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Standard Handbook of Petroleum
and Natural Gas Engineering
Standard Handbook of
Petroleum and Natural
Gas Engineering

Third Edition

William C. Lyons, Ph.D., P.E.

Gary J. Plisga, B.S.
Michael D. Lorenz, B.S.

AMSTERDAM • BOSTON • HEIDELBERG • LONDON

NEW YORK • OXFORD • PARIS • SAN DIEGO
SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO
Gulf Professional Publishing is an imprint of Elsevier
Gulf Professional Publishing is an imprint of Elsevier
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Contributors

Egill Abrahamsen Weatherford International Limited, Francisco Ciulla Weatherford International Limited,
Houston, Texas Houston, Texas
Chip Abrant Weatherford International Limited, Houston, Ivan W. Clay CGMS
Texas Vern Cobb Consultant
Bo Anderson Weatherford International Limited, Houston, Robert M. Colpitts Consultant in Geology and Geo-
Texas physics, Las Vegas, Nevada
Peter Anselmo New Mexico Institute of Mining and Tech- Robert B. Coolidge Weatherford International Limited,
nology, Socorro, New Mexico Houston, Texas
Cory Arceneaux Chevron, Katy, Texas Heru Danardatu Schlumberger, Balikpapan, Indonesia
Mirambek Ataushiyev Chevron, Houston, Texas Tracy Darr van Reet Chevron—retired, El Paso, Texas
Robert P. Badrak Weatherford International Limited, Robert Desbrandes Louisiana State University, Baton
Houston, Texas Rouge, Louisiana
Dave Barrow Chevron, Houston, Texas Aimee Dobbs Global Santa Fe, Houston, Texas
Frederick E. Beck Consultant, Denver, Colorado Patricia Duettra Consultant in Applied Mathematics and
Susan Beck Weatherford International Limited, Houston, Computer Analysis, Albuquerque, New Mexico
Texas Ernie Dunn Weatherford International Limited, Houston,
Joe Berry Varco Incorporated, Houston, Texas Texas
Ed Blair Chevron, Houston, Texas Michael Economides University of Houston, Houston,
Tom Blasingame Texas A&M University, College Station, Texas
Texas Ksenia Eliseeva Chevron, Houston, Texas
Daniel E. Boone Consultant in Petroleum Engineering, James Falconer National Oilwell Varco
Houston, Texas John Farraro Chevron, Houston, Texas
Gordon R. Bopp Environmental Technology and Jason Fasnacht Boart Longyear, Salt Lake City, Utah
Educational, Services Company, Richland,
Washington Joel Ferguson Weatherford International Limited, Houston,
Texas
T. Wayne Brewster Chevron, Houston, Texas
Jerry W. Fisher Weatherford International Limited,
John Breidenthal Consultant, International Association of Houston, Texas
Drilling Contractors (IADC)
Robert Ford Smith Bits International, Houston, Texas
Ronald M. Brimhall Consultant, College Station, Texas
B.J. Gallaher
Ernie Brown Schlumberger, Sugarland, Texas
Craig Gardner Chevron, Houston, Texas
David Burt BP, France
Kazimierz Glowacki Consultant in Energy and
Tom Carlson Halliburton Energy Services Group, Houston, Environmental Engineering, Krakow, Poland
Texas
Bill Grubb Weatherford International Limited, Houston,
Thomas Carter Consultant, Houston, Texas Texas
William X. Chavez, Jr. New Mexico Institute of Mining Boyun (Gordon) Guo University of Louisiana, Lafayette,
and Technology, Socorro, New Mexico Louisiana

vii
viii Contributors

Anton Hriczko CGMS Tom Morrow Global Santa Fe, Houston, Texas
Mark Heironimus El Paso Production, El Paso, Texas Abdul Mujeeb Henkels & McCoy, Incorporated, Blue Bell,
Matthew Hill Unocal Indonesia Company, Jakarta, Pennsylvania
Indonesia Bob Murphy Weatherford International Limited,
John Hosford Chevron Texaco, El Paso, Texas Houston, Texas

Michael C. Jackson Chevron Charles Nathan

Phillip W. Johnson University of Alabama, Tuscaloosa, PK Pande Annadarko Petroleum Corp., Houston, Texas
Alabama Tim Parker Weatherford International Limited, Houston,
Harald Jordan BP America, Inc., Farmington, Texas
New Mexico Phil Pattillo Consultant
Mike Juenke Weatherford International Limited, Houston, Pudji Permadi Institut Teknologi Bandung, Bandung,
Texas Indonesia
Reza G. Kashmiri International Lubrication and Fuel, Jim Pipes Weatherford International Limited, Houston,
Incorporated, Rio Rancho, New Mexico Texas
William Kersting MS, New Mexico State University, Las Adam Pitts Tesco, Houston, Texas
Cruces, New Mexico Gary Plisga Consultant in Hydrocarbon Properties
Murty Kuntamukkla Westinghouse Savannah River (retired), Katy, Texas
Company, Aiken, South Carolina Floyd Preston University of Kansas, Lawrence, Kansas
Joseph V. LaBlanc Toby Pugh Weatherford International Limited, Houston,
Doug LaBombard Weatherford International Limited, Texas
Houston, Texas Randy Pyrch CanRig Drilling Technology Ltd., Houston,
Julius P. Langlinais Louisiana State University, Baton Texas
Rouge, Louisiana Carroll Rambin Weatherford International Limited,
William Linn Key Energy Services, Houston, Texas Houston, Texas
John Lofton Chevron, Houston, Texas Bharath N. Rao President, Bhavya Technologies, Inc.
Michael Lorenz Chevron, Houston, Texas Richard S. Reilly New Mexico Institute of Mining and
Catherine Rivera Lyons ERM Technology, Socorro, New Mexico
William C. Lyons Consultant (retired), Houston, TX Steven Riedinger Chevron, Houston, Texas
Tom Mangum Consultant, Tomball, Texas Cheryl Rofer Tammoak Enterprises, LLC, Los Alamos,
New Mexico
James Martens Weatherford International Limited,
Houston, Texas Chris S. Russell Consultant in Environmental Engineering,
Grand Junction, Colorado
F. David Martin Consultant, Albuquerque, New Mexico
Oleg Salzberg
Robert Martin Chevron, Houston, Texas
Jorge H.B. Sampaio, Jr. New Mexico Institute of Mining
George McKown Smith Services, Houston, Texas and Technology, Socorro, New Mexico
Graham Mensa-Wilmot Chevron, Houston, Texas Alex Sas-Jaworsky SAS Industries, Houston, Texas
David Mildren Dril Tech Mission, Fort Worth, Texas Eddie Scales National Oil Well, Houston, Texas
Mark Miller Pathfinder, Texas Ron Schmidt Weatherford International Limited, Houston,
Richard J. Miller Richard J. Miller and Associates, Texas
Incorporated, Huntington Beach, California Sue Schrader
Stefan Miska University of Tulsa, Tulsa, Oklahoma Ardeshir K. Shahraki Dwight’s Energy Data, Inc.,
Carl Montgomery NSI Technologies Inc., Tulsa, Richardson, Texas
Oklahoma Paul Singer New Mexico Institute of Mining and
Steve Morey BP, Houston, Texas Technology, Socorro, New Mexico
 Contributors ix

Francisco Sinisterra Archer Tom Wadsworth TH Hill Associates, Spring, Texas

Jack Smith Weatherford International Limited, Bill Wamsley Smith Bits International, Houston, Texas
Houston, Texas Sue Weber Consultant in Computer and Mathematics
Michael B. Smith NSI Technologies Inc., Tulsa,
Deryck Williams Chevron, Houston, Texas
Oklahoma
Jack Wise Sandia National Labs, Albuquerque,
Mark Trevithick T&T Engineering Services, Inc.,
New Mexico
Houston, Texas
Dana Witt Chevron, Houston, Texas
Dwayne Tyus CanRig Drilling Technology Ltd.,
Houston, Texas Andrzej K. Wojtanowicz Louisiana State University,
Baton Rouge, Louisiana
Adrian Vuyk, Jr. Weatherford International Limited,
Houston, Texas Tom Wynn AGR
Preface

First, we would like to introduce an addition to the edi- publication easily read and understood by any up-to-date
torial team that is responsible for organizing each of the engineer or technician, regardless of discipline.
new editions of the Standard Handbook of Petroleum and The initial chapters of this edition set the tone by inform-
Natural Gas Engineering. Stemming from an original pub- ing the reader of the common language and notation that
lication called Practical Petroleum Engineer’s Handbook all engineering disciplines utilize. This common language
first published in the 1940s, the first edition of this hand- and notation is used throughout the handbook (in nearly
book was published in 1996 after nearly 8 years of initial all cases consistent with Society of Petroleum Engineers
preparation by the handbook’s first technical editor William publication practices). The 120 contributing authors through
(Bill) Lyons. For the second edition, Gary Plisga was added the past three editions have tried to avoid the jargon that has
to the technical editorial staff. This second edition of the crept into petroleum engineering literature over the past few
handbook was published in 2005 after 2 years of review decades. A classic example has been the use of the oil field
of the original material organized by Bill Lyons and Gary slang term of “mud density” for the specific weight (lb/gal).
Plisga. This new third edition required the addition of a In most places in the handbook, the use of either MW
third member to the technical editorial staff. This new (lb/gal) or alternate term SG (for specific gravity) allows a
member is Michael Lorenz. It is anticipated that Michael reader to go easily to either SI, the British Imperial System,
Lorenz will have to carry out the technical editing duties or the US Customary System.
in a new fourth edition because of the present ages of The specific petroleum engineering discipline chapters
Bill Lyons and Gary Plisga. Michael Lorenz in addition cover drilling and well completions, reservoir engineering,
to learning the procedures this new third edition, has also production engineering, and economics (with valuation and
written contributions for this present new handbook third risk analysis). These chapters contain information, data, and
edition. example calculations directed toward practical situations
As in the previous two editions of this handbook, this that petroleum engineers often encounter. Also, internal to
new third edition has been prepared in the spirit of the each of these chapters is the growing role of natural gas in
classic handbooks that have been prepared for the other the world economies by integrating natural gas topics and
important major engineering disciplines, namely, mechan- related subjects throughout the new third edition.
ical engineering, chemical engineering, and electrical engi- As in both previous editions of this handbook, this new
neering. In that regard, this new third edition of this third edition has incorporated many important data bases
handbook has been developed to allow the engineers and from both the American Petroleum Institute and the Soci-
technicians that serve the upstream of the worldwide oil and ety of Petroleum Engineers publications. The authors and
gas industries to have a quick reference for technical defi- editors thank these two institutions for their cooperation.
nitions, data, calculation equations, and example solutions. The authors and editors would also like to thank all the
The updated information from the old editions continues petroleum production and service company employees that
the effort to make the new edition more SI friendly. As in have assisted in this project.
the second edition, this new third edition is available in a After nearly 30 years of college level teaching, Bill
single hardback traditional handbook volume, or available Lyons retired from the New Mexico Institute of Mining
as an e-book downloadable from the Elsevier website and and Technology in 2006. In early 2007, he joined the
other online retailers. An important quality of this new BP Chevron Drilling Training Alliance (DTA) in Houston,
third edition is the editors’ continued effort to make this Texas to continue his teaching career in the professional

xi
xii Preface

development instruction arena. At the end of 2012, BP and preparation of many of the included figures and drawings.
Chevron dissolved the DTA and went their separate ways to These are Anton Hriczko, Ann Arens, and Jim Thacker. Fur-
carry out internal professional development of their staffs. ther, the technical editors would like to thank the Elsevier’s
The DTA was managed through most of its very successful staff editors Katie Hammon, Kattie Washington, and Sruthi
18 years of operation by Gary Massie with the competent Satheesh. Thanks to each of you for all of your patience
managerial assistance of Saad Hashmi. At the end of 2012, in dealing with all of the individual co-authors and the
the DTA was honored with ASME’s Excellence in Profes- technical editors.
sional Instruction. The readers will see in this new third
edition the influence of operational engineering subjects William C. Lyons, Ph.D., P.E.(ret)
that the technical editors experienced while with the BP Sugar Land, Texas
Chevron DTA over the past decade. Gary J. Plisga, B.S.
In the detailed preparation of this new third edition, Katy, Texas
the co-authors and technical editors would like to specif- Michael D. Lorenz, B.S.
ically thank the many graphic artists that assisted in the Houston, Texas
Chapter 1

Mathematics

are complementary if their sum is 90◦ or are supplementary

1.1 GENERAL if their sum is 180◦ . Angles are congruent if they have
See Reference 1 for additional information. the same measurement in degrees and line segments are
congruent if they have the same length. A dihedral angle
is formed by two half-planes having the same edge, but not
1.1.1 Sets and Functions lying in the same plane. A plane angle is the intersection of
A set is a collection of distinct objects or elements. The a perpendicular plane with a dihedral angle.
intersection of two sets S and T is the set of elements which
belong to S and which also belong to T. The union (or 1.2.2 Polygons
inclusive) of S and T is the set of all elements that belong to
S or to T (or to both). A polygon is a closed figure with at least three line segments
A function can be defined as a set of ordered pairs, that lies within a plane. A regular polygon is a polygon
denoted as (x, y) such that no two such pairs have the same in which all sides and angles are congruent. Two polygons
first element. The element x is referred to as the independent are similar if their corresponding angles are congruent and
variable, and the element y is referred to as the dependent corresponding sides are proportional. A segment whose end
variable. A function is established when a condition exists points are two nonconsecutive vertices of a polygon is a
that determines y for each x, the condition usually being diagonal. The perimeter is the sum of the lengths of the
defined by an equation such as y = f(x) [2]. sides.

