in the excreta. Often eosinophilia is present.
According to the homoeopathic philosophy, a child with psoric constitution falls prey to the worm infestation and when it gets appropriate anti psoric treatment so as to remove the psoric taint, the worms will find the habitation unfavorable for their nourishment and growth.
Management
Proper hygienic conditions, personal hygiene and consumption of clean and washed fruits and vegetables are an absolute necessity to avoid infestation of children by worms. It is absolutely essential that the habit of washing hands before meals and after going to the toilet should be inculcate in children. Nails must be cut short and wearing shoes should be made habit in children so that hook worms cannot get into the body.
Homoeopathic Therapeutics
Homoeopathic treatment aims at the Constitution of a child which pre disposes it to the worm infestation. In treating a child for worms, the identification of the worm, or the presence of ova in the faeces or the presence symptoms pointing to worms are not sufficient to arrive at a prescription. It is essential that all the signs and symptoms of the child should be taken into consideration and the prescription based on the totality. Following medicines have been found effective in the treatment of worms and are discussed below, though other medicines, based on the totality,  may sometimes be found necessary.
Dr. J. T. Kent advises under Calc carb in lecture on Homoeopathic Materia Medica :
The idea with homoeopathic physician is not to give vermifuges,  but to so correct the digestion that worms will not thrive, and it is that worms will not thrive in healthy stomach and intestines. Whether they leave by expulsion or whether they are destroyed, or what becomes of them, I do not know. To remove them by physicking them out,  and by vermifuges, only makes a bad matter worse, because it increases the indigestion,  it increases the turmoil. So is with all worms in the stomach and rectum, all those worms will come if they are favored with just exactly the right kind of fluids to hatch out in. They come and they grow. I suppose at least twenty five times the last twenty years have I known Calc carb to bring away tape worms, and in most instances I did not know it was present, but I simply prescribed for the patient. I was aware of its existence. It is so with many remedies.
Calc carb
It is one of the strong anti psorics and is useful for treatment against worms in order to correct the worm constitution or hereditary pre disposition to a helminthiaasis is especially indicated in children who eat mud owing to deficiency of certain minerals and ingest round worms. The typical Calc carb child is flabby and fair with the abdomen like an inverted saucer. The child perspires profusely especially on head. It craves for indigestible things like chalk,  coal, pencils etc.
Cina
It is leading remedy against worms, more so for effects worms. The Cina child is irritable, and cross and does not want to be touched or carried. The child rubs or picks nose constantly, bores fingers in to nose. There is variable appetite, grinding of teeth, convulsions and violent Jerkings of hands and feet. Itching of nose all the time. One of the characteristic symptom of Cina is that there is circumscribed redness of cheeks with pale face and dark rings around eyes. Often one cheek is red and other pale. This remedy is especially useful for round or thread worms causes considerable itching of anus. The typical Cina stool is white, watery stool, the child throws arms from side to side and stretches out feet spasmodically.
Cup oxy nig
This is for tape worms this remedy to be excelling in removing all kinds of worms, curing trichinosis and even tape worms.
Filix mas  This remedy is recommended for tape worms. The child suffers from diarrhoea and vomiting and has intense Itching of nose, pale face, blue rings around eyes. Typical worm colic accompanied with constipation makes this remedy indicated against worm complaints of children. Dr Hering recommend use of this remedy along with Kousso, in mother tincture against tape worms.
Granatum It is an excellent remedy for vermifuge especially for tape Worms. The child complaints of pain in stomach and abdomen worse about navel. Great itching at anus, constant hunger and profuse salivation. Convulsions due to worms.
Nat phos it is against Worms and worm like symptoms in children. Hyper acidity with sour vomiting and sour taste in the mouth. Tongue is coated yellow. Diarrhoea with green stools. It is especially useful for children who indulge excessive sweets and other starchy foods. This remedy is useful for round and thread worms.
Santonin  Chief symptoms of the medicine are foul breath, heavily coated tongue, restlessness and moaning at night, grinding of teeth, itching of nose, enuresis and night cough. Round and thread Worms.
Siliceia Against sickly children who are constitutionally chilly and perspire all over the head hands feet. The children are faint hearted and sensitive and cry when spoken to kindly. One of the characteristic symptom of this remedy is sensation of hair on tongue.
Stann  Cramps like colic around navel with a feeling of emptiness relived by hard pressure. According to Dr. Hahnemann, Stannum so stupefies the worms what they are easily dislodged by any purgative and expelled. The  child has a pale sunken countenance with dark rings around eyes and is hungry but cannot eat enough except in the evening, felling of weakness in chest so child can hardly talk. Teuc Is a great remedy against ascarides. The child is very restless at night, and great itching of anus and constant irritation after going to bed it is especially useful in children with psoric and tubercular taint. Crawling sensation in rectum after stools. Pin Worms.
Chenopodium and Thymol
Specific for hook Worms.
Cases treated
A 3 years old male child was brought to me for treatment of persistent itching of anus and complete loss of appetite. On observation it was found that there was redness in the perianal area and slight ulceration due to hard scratching. On an inquiry, the parents informed that the child occasionally had vomiting of milk and food which smelt very sour and also periodically suffered from green diarrhoea. Based on the above symptoms Nat phos 3 x three tablets four times daily was prescribed. In addition the lime water as prepared in the earthen pot and discussed earlier recommend to the parents. After about a week, the parents informed me that the child had passed 6/7 round Worms and enquired whether they should give any purgative which I did not advise. After about three weeks of treatment, the child regained appetite and the skin of the perianal area regained normal colour. The case was dismissed after administration of Calc carb 1m based on constitutional symptoms. The child has no trouble since then.

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