Thread-worm

- SWAYANADAN K. R.,
General considerations
The common thread-worm, Oxyuris vermiculari, is also known by the name pin-worm. It is usually found in children although it may attack the adults also. Its life-history is the main reason for this. As to the size and shape of the thread-worm it is interesting to know the descriptions made by some authors. 'Hygiene for nurses' written by John Guy and G.J. I. Link later says: "Oxyuris vermicularies is very small, the female being only three-tenths of an inch long, and the male half that size." In his voluminous book 'diseases of children' Dr. Fisher opines: "They look like little pieces of chopped white thread, no longer in sizes than from a twelfth to a sixth of an inch in length". Moore's 'Family Medicine and Hygiene of India's or C.A. Sprawson and R.D. Alexandre says: " thread-worms are about one-third of an inch long, slightly bent, white and semi-transparent". A medical text-book 'Clinical Methods describes: "To the naked eye they look like small white threads from a half to one centimeter in length".
Oxyuris vermicularis inhabits the large intestines, caecum and vermiform appendix. They almost constantly infest the lower parts of the bowels near the fundament the presence of which is associated with considerable itching about the anus. They are seen passed with the faeces. In certain cases of heavily infested with thread-worms the whole mucous surface of the colon and rectum seem to be coated with them. They may crawl out during the night on the cloths and even into the vagina in females creating irritation and discharge. Thread-worms can even excite blood stools. They are generally seen wriggling about in the recently passed faeces.

The female thread-worm is provided with a large uterus filled with ove and the posterior end which enable us to distinguish it under the microscope. To deposit the eggs the pregnant females come down to the anus and its outside. The movements in doing so cause intense itching in and around the anus, especially at night. Often in his or her sleep the patient scratches the anus. Later the nose is picked at, or the finger is rubbed against the mouth of the patient. In this way the eggs are conveyed from the anus back to the stomach and so the life-history is maintained. It is to be particularly noted that a patient whose general condition is unwholesome as well as weak and anaemic is more commonly affected with thread-worm.

Symptoms
It is not always possible to determine the presence of thread-worms from the symptoms. The only certain proof is the presence of the worms in the stool or about the anus.
The symptoms commonly ascribed to thread-worms are:
Involuntary twitching of the muscles of the face.
Itching of the nose.
Grinding of the teeth.
Irregular appetite.
Incontinence of urine.
Constant nightly wetting of the bed.
Retention of the urine with great vesical distension.
Itching about the anus and vulva.
Sudden crying out in sleep.
Disturbed sleep.
Nightly terror.
Jerking of the hands and arms.
Peevishness.
Debility.
Recurrences of feverish attacks even to typical worm fever.

Treatment
The treatment is easy to reduce the number of thread-worms. But it is very difficult to eradicate them because the fact is that it will be again found usually after a few days or weeks. Several authors advocate to give Vermifuges followed by active purgation. They are under the impression of expelling the thread-worms outright and causing them to be thrown off health of the alimentary tract by constitutional treatment extending for a long period so as to make it unsuited as a habitat. They also think that such a treatment is efficacious to eradicate them from the host.
In the connection with thread-worms I remember, about forty years back while I was a boy, I happened to see a girl of nine who was constantly troubled with the thread-worms. By night she had to suffer intolerable itching in the anus which made her restless and scream. Every day, by night, her mother advised her to lie on the knee-elbow position. Then the mother the skin at the anus ring apart which easily enabled an onlooker to see the innumerable tread-worms crawling and took them one by one with the end of a splinter and killed them in the flame of a lighted lamp. Thus troubling for one hour or so the girl was able to sleep without scream or restlessness. For how may days, the woman continued this unfruitful act for eradication of the thread-worms I really do not remember well. The girl might have got considerable amelioration for days if some cathartic might have been given to her one day. But there was nobody to advise her as may village was very poor in getting a medical aid in those days.