REFERENCE 1.2.3 Triangles

1. Mark’s Standard Handbook for Mechanical Engineers, 8th Edition, A triangle is a three-sided polygon. The sum of the angles of
Baumeister, T., Avallone, E. A., and Baumeister III, T. (Eds.), McGraw-
a triangle is equal to 180◦ . An equilateral triangle has three
Hill, New York, 1978.
sides that are the same length, an isosceles triangle has two
sides that are the same length, and a scalene triangle has
1.2 GEOMETRY three sides of different lengths.
See References 1 and 2 for additional information. A median of a triangle is a line segment whose end
points are a vertex and the midpoint of the opposite side. An
angle bisector of a triangle is a median that lies on the ray
1.2.1 Angles bisecting an angle of the triangle. The altitude of a triangle
Angles can be measured using degrees or with radian is a perpendicular segment from a vertex to the opposite
measure. Using the degree system of measurement, a circle side.
has 360◦ , a straight line has 180◦ , and a right angle has 90◦ . Two triangles are congruent if one of the following is
The radian system of measurement uses the arc length of a given (where S = side length and A = angle measurement):
unit circle cut off by the angle as the measurement of the SSS, SAS, AAS, or ASA.
angle. In this system, a circle is measured as 2π radians, a
straight line is π radians and a right angle is π/2 radians.
An angle A is defined as acute if 0◦ < A < 90◦ , right if
1.2.4 Quadrilaterals
A = 90◦ , and obtuse if 90◦ < A < 180◦ . Two angles A quadrilateral is a four-sided polygon.
Standard Handbook of Petroleum and Natural Gas Engineering. http://dx.doi.org/10.1016/B978-0-12-383846-9.00001-1
Copyright © 2016 Elsevier Inc. All rights reserved. 1-1
1-2 Standard Handbook of Petroleum and Natural Gas Engineering

A trapezoid has one pair of opposite parallel sides. A The angle bisectors of a triangle are concurrent at a point
parallelogram has both pairs of opposite sides congruent equidistant from their sides, and the medians are concurrent
and parallel. The opposite angles are then congruent, and two thirds of the way along each median from the vertex to
adjacent angles are supplementary. The diagonals bisect the opposite side. The point of concurrency of the medians
each other and are congruent. A rhombus is a parallelogram is the centroid.
whose four sides are congruent and whose diagonals are
perpendicular to each other.
A rectangle is a parallelogram having four right angles; 1.2.8 Similarity
therefore, both pairs of opposite sides are congruent. A rect- Two figures with straight sides are similar if corresponding
angle whose sides are all congruent is a square. angles are congruent and the lengths of corresponding sides
are in the same ratio. A line parallel to one side of a
1.2.5 Circles and Spheres triangle divides the other two sides in proportion, producing
a second triangle similar to the original one.
If P is a point on a given plane and r is a positive number,
the circle with center P and radius r is the set of all points
of the plane whose distance from P is equal to r. The sphere 1.2.9 Prisms and Pyramids
with center P and radius r is the set of all points in space A prism is a three-dimensional figure whose bases are any
whose distance from P is equal to r. Two or more circles congruent and parallel polygons and whose sides are paral-
(or spheres) with the same P but different values of r are lelograms. A pyramid is a solid with one base consisting of
concentric. any polygon and with triangular sides meeting at a point in
A chord of a circle (or sphere) is a line segment whose a plane parallel to the base.
end points lie on the circle (or sphere). A line which Prisms and pyramids are described by their bases: a
intersects the circle (or sphere) in two points is a secant of triangular prism has a triangular base, a parallelpiped is
the circle (or sphere). A diameter of a circle (or sphere) is a a prism whose base is a parallelogram and a rectangular
chord containing the center, and a radius is a line segment parallelpiped is a right rectangular prism. A cube is a
from the center to a point on the circle (or sphere). rectangular parallelpiped all of whose edges are congruent.
The intersection of a sphere with a plane through its A triangular pyramid has a triangular base, etc. A circular
center is called a great circle. cylinder is a prism whose base is a circle and a circular cone
A line that intersects a circle at only one point is a is a pyramid whose base is a circle.
tangent to the circle at that point. Every tangent is per-
pendicular to the radius drawn to the point of intersection.
Spheres may have tangent lines or tangent planes. 1.2.10 Coordinate Systems
Pi (π) is the universal ratio of the circumference of any
circle to its diameter and is approximately equal to 3.14159. Each point on a plane may be defined by a pair of numbers.
Therefore, the circumference of a circle is πd or 2πr. The coordinate system is represented by a line X in the plane
(the x-axis) and by a line Y (the y-axis) perpendicular to
line X in the plane, constructed so that their intersection,
1.2.6 Arcs of Circles the origin, is denoted by zero. Any point P on the plane can
be described by its two coordinates, which form an ordered
A central angle of a circle is an angle whose vertex is the
pair, so that P(x1 , y1 ) is a point whose location corresponds
center of the circle. If P is the center and A and B are points,
to the real numbers x and y on the x-axis and the y-axis.
not on the same diameter, which lie on C (the circle), the
If the coordinate system is extended into space, a third
minor arc AB is the union of A, B, and all points on C in the
axis, the z-axis, perpendicular to the plane of the x1 and y1
interior of <APB. The major arc is the union of A, B, and
axes, is needed to represent the third dimension coordinate
all points on C on the exterior of <APB. A and B are the end
defining a point P(x1 , y1 , z1 ). The z-axis intersects the x
points of the arc and P is the center. If A and B are the end
and y axes at their origin, zero. More than three dimensions
points of a diameter, the arc is a semicircle. A sector of a cir-
are frequently dealt with mathematically but are difficult to
cle is a region bounded by two radii and an arc of the circle.
visualize.
The slope m of a line segment in a plane with end points
1.2.7 Concurrency P1 (x1 , y1 ) and P2 (x2 , y2 ) is determined by the ratio of the
change in the vertical (y) coordinates to the change in the
Two or more lines are concurrent if there is a single point
horizontal (x) coordinates or
that lies on all of them. The three altitudes of a triangle
(if taken as lines, not segments) are always concurrent,
and their point of concurrency is called the orthocenter. m = (y2 − y1 )/(x2 − x1 )
 Mathematics Chapter | 1 1-3

except that a vertical line segment (the change in x coor- ● Right triangle (Figure 1.2.1)
dinates equal to zero) has no slope (i.e., m is undefined).
A horizontal segment has a slope of zero. Two lines with A
the same slope are parallel and two lines whose slopes are
negative reciprocals are perpendicular to each other. c
Because the distance between two points P1 (x1 , y1 ) and b
P2 (x2 , y2 ) is the hypotenuse of a right triangle, the length
(L) of the line segment P1 P2 is equal to B c
a

L = (x2 − x1 )2 + (y2 − y1 )2
c2 = a2 + b2 (Pythagorean theorem)
1.2.11 Graphs area = 1/2 • ab = 1/2 • a2 cot A
A graph is a set of points lying in a coordinate system and = 1/2 • b2 tan A = 1/4 • c2 sin 2A
a graph of a condition (such as x = y + 2) is the set of ● Any triangle (Figure 1.2.2)
all points that satisfy the condition. The graph of the slope-
intercept equation, y = mx + b, is a straight line which A
passes through the point (0, b), where b is the y-intercept
(x = 0) and m is the slope. The graph of the equation
c b
(x − a)2 + (y − b)2 = r2 h

is a circle with center (a, b) and radius r. B C

a

1.2.12 Vectors area = 1/2 base • altitude = 1/2 • ah = 1/2 • ab sin C

= ± 1/2 • {(x1 y2 − x2 y1 )
A vector is described on a coordinate plane by a directed + (x2 y3 − x3 y2 )
segment from its initial point to its terminal point. The + (x3 y1 − x1 y3 )}
directed segment represents the fact that every vector where (x1 , y1 ), (x2 , y2 ), (x3 , y3 ) are coordinates of
determines a magnitude and a direction. A vector v is not vertices.
changed when moved around the plane, if its magnitude ● Rectangle (Figure 1.2.3)
and angular orientation with respect to the x-axis is kept
constant. The initial point of v may therefore be placed
at the origin of the coordinate system and v may be
denoted by
u b
v = a, b D D

where a is the x-component and b is the y-component of the a

terminal point. The magnitude may then be determined by
the Pythagorean theorem
area = ab = 1/2 • D2 sin u
 where u = angle between diagonals D, D.
v = a2 + b2 ● Parallelogram (Figure 1.2.4)
For every pair of vectors (x1 , y1 ) and (x2 , y2 ), the vector
sum is given by (x1 + x2 , y1 + y2 ). The scalar product of b
the vector P = (x, y) and a real number (a scalar) r is rP = h
(rx, ry). Also see the discussion of polar coordinates in the
a u
Section “Trigonometry” and Chapter 2, “Basic Mechanics.” D1 D2
C

1.2.13 Lengths and Areas of Plane Figures

For definitions of trigonometric functions, see “Trigono- area = bh = ab sin c = 1/2 • D1 D2 sin u
metry.” where u = angle between diagonals D1 and D2 .
1-4 Standard Handbook of Petroleum and Natural Gas Engineering

● Trapezoid (Figure 1.2.5) ● Sector (Figure 1.2.8)

a r

A s
h u
D1 D2

b
area = 1/2 • rs = πr2 A/360◦ = 1/2 • r2 rad A
where rad A = radian measure of angle A
area = 1/2 • (a + b)h = 1/2 • D1 D2 sin u s = length of arc = r rad A
● Ellipse (Figure 1.2.9)
where u = angle between diagonals D1 and D2
and where bases a and b are parallel. x
● Any quadrilateral (Figure 1.2.6)
b b
y
a y
u b
D2
c a a
D1

area of ellipse = πab

d
area of shaded segment = xy + ab sin−1 (x/a)
length of perimeter of ellipse = π(a + b)K,
where K = (1 + 1/4 • m2 + 1/64 • m4 + 1/256 •
m6 + . . .)
area = 1/2 • D1 D2 sin u m = (a − b)/(a + b)
● Hyperbola (Figure 1.2.10)
Note: a2 + b2 + c2 + d2 = D21 + D22 + 4 m2
where m = distance between midpoints of D1 and D2 .
P
● Circles
area = πr2 = 1/2 • Cr = 1/4 • Cd = 1/4 • πd2 = b y
0.785398 d2 a A
where r = radius
d = diameter b y
C = circumference = 2πr = πd.
●
a
Annulus (Figure 1.2.7)
x

For any hyperbola,

shaded area A = ab • ln[(x/a) + (y/b)]
For an equilateral hyperbola (a = b),
r R area A = a2 sinh−1 (y/a) = a2 cosh−1 (x/a)
where x and y are coordinates of point P.
● Parabola (Figure 1.2.11)

b d
A c
D

area = π(R2 − r2 ) = π(D2 − d2 )/4 = 2πR b h

where R = mean radius = 1/2 • (R + r)
b=R−r
 Mathematics Chapter | 1 1-5

shaded area A = 2/3 • ch ● Any prism or cylinder (Figure 1.2.15)

y
P
u
T O F M

h
In Figure 1.2.12,
length of arc OP = s = 1/2 • PT + 1/2 • p •
ln [cot(1/2 • u) ]
Here c = any chord
p = semilatus rectum
PT = tangent at P
Note: OT = OM = x
volume = Bh = Nl
1.2.14 Surfaces and Volumes of Solids lateral area = Ql
where l = length of an element or lateral edge
● Regular prism (Figure 1.2.13) B = area of base
N = area of normal section
Q = perimeter of normal section
● Hollow cylinder (right and circular)
volume = πh(R2 − r2 ) = πhb(D − b) = πhb(d + b) =
πhbD = πhb(R + r)
h where h = altitude
r, R (d, D) = inner and outer radii (diameters)
b = thickness = R − r
D = mean diam = 1/2 • (d + D) = D − b = d + b
● Sphere
r
a a volume = V = 4/3 • πr3 = 4.188790r3 = 1/6 •
a πd3 = 0.523599d3
area = A = 4πr2 = πd2
volume = 1/2 • nrah = Bh
where r = radius √ √
lateral area = nah = Ph
d=√ 2r = diameter = √3
6V/π = 1.24070 3 V
where n = number of sides
= 3 A/π = 0.56419 A
B = area of base ● Hollow sphere, or spherical shell
P = perimeter of base
●
volume = 4/3 • π(R3 − r3 ) = 1/6 • π(D3 − d3 ) =
Right circular cylinder (Figure 1.2.14)
4πR21 t + 1/3 • πt3
where R, r = outer and inner radii
D, d = outer and inner diameters
t = thickness = R − r
R1 = mean radius = 1/2 • (R + r)
● Torus, or anchor ring (Figure 1.2.16)
h

r
r
c

volume = πr2 h = Bh
lateral area = 2πrh = Ph
where B = area of base

P = perimeter of base
1-6 Standard Handbook of Petroleum and Natural Gas Engineering

volume = 2π2 cr2 is some constant. If x ∞ 1/y, then x is inversely proportional

area = 4πr2 cr (proof by theorems of Pappus) to y and x = k/y.

1.3.2 Rules of Addition

REFERENCES
1. Moise, E. E., and Downs, Jr., F. L., Geometry, Addison Wesley, Melano
a + b = b + a (commutative property)
Park, 1982. (a + b) + c = a + (b + c) (associative property)
2. Graening, J., Geometry, Charles E. Merrill, Columbus, 1980. a − (−b) = a + b and
a − (x − y + z) = a − x + y − z

(i.e., a minus sign preceding a pair of parentheses operates

1.3 ALGEBRA to reverse the signs of each term within if the parentheses
See Reference 1.3 for additional information. are removed)

1.3.1 Operator Precedence and Notation 1.3.3 Rules of Multiplication

and Simple Factoring
Operations in an equation are performed in the following
order of precedence: a • b = b • a (commutative property)
(ab)c = a(bc) (associative property)
1. Parenthesis and grouping symbols a(b + c) = ab + ac (distributive property)
2. Exponents a(−b) = −ab and − a(−b) = ab
3. Multiplication or division (left to right) (a + b)(a − b) = a2 − b2
4. Addition or subtraction (left to right)
(a + b)2 = a2 + 2ab + b2
For example:
and
a + b • c − d3 /e
(a − b)2 = a2 − 2ab + b2
will be operated upon (calculated) as if it were written (a + b)3 = a3 + 3a2 + 3ab2 + b3

a + (b • c) − [(d3 )/e] and

The symbol |a| means “the absolute value of a,” or the (a − b)3 = a3 − 3a2 + 3ab2 − b3
numerical value of a regardless of sign, so that
(For higher-order polynomials, see the “Binomial Theo-
| − 2| = |2| = 2 rem.”) an + bn is factorable by (a + b) if n is odd, and

The n! means “n factorial” (where n is a whole number) a3 + b3 = (a + b)(a2 − ab + b2 )

and is the product of the whole numbers 1 to n inclusive,
and an − bn is factorable by (a − b), thus
so that

4! = 1 • 2 • 3 • 4 = 24 an − bn = (a − b)(an−1 + an−2 b + . . . + abn−2 + bn−1 )

0! = 1 by definition
1.3.4 Fractions
The notation for the sum of any real numbers a1 , a2 , . . . ,an is
The numerator and denominator of a fraction may be mul-

n tiplied or divided by any quantity (other than zero) without
ai altering the value of the fraction, so that, if m = 0,
i=1
ma + mb + mc a+b+c
and for their product =
mx + my x+y

n
To add fractions, transform each to a common denomi-
ai
nator and add the numerators (b, y = 0):
i=1

The notation “x ∞ y” is read “x varies directly with y” a x ay bx ay + bx

+ = + =
or “x is directly proportional to y,” meaning x = ky where k b y by by by
 Mathematics Chapter | 1 1-7

To multiply fractions (denominators = 0): and since 1/M = 2.302585, for conversion (ln = loge )
a x ax ln x = 2.3026 log10 x
• =
b y by
a ax
•x= 1.3.7 Binomial Theorem
b b
a x c axc
• • = Let
b y z byz
n1 = n
To divide one fraction by another, invert the divisor and
multiply: n(n − 1)
n2 =
2!
a x a y
÷ = • =
ay n(n − 1)(n − 2)
b y b x bx n3 =
3!
and so on. Then for any n, |x| < 1,
1.3.5 Exponents
(1 + x)n = 1 + n1 x + n2 x2 + n3 x3 + . . .
am • an = am+n and am ÷ an = am−n
a0 = 1 (a = 0) and a1 = a If n is a positive integer, the system is valid without
a−m
= 1/a m restriction on x and completes with the term nn xn .
Some of the more useful special cases follow [1]:
(a ) = amn
m n
√ √ √ 1 1 1
= na am/n = am
n
a1/n and 1 + x = (1 + x)1/2 = 1 + x − x2 + x3
2 8 16
(ab)n = an bn
5 4
(a/b)n = an /bn − x + . . . (|x| < 1)
128
√ 1 1 5
1 + x = (1 + x)1/3 = 1 + x − x2 − x3
3
Except in simple cases (square and cube roots), radical
3 9 81
signs are replaced by fractional exponents. If n is odd,
10 4
√ √ − x + . . . (|x| < 1)
n
−a = − n a 243
1
= (1 + x)−1 = 1 − x + x2 − x3
but if n is even, the nth root of −a is imaginary. 1+x
+ x4 − . . . (|x| < 1)
1 1 3 5
1.3.6 Logarithms √ = (1 + x)−1/2 = 1 − x + x2 − x3
1+x 2 8 16
The logarithm of a positive number N is the power to which 35 4
the base must be raised to produce N. So, x = logb N + x − . . . (|x| < 1)
128
means bx = N. Logarithms to the base 10, frequently used
1 1 2 14
in numerical computation, are called common or denary √ = (1 + x)−1/3 = 1 − x + x2 − x3
logarithms, and those to base e, used in theoretical work,
3
1+x 3 9 81
are called natural logarithms and frequently notated as ln. 35 4
+ x − . . . (|x| < 1)
In any case, 243
 3 3 1
(1 + x)3 = (1 + x)3/2 = 1 − x + x2 − x3
log(ab) = log a + log b 2 8 16
log(a/b) = log a − log b 3 4
+ x − . . . (|x| < 1)
log(1/n) = − log n 128
1 3 15 35
log(an ) = n log a  = (1 + x)−3/2 = 1 − x + x2 − x3
(1 + x) 3 2 8 16
logb (b) = 1, where b is either 10 or e
315 4
log 0 = −∞ + x − . . . (|x| < 1)
128
log 1 = 0
with corresponding formulas for (1 − x)1/2 , etc., obtained
log10 e = M = 0.4342944819 . . . , so for conversion
by reversing the signs of the odd powers of x. Provided
log10 x = 0.4343 loge x |b| < |a|:
1-8 Standard Handbook of Petroleum and Natural Gas Engineering

 
b n (x − p)(x − q)(x − r) . . . = 0
(a + b)n = an 1 +
a
then p, q, r, . . . are the roots of the equation. If |x| is very
= an + n1 an−1 b + n2 an−2 b2 + n3 an−3 b3 + . . . large, the terms containing the lower powers of x are least
where n1 , n2 , etc., have the values given earlier. important, while if |x| is very small, the higher-order terms
are least significant.
First-degree equations (linear equations) have the form
1.3.8 Progressions
In an arithmetic progression, (a, a + d, a + 2d, a + 3d, . . .), ax + b = c
each term is obtained from the preceding term by adding a
with the solution x = b − a and the root b − a.
constant difference, d. If n is the number of terms, the last
Second-degree equations (quadratic equations) have the
term is p = a + (n − 1)d, the “average” term is 1/2(a + p)
form
and the sum of the terms is n times the average term or s =
n/2(a+p). The arithmetic mean between a and b is (a+b)/2. ax2 + bx + c = 0
In a geometric progression, (a, ar, ar2 , ar3 , . . .), each
term is obtained from the preceding term by multiplying by with the solution
a constant ratio, r. The nth term is arn−1 , and the sum of the √
first n terms is s = a(rn − 1)/(r − 1) = a(1 − rn )/(1 − r). If −b ± b2 − 4ac
x=
r is a fraction, rn will approach zero as n increases and the 2a
sum of n terms will approach a/(1 − r) as a limit. and the roots
The geometric mean, also √called the “mean propor- √
tional,” between a and b is ab. The harmonic mean −b + b2 − 4ac
between a and b is 2ab/(a + b). 2a
and
1.3.9 Sums of the First n Natural Numbers √
−b − b2 − 4ac
● To the first power:
2a
1 + 2 + 3 + . . . + (n − 1) + n = n(n + 1)/2 The sum of the roots is −b/a and their product is c/a.
Third-degree equations (cubic equations) have the form,
● To the second power (squared): after division by the coefficient of the highest-order term,
12 + 22 + . . . + (n − 1)2 + n2 = n(n + 1)(2n + 1)/6 x3 + ax2 + bx + c = 0
● To the third power (cubed): with the solution
1 + 2 + . . . + (n − 1) + n = [n(n + 1)/2]
3 3 3 3 2
x31 = Ax1 + B

where x1 = x − a/3
A = 3(a/3)2 − b
1.3.10 Solution of Equations
B = −2(a/3)3 + b(a/3) − c
in One Unknown Exponential equations are of the form
Legitimate operations on equations include addition of any
quantity to both sides, multiplication by any quantity of both ax = b
sides (unless this would result in division by zero), raising with the solution x = (log b)/(log a) and the root
both sides to any positive power (if ± is used for even roots) (log b)/(log a). The complete logarithm must be taken, not
and taking the logarithm or the trigonometric functions of just the mantissa.
both sides.
Any algebraic equation may be written as a polynomial
of nth degree in x of the form 1.3.11 Solution of Systems of Simultaneous
Equations
a0 xn + a1 xn−1 + a2 xn−2 + . . . + an−1 x + an = 0
A set of simultaneous equations is a system of n equations
with, in general, n roots, some of which may be imaginary in n unknowns. The solutions (if any) are the sets of
and some equal. If the polynomial can be factored in the values for the unknowns that satisfy all the equations in the
form system.
 Mathematics Chapter | 1 1-9

First-degree equations in 2 unknowns are of the form 3. If two columns are equal or if one is a multiple of the
other, the determinant is zero.
a1 x1 + b1 x2 = c1 4. To multiply a determinant by any number m, multiply
a2 x1 + b2 x2 = c2 all elements of any one column by m.