It is an erroneous belief that a cathartic alone can eradicate the thread-worms. When one is highly infested with thread-it is unwise also to rely upon constitutional treatment alone. According to the author, when one is highly infested with them it is advisable to give vermifuges and later to make use of constitutional treatment extending for a long period. Measures also should be taken to prevent reinfection from the anus. The child may sleep in closed drawers. For slight manifestations symptomatic treatment will be efficient to eradicate the worms.
Tread-worms should be attacked both from above for those in caccum and from below for those lower down. This method of treatment is found highly effective. I have got encouraging results by injecting the lower gut daily in the evening with a table-spoonful of common salt in eight ounces of water of about 104° F. Children should be given an enema containing teaspoonful of salt. The enema treatment as continued daily for ten days. Combined with this I have given symptomatic treatment for which I have got beneficial results.

A domestic, excellent, efficient and harmless vermifuge is the milky fluid of green papaya. Take quarter of an ounce of the milky fluid (latex) of green papaya and mix it with equal quantity of honey. It is then stirred well in two ounces of boiled water, when it becomes cold, drink it, when two hours are passed by, take an ounce of good castor oil mixed with half an ounce of the juice of lime. This should be taken early morning as a result of which all the tread-worms are expelled out. Till the purging are over taking of boiled and cooled water is only admissible. Children from three to seven years may take only half the above dose and below three years, half of it. Some are attacked with sharp diarrhoea after the administration of the above vermifuge and castor oil. It is interesting to note that drinking of pure water in which sugar is dissolved is highly recommended to cure this.
Once a patient troubled with thread-worms cut a large green papaya into slices. He then ate it after cooking as a result of which sharp diarrhoea ensued. Though the thread-worms were expelled he became weak with diarrhoea. According to the advice of some one he took sugar water in large quantities and gave him the desired result.

Medication
Indigo tinctoria
3x
This is good remedy for melancholic children. It is invaluable in convulsions resulting from intense pain in the umbilical region. Convulsion commencing in the abdomen very acute pains with no distention of the abdomen. No disturbance of the appetite, bit wormy diarrhoea of faecal matter with mucus and thread-worms in the discharge.
Santoninum
Ix (trit)
Useful in all kinds of worms.
Sepia officinalis
30
Wormy state in young girl with lucorrhoea.
Stannum metallicum
30
Foul breath, heavily coated tongue, ravenous appetite with nausea after eating; moaning and restlessness at night with pale face and abject fear. It prefers to lie on its stomach to relieve the abdominal suffering. Dull and stupid appearance with pale face and sunken eyes.
AGE 29
Cina is useful for the high nerve tension found in wormy conditions. Sluggishness of disposition, general torpor, fetor of breath flatus and passive fever are the prominent indication for Stannum.
Dr. Fisher says that he had reports of the passing pridigious quantities of thread worms and ascarides under the use of Stannum.
The book entitled the Homeopathic Family Practice published by M. Bhattacharya and Co. says that the secretion of excessive mucus may be prevented by the use of Viola odorata 6 before breakfast and Stannum 30 at bed time.
Sulphur
30
Worm colic: when there has been partial alleviation of troubles by the used of other medicines.
Teucrium marum verum
1x
Severe inflammation of rectum; sleeplessness; giddiness.
Other remedies are; Acon; Bar. m.; Bell; Calc; Chin; Cina; Cupr, Oxy. nig; Ipec; Lyc; Merc sol; Merc; Sabad; Spig; and Sulph the symptoms of which are deal with on page 10 under the medication given for round-worms.
In the Biochemic system natrum phos 3x is the principal remedy. Symptoms of acidity in children, with pain in the bowels, picking of the nose, itching of the anus, restless sleep and grinding of the teeth are the prominent symptoms.
Kali mur is also beneficial in the affections caused by thread-worms.

Number 1 and 14(pills) of the specific system are said to be salutary. When the evil influence of worms is suspected specific No. 33 should be given intercurrently at bed-time and rising.
Diet
Thread-Worms flourish well in starchy food. Therefore a diminution in such food as bread and rice in the diet is quite essential. The number of thread-worms lessens when curries made from green bananas as leaf vegetables are avoided in the diet. Avoid sweets and food stiffs containing too much oil. Jaggery, milk and curd are other articles in which the thread-worms multiply considerably. Fish curry is a suitable one that can be included in the diet of a thread-worm patient

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