The solution is found by multiplication of Equations Systems of simultaneous equations may be solved by
1.3.1 and 1.3.2 by some factors that will produce one the use of determinants using Cramer’s rule. Although the
term in each that will, upon addition of Equations 1.3.1 example is a third-order system, larger systems may be
and 1.3.2, become zero. The resulting equation may then solved by this method. If
be rearranged to solve for the remaining unknown. For
a1 x + b1 y + c1 z = p1
example, by multiplying Equation 1.3.1 by a2 and Equation
1.3.2 by −a1 , adding Equation 1.3.1 and Equation 1.3.2 and a2 x + b2 y + c2 z + p2
rearranging their sum a3 x + b3 y + c3 z = p3
a2 c1 − a1 c2 and if
x2 =
a2 b1 − a1 b2  
 a1 b1 c1 
 
and by substitution in Equation 1.3.1: D =  a2 b2 c2 =0

 a3 b3 c3 
b1 c2 − b2 c1
x1 =
a2 b1 − a1 b2 then
A set of n first-degree equations in n unknowns is
x = D1 /D
solved in a similar fashion by multiplication and addition
y = D2 /D
to eliminate n − 1 unknowns and then back substitution.
z = D3 /D
Second-degree equations in 2 unknowns may be solved
in the same way when two of the following are given: where
the product of the unknowns, their sum or difference, the  
sum of their squares. For further solutions, see “Numerical  p1 b1 c1 
 
Methods.” D1 =  p2 b2 c2 

 p3 b3 c3 
 
 a1 p1 c1 
1.3.12 Determinants  
D2 =  a2 p2 c2 

Determinants of the second order are of the following form  a3 p3 c3 
 
and are evaluated as  a1 b1 p1 
 
 
 a1 b1  D3 =  a2 b2 p2 

   
 a2 b2  = a1 b2 − a2 b1
a3 b3 p3

and of the third order as

 
 a1 b1 c1       
        REFERENCE
 a2 b2 c2  = a1  b2 c2  − a2  b1 c1  + a3  b1 c1 
   b3 c3   b3 c3   b2 c2 
 a3 b3 c3  1. Benice, D. D., Precalculus Mathematics, 2nd Edition, Prentice Hall,
Englewood Cliffs, 1982.
and of higher orders, by the general rules as follows. To
evaluate a determinant of the nth order, take the elements
of the first column with alternate plus and minus signs and 1.4 TRIGONOMETRY
form the sum of the products obtained by multiplying each
1.4.1 Directed Angles
of these elements by its corresponding minor. The minor
corresponding to any element en is the determinant (of the If AB and AB are any two rays with the same end point
−→ −→
next lowest order) obtained by striking out from the given A, the directed angle <BAB is the ordered pair (AB, AB ).
determinant the row and column containing en . −→ −
→
AB is the initial side of <BAB and AB the terminal side.
Some of the general properties of determinants are <BAB = <B AB and any directed angle may be ≤0◦ or
1. Columns may be changed to rows and rows to columns. ≥180◦ .
2. Interchanging two adjacent columns changes the sign of A directed angle may be thought of as an amount of
−→
the result. rotation rather than a figure. If AB is considered the initial
1-10 Standard Handbook of Petroleum and Natural Gas Engineering

θ TABLE 1.4.1 Angle Reduction to First Quadrant

S2 If 90◦ < x < 180◦ 180◦ < x < 270◦ 270◦ < x < 360◦
sin x = +cos(x − 90◦ ) −sin(x − 180◦ ) −cos(x − 270◦ )

cos x = −sin(x − 90◦ ) −cos(x − 180◦ ) +sin(x − 270◦ )

tan x = −cot(x − 90◦ ) +tan(x − 180◦ ) −cot(x − 270◦ )

h
csc x = +sec(x − 90◦ ) −csc(x − 180◦ ) −sec(x − 270◦ )

sec x = −csc(x − 90◦ ) −sec(x − 180◦ ) +csc(x − 270◦ )

S1
cot x = −tan(x − 90◦ ) +cot(x − 180◦ ) −tan(x − 270◦ )

FIGURE 1.4.1 Trigonometric functions of angles.

TABLE 1.4.2 Trigonometric Function Values by
Quadrant
position of the ray, which is then rotated about its end point
−→ 0◦ < x 90◦ < 180◦ < 270◦ <
A to form <BAB , AB is its terminal position. < 90◦ x < 180◦ x < 270◦ x < 360◦
If

1.4.2 Basic Trigonometric Functions sin x +0 to +1 +1 to +0 −0 to −1 −1 to −0

A trigonometric function can be defined for an angle θ cos x +1 to +0 −0 to −1 −1 to −0 +0 to +1

between 0◦ and 90◦ by using Figure 1.4.1. tan x +0 to +∞ −∞ to −0 +0 to +∞ −∞ to −0

csc x +∞ to +1 +1 to +∞ −∞ to −1 −1 to −∞
1.4.3 Trigonometric Properties
sec x +1 to +∞ −∞ to −1 −1 to −∞ +∞ to +1
sin θ = opposite side/hypotenuse = s1 /h
cos θ = adjacent side/hypotenuse = s2 /h cot x +∞ to +0 −0 to −∞ +∞ to +0 −0 to −∞
tan θ = opposite side/adjacent side = s1 /s2 = sin θ/ cos θ

and the reciprocals of the basic functions (where the func-

tion = 0)
TABLE 1.4.3 Trigonometric
cotangent θ = cot θ = 1/ tan θ = s2 /s1 Function Values at Major Angle
secant θ = sec θ = 1/ cos θ = h/s2 Values
cosecant θ = csc θ = 1/ sin θ = h/s1
Values at 30◦ 45◦ 60◦
√ √
To reduce an angle to the first quadrant of the unit circle, sin x 1/2 1/2 2 1/2 3
that is, to a degree measure between 0◦ and 90◦ , see Table √ √
cos x 1/2 3 1/2 2 1/2
1.4.1. For function values at major angle values, see Tables √ √
1.4.2 and 1.4.3. Relations between functions and the sum tan x 1/3 3 1 3
√ √
or difference of two functions are given in Table 1.4.4. csc x 2 2 2/3 3
Generally, there will be two angles between 0◦ and 360◦ √ √
sec x 2/3 3 2 2
that correspond to the value of a function.
√ √
The trigonometric functions sine and cosine can be cot x 3 1 1/3 3
defined for any real number by using the radian measure of
the angle as described in the section on angles. The tangent
function is defined on every real number except for places
where cosine is zero.
of the cosine function. The graph of the tangent function is
1.4.4 Graphs of Trigonometric Functions discontinuous when the value of tan θ is undefined, that is,
Graphs of the sine and cosine functions are identical in at odd multiples of 90◦ (. . ., 90◦ , 270◦ , . . .). For abbrevi-
shape and periodic with a period of 360◦ . The sine function ated graphs of the sine, cosine, and tangent functions, see
graph translated ± 90◦ along the x-axis produces the graph Figure 1.4.2.
 Mathematics Chapter | 1 1-11

TABLE 1.4.4 Relations Between Trigonometric TABLE 1.4.4 Relations Between Trigonometric
Functions of Angles Functions of Angles—cont’d

Single Angle cos2 x − sin2 y = cos2 y − sin2 x= cos(x + y) cos(x − y)

sin2 x + cos2 x = 1 sin(45◦ + x) = cos(45◦ − x), tan(45◦ + x) = cot(45◦ − x)

tan x = (sin x)/(cos x) sin(45◦ − x) = cos(45◦ + x), tan(45◦ − x) = cot(45◦ + x)

cot x = 1/(tan x) Multiple and Half Angles

1 + tan2 x = sec2 x tan 2x = (2 tan x)/(1 − tan2 x)

1 + cot2 x = csc2 x cot 2x = (cot2 x − 1)/(2 cot x)
sin(−x) = − sin x, cos(−x) = cos x, tan(−x) = − tan x sin(nx) = n sin x cosn−1 x − (n)3 sin3 x cosn−3 x
Two Angles +(n)5 sin5 x cosn−5 x − . . .
sin(x + y) = sin x cos y + cos x sin y cos(nx) = cosn x − (n)2 sin2 x cosn−2 x + (n)4 sin4 x cosn−4 x − . . .
sin(x − y) = sin x cos y − cos x sin y
(Note: (n)2 , . . . are the binomial coefficients)
cos(x + y) = cos x cos y − sin x sin y √
sin(x/2) = ± 1/2(1 − cos x)
cos(x − y) = cos x cos y + sin x sin y √
cos(x/2) = ± 1/2(1 + cos x)
tan(x + y) = (tan x + tan y)/(1 − tan x tan y) √
tan(x/2) = (sin x)/(1 + cos x) = ± (1 − cos x)/(1 + cos x)
tan(x − y) = (tan x − tan y)/(1 + tan x tan y)
Three Angles Whose Sum = 180◦
cot(x + y) = (cot x cot y − 1)/(cot y + cot x)
sin A + sin B + sin C = 4 cos(A/2) cos(B/2) cos(C/2)
cot(x − y) = (cot x cot y + 1)/(cot y − cot x)
cos A + cos B + cos C = 4 sin(A/2) sin(B/2) sin(C/2) + 1
sin x + sin y = 2 sin[1/2(x + y)] cos[1/2(x − y)]
sin A + sin B − sin C = 4 sin(A/2) sin(B/2) cos(C/2)
sin x − sin y = 2 cos[1/2(x + y)] sin[1/2(x − y)]
cos A + cos B − cos C = 4 cos(A/2) cos(B/2) sin(C/2) − 1
cos x + cos y = 2 cos[1/2(x + y)] cos[1/2(x − y)]
sin2 A + sin2 B + sin2 C = 2 cos A cos B cos C + 2
cos x − cos y = − 2 sin[1/2(x + y)] sin [1/2(x − y)]
sin2 A + sin2 B − sin2 C = 2 sin A sin B cos C
tan x + tan y = [sin(x + y)]/[cos x cos y]
tan A + tan B + tan C = tan A tan B tan C
tan x − tan y = [sin(x − y)]/[cos x cos y]
cot(A/2) + cot(B/2) + cot(C/2) = cot(A/2) cot(B/2) cot(C/2)
cot x + cot y = [sin(x + y)]/[sin x sin y]
sin 2A + sin 2B + sin 2C = 4 sin A sin B sin C
cot x − cot y = [sin(y − x)]/[sin x sin y]
sin 2A + sin 2B − sin 2C = 4 cos A cos B sin C
sin2 x − sin2 y = cos2 y − cos2 x = sin(x + y) sin (x − y)

sin X cos X tan X

1 1 2

0 90 180 270 360 0 90 180 270 360 −90 0 90 180 270

−1 −1 −2

The sine graph The cosine graph The tangent graph

period 360° period 360° period 360°

FIGURE 1.4.2 Graphs of the trigonometric functions.

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This species, very rare in Central and Northern Europe, inhabits the
small intestine, especially of children; it burrows very deeply into the
mucosa. Not uncommonly several thousand have been found in one
case (Nicolo, 704 E. Stoerk and Haendel 705). It is remarkable that
these Cestodes have been found so frequently post mortem and
after vermifuges given for other reasons. Thus the clinical symptoms
must often be very indefinite (Stoerk and Haendel), so that one may
assume that only a slight percentage of cases of Hymenolepis nana
come under observation and are published as such. On the other
hand, it is certainly conceivable that with the large number of
parasites that frequently occur in one individual a whole series of
symptoms, in part quite severe, are capable of being produced.
These are partly symptoms of intestinal catarrh, consisting of
abdominal pains, constipation, alternating with attacks of diarrhœa,
perverse appetite, and boulimia, abdominal pains of a cramp-like
nature, followed by emaciation, headache, sleeplessness, pallor,
lassitude, and in part nervous symptoms—epileptiform attacks
without loss of consciousness, weakness of memory, melancholia,
irregular febrile attacks (Lutz 706). Possibly, too, Hymenolepis nana
infects the urinary organs, producing true chyluria
(Predtetschensky 707). Stoerk and Haendel are inclined to think that
this species, unlike other Cestodes parasitic in man and domestic
animals, needs no intermediate host for its development, and that
the larval forms (cysticercoid) live in the same host as the adults.
The diagnosis is based on the demonstration of ova in the stools. As
far as expulsion of this Cestode is concerned, santonin, kamala,
kousso flowers and thymol appear to have no effect of importance;
whilst extract of male fern, recommended by Grassi 708 as a result of
his considerable and successful experience, has been given, with the
result that the worms really are expelled, and that after the
treatment neither worms nor ova are any longer demonstrable in the
stools of patients. In his cases of chyluria Predtetschensky
prescribed ol. terebinth. 20 drops three times daily for a fortnight,
then acid. gallic. 0·5 grm. three times a day for two days, then
1·0 grm. three times a day; the urine became clear, but whether
permanent cure resulted remained doubtful.
Hymenolepis diminuta, H. lanceolata, Davainea asiatica, and D.
madagascarensis possess no actual clinical interest; with regard to
the latter it need only be pointed out that Bordier 709 in studying a
case of chyluria found this species in the kidneys of a person in
Madagascar.

Tænia solium.
Tænia solium inhabits the small intestine of man; single proglottides
or whole worms may get into the abdominal cavity and the bladder
through fistulæ, and penetrating the abdominal wall escape
outwards or become discharged with the urine. Symptoms of
intestinal stenosis are certainly very rare, as in the case recorded by
Steinhaus 710 of a child, aged 9, the stenosis ceasing after the
expulsion of the segments. The usual position of the worm in the
small intestine is with the head closely adherent to the mucosa and
the proglottides lying along the intestine; from time to time portions
are discharged with the fæces per rectum. Its position can also be
reversed, and the proglottides in the gut become thus discharged by
vomiting.
The diagnosis depends upon the proglottides being generally
discharged in pieces in the stools, or eventually an examination for
eggs. Larval infection (Cysticercus cellulosæ) occurs also in man
through auto-infection or through food.
Cysticercus cellulosæ of the skin and subcutaneous tissue occurs
very seldom singly; as a rule they are found in hundreds and
thousands in the same individual. They occur in different parts of the
body, especially on the flexor surfaces of the extremities (generally
symmetrically), small globular swellings, the size of a pea or a hazel
nut, smooth, of a tough cartilaginous consistence, fairly movable
under the skin, in the muscles less so. They never degenerate or
cause the surrounding skin to lose its colour. It is an interesting fact
that in the case described by Posselt 711 nodules on the face, namely
in the neighbourhood of the left cheek and behind the left ear,
reformed. The following are, according to Posselt, characteristic for
cutaneous tumours due to cysticerci: (1) the position in the
subcutaneous connective tissue (and almost always simultaneously
in the muscles); (2) the approximately equal size and regularly
rounded oval form; (3) the peculiar density, almost reminding one of
cartilage in its hardness and the sensation of tightly distended thick-
walled bladders; (4) proportionately slight mobility; (5) with
painlessness, absence of any cutaneous reaction (hyperæmia or
swelling of the skin or pigmentation). The very gradual appearance
generally of the tumours supports the diagnosis, and in addition to
this evidence we may emphasize the preponderating liability of the
upper part of the body to attack and the symmetrical arrangement
of the nodules. Cutaneous and muscular cysticerci cause the most
varied symptoms, sensory disturbances, abnormal sensations,
depression and a feeling of weariness whenever the diseased parts
are moved, weakness in the lower extremities, pains in the course of
the sciatic nerve, in addition to those which simulate cramp in the
calves, numbness in the hands, pains upon their being moved. In
the case of a cysticercus situated in the elbow-joint, painful dragging
sensation in the course of the ulnar nerve persisted. In other cases
the arm was almost paralysed, or it could not be completely
extended; stiffness and bending of the little finger were noticed.
Cysticerci of the gluteal muscle cause trouble upon sitting and upon
defæcation. Remittent unilateral headaches were present in the case
of a cysticercus of the region of the right eyebrow; pains of a
neuralgic character radiated from the diseased temporal region. The
cysts may be inflamed and may suppurate; this especially happens
in the case of solitary cutaneous and muscle cysticerci. The best
treatment consists in puncture of the cysts with a Pravaz syringe and
subsequent injection of a drop of 1 per cent. sublimate solution.
Tincture of iodine has similarly been proposed (Wolff 712).
Frangenheim 713 recommends early extirpation (this, however, only in
the case of solitary cysts). Pelagutti 714 believes that in his case
diminution in the size of the cysts was obtained by the use of
anthelminthic remedies continued over a long period combined with
potassium iodide and calcium salts (internally). Cysticercus is very
rarely found in the tongue; there the worms generally lie in front of
the sulcus terminalis, corresponding to the middle of the tongue,
according to Glas. 715 In the case recorded by Gaetano 716 (a boy,
aged 10) there was a nodule on the left side of the tongue which
grew very rapidly till it reached the size of a nut; it was embedded in
the muscle and covered over by normal mucosa. Cysticerci are just
as rare in the pleuræ, in the lungs, in the intestinal submucosa, in
the submucosa of the small intestine, in the mesenteric glands, in
the liver, pancreas, spleen and kidneys, in the mamma, in the heart,
in the bones and in the great vessels (Huber 717). Cysticercus of the
eye deserves special mention; in rare cases the cysticercus has been
met with in the subcutaneous cellular tissue of the eyelid, once in
the muscle bundles of the musculus orbicularis. Subconjunctival
cysts are found chiefly in youthful individuals. Their position is most
varied, generally in the neighbourhood of the inner angle of the eye.
Dilated vessels pass right over the cysts, which are generally
movable, together with the base they rest upon, producing a
spherical protrusion. The head of the worm can sometimes be seen
shining through as a whitish speck. The only symptoms are those of
a slight irritation of the connective tissue and some difficulty in
closing the lid; larger cysts dislocate the globe. The diagnosis has
the rapid growth of the cystic tumour to support it; there is the
possibility of its being mistaken for a foreign body (Kaldrovils 718).
After division of the connective tissue capsule extraction is easily
performed. It is most rare for the cysticercus to occur in the orbit.
Suppuration of the cyst may have serious consequences for the eye.
It is only exceptionally that the cysticerci gain access to the anterior
chamber of the eye.
Subretinal cysticerci or those localized in the vitreous are more
frequent. Upon examination with the ophthalmoscope there is seen
in the vitreous a bluish bladder with a smooth surface. The head is
seen as a white patch, and the circle of hooks and the suckers also
come into view, also the frequent movements which the head and
neck make in the vitreous. Operation generally yields good results;
in rare instances the globe is atrophied and must be enucleated.
Formerly cysticerci in the brain were met with in fair frequency, but
the number of such cases has generally decreased of late years in a
remarkable way, in correspondence with the diminution of cysticerci,
which is to be attributed to compulsory meat inspection. Whilst, for
example, the post-mortem records of the Pathological Institute in
Berlin before the year 1875 showed 20 per cent. cysticerci affecting
the brain, this number declined later to 16·3 per cent., and of late
years has fallen to 1 per cent. (Orth 719). Nevertheless even now
cysticercus still plays no inconsiderable part in the etiology of
cerebral diseases. For example, in the clinic of de Amicis at Naples,
among seven cases of cysticerci of the skin, they were found four
times also in the brain (Sipari 720). Cysticerci may occur in the dura
mater, arachnoid, pia mater, choroid plexus, the surface of the
cerebral hemisphere, the medullary substance, the ventricles, the
aqueduct, the corpus striatum, corpora quadrigemina, the pineal
gland, the pons, the cerebellum, the olfactory trigone, the bulb, the
medulla oblongata, and the olive. They are most frequently found in
the cortical substance and in the ventricles; the frequency of the
latter situation may be explained by the flow of the fluid
(Henneberg 721). The severity of the symptoms is not always in
proportion to the number of cysticerci. Cases have been known in
which ten, twenty and forty cysticerci have been found (Hagen-
Thorn 722), and yet the clinical symptoms have been remarkably
slight. On the other hand, solitary cysts may both run a course
completely without symptoms and also cause the severest symptoms
when located in specially important parts of the brain (crus, pons,
central convolutions). In the case mentioned by Jacobson 723 the
invasion of the brain by cysticerci was immense; the largest cyst was
found in the cerebral cortex. The chief symptoms of cysticercus of
the brain substance consist in the onset of cortical epilepsy, which
sometimes runs a very pernicious course, frequently with psychical
disturbances, whilst paralyses are absent. Perhaps, too, the
localization of pain, spontaneous and on pressure, corresponding
with the points observed on the cranium, is of importance. Cysticerci
may also change their position in the brain; patients who had earlier
suffered from epileptiform convulsions later showed intra-ocular
cysticerci after the cerebral symptoms had completely disappeared.
Treatment can only be surgical; v. Bergmann 724 operated in two
cases with well-marked improvement. Parasites in the ventricles are
especially dangerous, more especially so when free in the ventricles,
and so capable of giving rise to the danger of sudden closure of the
foramen of Majendie (Simmonds, 725 Versé 726). Stern 727 states the
symptoms of cysticercus in the fourth ventricle to be the following:
general cerebral pressure symptoms (headache, vertigo, vomiting,
somnolence, congested disc caused by internal hydrocephalus); in
addition, there are symptoms which point to disease of the hind-
brain—pain and stiffness in the neck, vertigo and cerebellar ataxy,
violent and persistent vomiting, slowness of pulse; and lastly those
rare but certain symptoms of a lesion of the bulb, such as diabetes,
respiratory disturbances and paralysis of cerebral nerves, especially
of the abducens. These are far less marked than the general
symptoms of cerebral pressure. One characteristic is the remarkable
alternation between severe general symptoms and periods of
complete sense of well-being; in this way a functional nervous
affection may be simulated (Jolasse 728). Brun’s symptom (in the
widest sense, sudden onset of violent cerebral symptoms upon
change of head-posture) is a specially characteristic sign of free
cysticercus in the fourth ventricle; the disease generally terminates
with sudden death from cessation of the heart’s action. Defects in
motor power, convulsions, implication of other nerves, are rare and
unessential complications (Hartmann 729). Carefully carried out,
lumbar puncture may possess some diagnostic and therapeutic
value. Treatment is purely symptomatic, or eventually Neisser’s
ventricle puncture may be considered.
At the base of the brain the cysticerci, as a rule, assume that form
which is designated as C. racemosus, and consists of rows of
delicate grape-like bladders in groups, sometimes also markedly
branched, but generally sterile, which develop in the meshes of the
soft meninges and may envelop the nerves and vessels of the base
of the brain. Such tumours bring about hydrocephalus and chronic
leptomeningitis, which must be regarded as the causes of the clinical
disturbances (cysticercus meningitis), attacks of loss of
consciousness, dementia and apathy, dulness and confusion and
headaches. In the case recorded by Meyer 730 symptoms which
resembled paralysis agitans were noteworthy, and defects in speech
in the case recorded by Durst 731 (C. racemosus in the region of the
left Sylvian fossa). According to Markwald 732 C. racemosus of the
fourth ventricle is said to represent a characteristic clinical picture:
violent headaches, attacks of vertigo followed very soon by deep
coma and death in a few days. Treatment in Cysticercus racemosus
is ineffectual. In the diagnosis of cerebral cysticerci in general the
recognition of multiple cysticerci in the skin and muscle and of the
tapeworm is of importance. In cases of cerebral diseases in which
cysticerci may be a possible cause, Remmert 733 recommends that
the skin of the whole body should be palpated.
Cysticercus in the spinal cord and in the vertebral column is
occasionally observed; as a rule, other organs, above all the brain
and its membranes, are simultaneously affected. Here, too, the
cysticercus occurs in two forms—sometimes the cysts are roundish
or oval, solitary or multiple, and at other times Cysticercus
racemosus occurs.

Tænia saginata.
Occurs in the small intestine of man. It is characteristic of the habit
of life of this parasite that once it has become mature its
proglottides are dropped off daily in increasing numbers because its
growth is extraordinarily rapid. The joints are discharged generally
spontaneously during the whole day without a stool. An
extraordinarily unpleasant sensation is produced by the damp, cool
joints slipping down into one’s lower garments and over one’s legs
when walking; women especially, in whom the proglottides slip
through their petticoats on to their legs, complain bitterly of this
troublesome symptom. Another unpleasant symptom is superadded
in the shape of the proglottides tickling the rectum, and this excites
irritable people to the last degree. Different species of tapeworms
are not mutually exclusive. B. latus and T. solium frequently occur
side by side, so also T. solium and T. saginata—for instance, in a
butcher’s assistant we once expelled twelve T. solium and one T.
saginata at the same time. The greatest number of Tæniæ which
have been observed at one time amounted to forty T. solium
(Kleefeld 734). Even though the cysticercus of T. saginata is not, as in
the case of T. solium, particularly dangerous to man, a parasite,
nevertheless, which requires so much nutrient material during its
rapid growth, and thereby sets up manifold disturbances in the
general condition of health, ought to be expelled as rapidly and
thoroughly as possible.
Tapeworms are found not uncommonly with other intestinal
parasites, such as Ascaris, Oxyuris, Trichocephalus or Ancylostoma.
Prunac 735 described a case in which a woman passed a Tænia
through the anus while she vomited a Fasciola hepatica.
The symptomatology of these three large species of Cestodes,
Dibothriocephalus latus, Tænia solium, and T. saginata, may very
well be summarized together, as, apart from some peculiarities, the
clinical symptoms, especially so far as their localization in the
intestine is concerned, are practically the same for all three species.
In a large number of cases the hosts have no suspicion whatever
that they are harbouring a tapeworm; they feel quite well and free
from any disquieting symptoms whatever, and only become aware of
the fact that they are the carriers of a tapeworm when the discharge
of the segments takes place; on the other hand, it is often difficult to
rid people of the idea that they are harbouring a Tænia
(Küchenmeister calls such Tænia imaginata); usually it is undigested
fibrous shreds of beefsteak which are regarded by the patients as
proglottides of tæniæ.
In a large number of cases, disturbances of the intestinal tract set
in, e.g., sense of pressure in the abdomen, which sometimes
becomes constant on one and the same side, or sometimes changes,
now at the umbilicus and again at the epigastrium; here and there
colicky pains are present. Derangements of appetite and digestion
are frequently complained of; the most frequent are the sensations
of morbid hunger or irregular appetite, nausea and vomiting. Thus,
at the Third Congress of Internal Medicine, Senator recorded a case
in which there were symptoms of nervous dyspepsia, cured after a
successful vermifuge. There is either constipation or diarrhœa, so
that many of such patients are brought for treatment with the
diagnosis of “chronic intestinal catarrh” and correspondingly treated.
As to the treatment of toxic action of the Tæniæ when such arises,
see the special section on the subject (bothriocephalus anæmia,
p. 644). The frequent disturbances of the general condition, so-
called reflex phenomena, so far as the action of toxic substances is
not in question, may be explained by the fact of their occurrence in
specially sensitive individuals who are affected by such phenomena.
The proof that a diseased condition is produced by a tapeworm will
be forthcoming with some degree of certainty if the symptoms cease
immediately after the removal of the parasites. As a whole series of
troubles, which certainly have nothing to do with them, are
erroneously ascribed to the tapeworm, as is frequently assumed,
one will do well to be somewhat critical in this respect.
The treatment is of a threefold nature: prophylactic, symptomatic
and radical.
Under any circumstances, the best prophylaxis is that which consists
in only eating the flesh of those animals in which any of the three
larval forms occur (pig, cattle, salmon, pike, burbot, etc.) so
prepared that the larval forms have been destroyed and the food
thus rendered innocuous. For domestic and public use the rule
prescribed by Küchenmeister is under all circumstances most easily
understood, namely to roast or boil till the flesh appear greyish-
white and sufficiently done by reason of the coagulation of the
albumen and decolorization of the blood. The general prophylaxis
simply concerns the tapeworm carriers trying to limit as far as
possible the further extension of the parasites in the animal world by
carefully rendering the expelled segments and worms harmless
(pouring sulphuric acid over the fæces and burning the worms) and
also by strictly adhering to official regulations. The official system of
meat inspection in this respect has been of immense service, and
much can still be done by means of thorough official control over
cleanliness in abattoirs and butchers’ shops. Galli-Valerio 736 very
rightly desires the abolition of the custom of manuring fruit-plants
such as strawberries, vegetables and salad with the contents of
privies, and would extend the use of privies in the country.
Symptomatic treatment consists, in the case of those Tæniæ which
resist radical attempts at expulsion, of repeated use of drugs
injurious to the worm as soon as ever new proglottides are formed,
or in special cases, as in the case of persons weakened by diseases
or operations, or frail old people, or patients with severe heart
failure, gastric or intestinal carcinoma, or in pregnancy, in effecting
the expulsion of a large chain of proglottides by the mildest
measures possible.
Radical treatment of the Tænia is not always equally easy in all three
species, even when the means used are the same; the easiest to
expel is T. solium, then D. latus, and the most difficult T. saginata.
That as yet no certain cure exists for Cestodes is clear from the large
number of drugs recommended from time to time, and the increase
of bungling treatment in this respect; in addition, there is no
department in which there is so much quackery as in vermifuges.
The treatment proper should always be preceded by thorough
preparatory treatment, the purpose of which is to render the gut as
empty as possible once for all, and on the other hand to put the
worms themselves into a diseased condition. How far the host
himself has been made ill by such preliminary cures (herring, pickle,
garlic, onions, preserved strawberries), many a person who has had
to do with such things can recount. In the opinion of Fischer 737 strict
preparatory treatment appears to favour the development of toxic
substances, or else it disposes to vomiting; as a rule it causes the
patient far more discomfort than the treatment itself. In recent times
far less weight is attached to these preparatory treatments than to
carefully prepared and correctly dosed drugs; the preparation is
generally limited to relieving the intestine in a simple way, the day
before the treatment, of the densest fæcal masses, by a simple
aperient or water enema.
We recommend the following, which has always proved itself to be
the best and simplest remedy against T. saginata. The patient takes
early in the evening before the treatment nothing but a plate of soup
or a glass of milk, and then takes a laxative (electuar. lenit or infus.
sennæ compos. or an enema), so that later in the evening one to
two stools are passed. In this connection we fail to agree with
Grawitz 738 and Boas, 739 who consider that at least preliminary
evacuation of the intestines can be dispensed with. On the following
morning the patient should take a cup of black coffee or tea without
anything else, and half an hour later the vermifuge.
The best drug is extract. filicis maris æther., which also forms the
main constituent of most of the secret remedies recommended for
tapeworms. Earlier mishaps with this preparation had their origin
principally in insufficient dosage. Also, in addition to correct dosage,
extract. filic. maris needs very careful preparation if satisfactory
results are to be attained. If preparations with the trade mark
“Helfenberg” or “Wohnar” are not used, but the male fern extract
has been prepared by a chemist, one must make certain that the
roots of the Aspidium filix-mas have been collected in May or
October, and only green sappy specimens selected, and that the
attached paleæ have been separated, that they have been broken
up small and ether poured over them with a little spirits of wine
while quite fresh. The whole mass is to be kept in a cool place, but
not too closely covered. If at any time a certain quantity is to be
used, it is taken out, the ether carefully distilled in a retort till the
extract has a suitable fluid consistency. Fischer attaches great
importance to the direction in the Pharmacopœia being exactly
followed, to the effect that the extract is to be carefully stirred
before prescribing, as the active substances undergo partial
crystallization if kept for any length of time and sink to the bottom,
so that the preparation has a different strength and toxicity in
different layers. Of this extract 10 to 12 to 15 grm. are to be taken
in gelatine capsules within half an hour. We consider it unjustifiable
to give greater doses than 15 grm. to adults, as many cases are
known in which to some extent severe toxic symptoms have
followed, such as headache, sensation of giddiness, dyspnœa and
cyanosis, yellow vision (xanthopsia), delirium, stupor, the most
severe cramps in the extremities, rapidly fatal trismus and tetanus.
The most serious are defects of vision of various kinds, which may
end in amblyopia and amaurosis, with permanent blindness. A
complete collection of toxicological literature up to the year 1903 is
to be found in Marx’s 740 Dissertation. Since that time further
instances of such intoxications have been made known. Nagel 741
observed them only in severe cases. O. Meyer 742 lays special stress
on the bad prognosis of the disturbances of vision evoked by
poisoning with extract. filicis maris. Studt 743 has seen two cases of
optic neuritis, one with circumscribed, the other with diffuse retinal
œdema. Uhthoff 744 has only seen one case; in that reported by
Noiszewski 745 the toxic retinitis was cured; in Viereck’s 746 case
bilateral concentric limitation of the field of vision followed three
days after taking 8·0 grm. extract. filicis maris. Stuelp 747 attributes
the amaurosis occurring after taking filix mas to a toxic action on the
muscularis of the central retinal artery; there followed paralysis of
the vessel, vascular engorgement, and thereby nutritional defects of
the nervous elements followed. In children one has to diminish the
dose correspondingly, as with them, still more so than with adults,
severe disturbances arise. Huber 748 claims that this drug should not
be given to children indiscriminately. The view is frequently
expressed that a combination of extractum filicis maris with fatty oils
in which the active constituents are soluble favours intoxication.
Marx 749 also argues from this standpoint and assumes that the ideal
preparation, free from objection, would be got if from filix-mas
extract a preparation free from fatty oils could be made, and he
considers it advisable to limit the use of castor oil as an aperient
before and after taking the “cure” and to prescribe instead a saline
laxative, such as Epsom salts or Glauber’s salts. Sonnenschein 750
also advises against the simultaneous exhibition of extractum filicis
maris with oleum ricini, as is the case with Helfenberg’s capsules,
and Boas 751 is likewise anxious that ol. ricini should be avoided.
Lenhartz 752 appears to consider the warning against the
simultaneous combination of the extract with fats or ethereal oils,
and especially against the employment of castor oil as an after-
treatment, as without justification, and we, too, in the course of our
many filix treatments, have never yet witnessed any unfavourable
effect from the use of castor oil in the after-treatment. The surest
way of obviating the toxic effects of extractum filicis is to give a
laxative (ol. ricini) as soon as the extract has left the stomach, say,
about half an hour, so that it need not stay longer than necessary in
the gut and become absorbed. Perhaps in most cases of poisoning,
transgressions against this rule have been the cause of the toxic
action. The nausea that sets in the day after taking the drug and the
inclination to vomit are best resisted by giving iced coffee, iced tea,
iced pills, peppermint tea, cognac, one to two wafer powders of
menthol and sacch. lactis āā 0·2 grm. (Apolant 753) half an hour
before the drug is taken. Fischer 754 considers that lying still in the
horizontal position is the best remedy. Boas 755 recommends the
injection of the drug into the stomachs of patients who tolerate
extractum filicis badly, in the form of a thin emulsion (with gi. arab.).
In the case of children the extract is prescribed with honey as an
electuary. The method recommended by Fowler 756 is without doubt
too detailed; he prescribes before the treatment two to three to four
days’ rest in bed; special diet, tablets of cascara sagrada three times
daily, on the fourth day senna infusion, and then to give the
extractum filicis maris in capsules in four doses, to be taken every
quarter of an hour.
Under Jaquet’s 757 direction, Kraft has prepared an amorphous acid
from the fern root extract which is designated filmaron. As a
vermifuge the drug is prescribed for children of 2 to 5 years of age
in doses up to 0·2 to 0·3 grm., for children of from 8 to 12 years in
doses up to 0·5 to 0·7 grm., and for adults up to 0·7 to 1·0 grm., so
as to expel the parasites. Bodenstein 758 gives the filmaron oil
introduced into commerce by the firm of Boehringer (one part
filmaron and nine parts castor oil) in still greater dosage, either
fasting or, in the case of sensitive patients, one hour after a cup of
tea; he gives peppermint tablets against possible nausea. Brieger 759
tested the preparation in twenty-three cases; in twenty-one of these
he prescribed it as an ether-castor oil mixture, and in two as
capsules. The action always took effect in from two to five hours,
and only in three cases were unpleasant after-effects in the shape of
colic observed; in sixteen cases the result was positive, in seven
negative.
The attempts made by Goldmann 760 to prepare from the bark of
Musenna abyssinica, a plant of the order Myrsinaceæ, indigenous to
Persia, the active substance, namely sebirol, have shown that when
this is given alone it certainly acts as a vermicide, but not as a
vermifuge; on the other hand, the results of a combination of sebirol
with thymol and salicylates were surprisingly good; this mixture has
been introduced into commerce as tæniol, in the shape of pastilles
prepared with chocolate for children. The method of giving tæniol is
as follows: On the day before the administration a light diet and
thorough purging with calomel are ordered; and then on the day of
the treatment itself, after a breakfast consisting of a cup of tea, in
the case of adults, thirteen to fifteen tæniol pastilles are taken in
some red wine at intervals of ten minutes respectively. In the middle
of this treatment an interval of some hours is interposed. After the
pastilles have been taken a calomel purge is again given. The results
obtained by Liermberger 761 are sufficiently encouraging to be put to
further test.
Fischer 762 has tested in some of his cases extracts of some new
species of fern root; he employed the extract from the rhizomes of
Aspidium spinulosum and A. dilatatum, two fern roots indigenous to
Sweden, and obtained remarkable results (doses of 4 grm.).
Laurén 763 had previously recorded similar results, and recently
Friedjung, 764 using extr. aspid. spinulos.
Cortex radicis granati as fresh bark is a very good drug, and is
usually given as a decoction: 180·0 bark to 1,000·0 water, boiled for
forty hours to 240·0, and a small cupful to be given every half an
hour; colic, vomiting and diarrhœa, are, however, easily induced.
The chief constituent of the granate root, pelletierinum, possesses
vermicidal properties, and is much recommended, especially in
France. Sequelæ easily arise (vertigo, hazy vision, malaise, vomiting,
quickened heart’s action, muscular tremors, cramps in the calves),
especially in delicate persons and children, so that one should refrain
from giving it to the latter especially (Drivon 765). Sometimes, judging
by the experience of Sobotta 766 and Boas, 767 the action is
problematical. Where it is desired to employ it in the case of adults,
the following is prescribed: pellet. sulfur. 0·3 to 0·4 grm., acid.
tannic. 0·5 grm., sir. rub. jd. 30·0 grm., to be taken at one time, and
a quarter to half an hour after a purgative (senna infusion). In the
case of children it is better to employ semina cucurbitæ maximæ
instead of extractum filicis maris. Sixty to 100 pumpkin seeds are
pounded up with sugar, which yield a pleasant-tasting electuary, and
which are taken all at once; half an hour afterwards a laxative is
taken (Storch, 768 Pick 769), Jungklauss’s preparation is nothing else
than a pumpkin extract; its action is favourable; it is, however, too
expensive (Ritter 770). Flores kousso up to 15 to 20 grm. in
compressed form or in sugar or honey in the form of electuaries
(children 2·0 to 10·0 grm. according to age) is not to be relied upon;
kussin, prepared from kousso flowers (Bedall, Munich), is not a pure
body; when taken it is divided into four parts up to 1·0 to 2·0 grm.
with elæosaccharum menthæ, at half-hourly intervals; it is said to be
less unpleasant than treatment with flores kousso (Liebreich and
Langgard 771). Kosinum crystallisatum (dose 1·5 to 2·0 grm.) is
prepared by the firm of Merck. Kamala is the least potent of the
tapeworm drugs in use, and is principally to be recommended in the
treatment of children: 1·5 to 3·0 grm. in electuaries. According to
Leichtenstern 772 and White 773 chloroform, even in toxic doses,
cannot do any harm to the tapeworm, nevertheless it has been
recently recommended by Carratú 774; chloroform 6·0, sirup. 60·0,
one teaspoonful to be taken every hour (fasting). Salol is
recommended by Galli-Valerio 775 as an absolutely harmless
tapeworm drug; thymotal (a derivative of thymol) by Pool, 776 3 grm.
to be given up to three to four times on four consecutive days.
The drug well known long ago, cuprum oxyd. nigr., has been
recently brought into fresh notice by Dörr. 777 It is also the chief
constituent of the tapeworm drug introduced into commerce by the
firm of Dehlsen (Itzehoe) (Koch 778). The coconut is absolutely
ineffectual, also naphthalin, croton-chloral, ether, gallanol, strontium
lactate, glycerine and bromide of potash.
Where possible one should endeavour to discover the head or the
heads of the tapeworm in the stools, so as to make certain whether
the treatment has been successful; this search is best carried out by
immediately and carefully pouring water over the total quantity of
evacuations collected in the night stool, without stirring them up, till
only the tapeworm is found lying at the bottom of the vessel.

NEMATODES.
 Strongyloides stercoralis.
The pathological significance of this intestinal parasite is not yet fully
demonstrated. In Seifert’s 779 observation, on what Leichtenstern 780
called the celebrated Würzburg case, the patient had suffered many
times from attacks of blood-stained diarrhœa with tenesmus, as in
Zinn’s 781 case of a three year old boy who had bloody purulent
diarrhœa. Schlüter 782 speaks of a hæmorrhagic enteritis produced
by Strongyloides. In other cases besides diarrhœa (either with or
without blood) there were noted: pains in the body (Schlüter),
tenderness of the abdomen, loss of appetite, gastric troubles of a
general kind, headache, giddiness, fainting attacks, anæmia
(Silvestri, 783 Valdes, 784 and Trappe 785), so that even if in isolated
cases (Fülleborn 786) symptoms are absent, some significance cannot
be denied these parasites as a matter of course (Bruns, 787
Leichtenstern 788). According to Kurlow, 789 in Siberia there is a form
of sporadic bloody diarrhœa which has its origin in the presence of
Strongyloides stercoralis. The parasite does not live only in the
intestinal lumen, but also in the intestinal wall, where it causes
abscesses, fistulæ and effusions of blood.
Diagnosis is easily made by the detection of the actively moving
larvæ in the stools.
Treatment is rather difficult, as it is not always successful in getting
rid of the parasites. Authors differ as to the effectiveness of extr. fil.
maris. Goldmann 790 still considers this preparation as the most
effective; he recommends preliminary treatment with calomel
0·2 grm. and tuber. jalapæ 0·5 grm. a day before the special
treatment, which consists of gelatine capsules of 15·0 grm. extr. fil.
maris (to be taken in the course of four hours); afterwards rectified
oil of turpentine in gelatine capsules. The thymol treatment (vide
Ancylostomiasis, p. 682), thymol alone or in combination with
calomel (Schlüter, 791 Valdes, 792 Soussino, 793 Goldmann 794), has
often caused diminution of the number of larvæ, but also often
remains resultless. Teissier 795 maintains that by degrees he procured
complete cure by the administration of mercury in the form of blue
pill. In our case neither thymol nor calomel, santonin, extr. fil. maris,
decoct, rad. granat., had any result whatever. Davaine 796 believes he
attained decrease and final disappearance of the larvæ by protracted
milk-cure. Santonin, tannalbin and other preparations seem
ineffectual. Tannin enemata (Mildner 797), high injections with starch
enemata (Schlüter 798), may alleviate in persistent diarrhœa.
Travellers who are visiting regions the native home of Strongyloides
must exercise the most extreme care and scrupulous cleanliness,
and these are also necessary in patients already suffering from
Strongyloides, to prevent auto-reinfection (Trappe 799).

Dracunculus medinensis (Dracontiasis).

The guinea worm develops in the dermis of human beings without
any symptoms; only when it is completely grown does it form boil-
like, extremely painful abscesses, in the greater majority of cases in
the legs, in the region of the ankle, and is accompanied by general
disturbance and a feeling of heaviness, dragging and pricking of the
affected part; it occurs more rarely in the arms, certain parts of the
back, the head, neck, scrotum and penis; in a superficial position the
worm can occasionally be felt through the skin. In most cases there
is only one worm and one abscess, but here and there one finds
patients with three, four or even up to eight worms, and very
exceptionally still more, as in the cases described by Poupée-
Desportes 800 (fifty worms) and by Harington 801 (seventeen worms).
Diagnosis offers no difficulty when the worms are presenting or can
be felt under the skin.
The inhabitants of the native home of the guinea worm, as a rule,
quietly wait till it has got so far out that it can be conveniently
grasped; it is then bound round with thread and fastened between
the tips of a split piece of wood and slowly wound out. In ten to
twelve days it can be wound out in this way. Emily 802 makes
injections of a 1 in 1,000 solution of sublimate either in the
neighbourhood of the worm or directly into its body. Mense 803
managed to remove the worm in one sitting by laying a wad of
cotton wool soaked in chloroform on the exposed portion, thus
stupefying it. Our therapeutic observations (Frangenheim 804) favour
the free laying open of the existing abscess and the consequent
complete extraction of the worm.
Prophylaxis depends on care in the use of water in the guinea worm
countries, especially dangerous being permanent waters infested by
Cyclops sp.

Filaria bancrofti.
The parasitism of this filaria leads to the formation of lymphangitis,
elephantiasis, chyluria, orchitis, chylocele, abscesses, lymphatic
varices, perhaps also to chylous ascites and chylous diarrhœa.
Lymphangitis usually attacks the extremities, beginning generally
with a rigor and swelling of the lymphatic vessels with adjoining
lymph glands. The lymphatics become hard, knotty and extremely
painful, the overlying skin red and swollen in longitudinal lines
(Looss), high fever sets in with, to some extent, severe general
disturbance. After some days the attack subsides, the swelling then
partially disappears, but not completely, and often abscesses
develop in consequence of the lymphangitis. Children, as a rule,
suffer from such lymphangitic attacks (Finucane 805).
Diagnosis is not easy, for many other causes frequently produce
lymphangitis.
Treatment consists in rest, raising the affected limb, applications of
vinegar and alum or liquor plumbi, in some cases incisions into the
swollen part under antiseptic precautions.
Elephantiasis (Arabian) is usually situated in the lower extremities, in
men in the scrotum and penis, in women in the labium pudendi,
mons veneris, and the mammæ; more rarely it attacks the upper
extremities or, indeed, the head. The disease develops during
repeated attacks, which occur at irregular intervals of weeks, months
or years, of fever accompanied by symptoms of lymphangitis and
erysipelas (elephantoid fever), and especially as the result of
different accidental occurrences such as chills, bodily exertions,
external irritation. The extremities become shapeless, heavy
cylinders, the scrotum occasionally a colossal tumour, the female
genitalia and the mammæ smaller or larger tumours; the penis often
shares in the general thickening, the inguinal glands form large hard
prominent masses, and enormous deformity is caused. The cause is
more often seen in men than women, rarely in children over 10,
never in younger children.
Treatment of elephantiasis of the extremities consists in raising the
affected part, massage, bandaging, vapour baths; the large
elephantoid tumours of the genitalia and mammæ can only be
treated by operative removal.
Chyluria (hæmato-chyluria), as a rule, begins by a series of attacks
and often ceases for weeks or months, the attacks being
accompanied by fever, pain in the back and lumbar region, about the
kidneys and in the perinæum. The attacks are separated by intervals
of months’ or even years’ duration, a continuous chyluria being quite
rare. The disease may last many years without the constitution being
markedly weakened, but in other cases anæmia and debility ensue
and result in death from marasmus. In chyluria the urine becomes
completely opaque like milk; but sometimes, from the presence of
blood, is of a peach-like redness: the sediment contains clotted
blood, and microscopically one finds fine dust-like fat granules and
red cells and leucocytes, and usually, but not always, filaria larvæ.
Sclerodermia may possibly be caused by Filaria (Bancroft 806).
Treatment, consists in administration of ol. santali, methylene blue
(0·12 grm. dose several times daily), ichthyol (in pills from 0·5 to
1·5 grm. per day), ol. terebinthinæ (0·5 to 1·5 gr. per day), thymol
(Ziemann 807 had no result from either thymol or methylene blue),
together with absolute rest in bed, diminution of all fatty
nourishment and administration of light purgatives.
Orchitis is in acute attacks a relatively frequent symptom in the East;
the chylocele is rarely marked; the fluid usually shows numerous
larvæ; in the case of abscesses they are generally caused directly by
the adult parasites, as they have often been found in them; varices
of the lymphatic vessels are either superficial or deep;
lymphorrhagia arises from rupture of the dilated vessels; chylous
ascites and chylous diarrhœa may also be produced by Filariæ.

Loa loa.
Loa loa, according to modern investigations, is a parasite of the
subcutaneous connective tissue of man, and its appearance in the
conjunctiva somewhat accidental; in earlier times it seems to have
been less common (Ziemann 808). A number of cases are seen in
Europe of patients who have lived in filaria regions, and on return
have been found to have this Nematode in the subconjunctival
tissue. Pick, 809 in the case of a man who had lived in the
Cameroons, found the parasites in active motion under the
connective tissue of the eyeball right over the cornea; extraction was
easy. Ziemann 810 noted three cases of Loa loa in the eye
accompanied by temporary migratory swellings in different parts of
the body. In one case, observed by Wurtz and Cleri 811 (a woman
from the French Congo), Loa loa was the cause of intermittent
elastic swellings in the subcutaneous and subconjunctival tissue
(marked eosinophilia). In the case recorded by Pollack 812 (for thirty
years police commissioner in the Cameroons) the worm under the
connective tissue of the left eye by its snake-like movements caused
an unpleasant itching. With cocaine and adrenalin the worm can be
made visible, and by means of a strabismus hook can be drawn out
of a small wound in the connective tissue. Martens 813 exhibited a
Filaria extracted from the eyelid under local anæsthesia.

Trichuris trichiura.
Whilst many authors consider the whip-worm as a harmless parasite
of the large intestine (Leichtenstern, 814 Eichhorst, 815 Askanazy 816),
the number of severe and even fatal cases of diseases caused by it
(trichocephaliasis) increase so much that the Trichuris trichiura must
be excluded from the group of harmless intestinal parasites. (For
disturbances of the nervous system and of the blood [anæmia] from
trichocephaliasis, see p. 650). Infection in human beings results from
the eggs that have developed outside the body, which probably
reach the digestive tract on the hands soiled with dirt or earth, or
possibly through drinking water. (Moosbrugger 817 and Kahane 818
mention in their cases that the children had an absolute passion for
earth-eating.) Possibly, too, patients reinfect themselves anew, as an
intermediate host is not necessary.
The anterior part of the body of the parasite is usually fixed in the
mucous membrane, and according to Askanazy feeds on the blood
of its host. Moosbrugger, 817 Schulze, 819 Kahane, 818 Vix, 820 Girard 821
and Blanchard 822 all found changes in the mucous membrane of the
gut, showing that the parasites had been in the gut for a
considerable time. Kahane 818 had an opportunity of seeing at the
Pasteur Institute Trichocephali with the anterior part of the body
penetrating not only the mucosa but also deep into the muscularis of
the gut wall. From this mode of attachment to the wall it is easily
understood how Trichocephali, especially when they are numerous in
the gut, cause local irritation and inflammatory conditions consisting
of frequent attacks of diarrhœa, sometimes twenty times a day,
lasting for months, resisting all remedies, and often accompanied by
colicky pains and symptoms of peritonitis. The stools often have
blood mixed with the fluid, very glassy, jelly-like mucus, more or less
abundantly as in the cases of Moesasca, Moosbrugger, 817 Kahane, 818
Girard, 821 Poledne, 823 and Rippe. 824 Nausea and vomiting are rarer
symptoms.
Diagnosis as a rule can only be made by microscopical examination
of the stools; together with the eggs, regular and beautifully formed
Charcot-Leyden crystals occur.
The prognosis is unfavourable in severe infections, in slighter cases,
where only a few worms are present, the danger of important
symptoms is less. Treatment consists in administration per os of
vermicides and in local treatment of the large gut. A remedy which
was once much used was calomel, which is much lauded by Gibson
and given as follows: calomel 0·06 grm., rheum. 0·3 grm., tinct. ferri
sesquichlor. 1·2 c.c., aq. dest. 90·0 grm., six dessert-spoonfuls three
times daily. Rippe appears to have got no result from the use of this
prescription. Thymol, especially in conjunction with local treatment
of the large intestine, had unquestionably some effect in certain
cases, such as those of Girard, Poledne, Hausmann, Kahane and
Schiller. The local treatment of the large bowel is most effectual
when high injections of water and benzine are given. Becker 825
obviously used too much benzine (1 dessert-spoonful to 1 litre of
water), for severe irritation was set up, whilst Peiper 826 used only a
few drops of benzine, 5 drops to 1 litre of water being enough
(Schiller). Instead of benzine enemata, garlic, 1 per cent. thymol
solution, and physiological saline injections have been used, but the
benzine enemata seem to be far and away the most effective. In
Schiller’s case 2,000 worms came away on the first day as the result
of such a combined treatment (thymol internally and benzine
enemata).

Trichinella spiralis.
Trichinosis is, happily, becoming so much rarer that many doctors
get no opportunity, either in their student days or in private practice,
of seeing this severe disease; we ourselves remember having
observed one typical case of a peasant, aged 17, from Metz in Med.-
Rat Merkel’s clinic in Nuremberg in the year 1879. In the description
of the disease we follow Merkel’s 827 observations.
The eating of flesh containing Trichinæ is often followed, if not
invariably so, by gastric disturbances of different kinds, especially by
vomiting and diarrhœa, with colic, great muscular fatigue, œdema of
the eyelids, muscular swellings with hardness and extreme
painfulness, disturbance of ocular movements, of deglutition and of
breathing, hoarseness, aphonia, intestinal hæmorrhage, bleeding of
the nose, ecchymosis of the skin and mucosæ, prurigo, herpes,
miliaria, pustules, boils, severe sweating, œdema of the extremities,
and, finally, desquamation of the skin; more rarely there is
considerable decubitus, bronchial catarrh, hypostatic and catarrhal
pneumonia, with dry and purulent pleurisy, and in severe cases
symptoms of collapse with delirium close the scene. Slight cases last
from three to six weeks, severe ones for several months, and in the
latter convalescence is very slow. It is remarkable that in cases of
trichinosis of long duration, cancer of the breast was observed at the
same time (Klopsch, 828 Langenbeck, 829 Babes 830). Death during
epidemics occurred in 30 per cent. of all cases. The disease begins
generally from one to ten days after eating trichinous flesh, yet there
have been cases noted in which the disease began several weeks
after.
Diagnosis in the presence of several cases, or in epidemics, is not
difficult, but in isolated cases, on the other hand, it is not easy. If
there is a suspicion of trichinosis, from the muscular fatigue and the
œdema of the eyelids, the diagnosis can be made by excision of a
piece of muscle and by finding the Trichinæ in the tissue, taken with
the results of the examination of the previously eaten sausage or
meat. In contradistinction to this circumstantial process, there is the
examination of the blood, which, according to Schleip 831 (Homburg
trichinosis epidemic, August 19 to 26, 1903, 130 cases), is the most
valuable method of diagnosing trichinosis when the Trichinæ have
not yet penetrated the muscles, for a blood examination shows a
large increase in the numbers of the eosinophile cells; Stäubli
detected his seven cases in this way, four of the severe ones
showing a marked hyperleucocytosis, and a combination of Kernig’s
sign with absence of the patellar reflex. On account of the rarity of
these two signs in combination in other infective diseases, they have
a certain diagnostic value. Stäubli 832 also observed in trichinosis the
constant appearance of a remarkably strong positive diazo-reaction
of the urine.
Prophylaxis in trichinosis is fully considered under Trichinella spiralis
(p. 429).
Treatment consists in those cases where it is known that trichinous
flesh has been swallowed in the first place of washing out the
stomach, but still more in a thorough evacuation of the bowels, for
which calomel (0·5 grm.), ol. ricini (a dessert-spoonful till the action
becomes marked), infusion of senna with sulphate of magnesia and
large enemata are employed, and should be repeated at intervals
during the first few weeks. Alcohol (cognac up to 250 c.c. a day) is
recommended by some, also glycerine (150 grm. at a dose) and
large doses of dilute hydrochloric acid. Beside these, a large number
of other remedies are recommended, of which, perhaps, benzine
and thymol, especially in the form of enemata, are worthy of notice.
When the disease is fully developed the treatment should be
symptomatic; a protracted practically continuous luke-warm bath is
especially useful.

Eustrongylus gigas.
Eustrongylus gigas is most frequently found in the pelvis of the
kidney. Infection in the majority of cases leads to pyelitis. The
inflammation extends to the capsule from the pelvis, resulting in a
purulent nephritis. In infections of longer duration, the affected
kidneys become changed into so-called kidney sacs, while the kidney
itself continuously shrinks. Owing to the worm fixing its posterior
end in the ureter, and owing to an inflammatory swelling of the
mucosa of the ureter, the passage of urine becomes very difficult.
The symptoms resemble those caused by a foreign body, e.g.,
kidney pain, suppression of urine, dysuria, discharge of blood and
pus with the urine. But these symptoms are not sufficient for a
diagnosis; this can only be established by finding eggs or the
parasite itself in the urine.
Moscato 833 records a case with chyluria, pain in the region of the
right kidney, and hysterical symptoms. During an hysterical attack a
specimen of Eustrongylus gigas was discharged in the urine, and the
chyluria and nervous affections disappeared. In a case described by
Stuertz 834 of an Australian with chyluria due to Eustrongylus gigas
the chyluria had existed for seven years. In the urine the eggs of
Eustrongylus gigas were found. The cystoscopic examination showed
that turbid urine was discharging from the left ureter. Nephrectomy
was considered.

Ancylostoma duodenale (Ancylostomiasis).

Whilst up to quite modern times it has been generally maintained
that the great majority of worm diseases cause more or less marked
symptoms, the exact investigations of the last few years have made
it plain that the great majority of people with worms are not only
perfectly healthy, but the most careful clinical observations show no
single sign of any ill-effect of the intestinal parasites on the health of
the host (Löbker and Bruns 835). If infection has led to the
development of only a few ancylostomes, then injury to the general
health is, as a rule, scarcely noticeable. In order to produce severe
illness the presence of several hundred worms in the intestine is
necessary, and in general the intensity of illness varies in exact
proportion to the number of worms. Then the duration of the
infection comes into play: the longer the human organism is
submitted to the injurious effect of the parasite, the clearer is the
effect on the host. Besides, the resistance of the individual has to be
considered. Whilst a more robust person can harbour without ill-
effect for a longer time a larger number of ancylostomes, the
symptoms of the disease become more markedly and much sooner
apparent in weakly persons or in those weakened by other diseases.
The first symptom is disturbance of the digestive system; more often
there is a feeling of pain in the epigastrium, more severe upon
pressure, heartburn, nausea, vomiting of mucus or food at different
times of the day (occasionally ancylostome ova have been found in
the vomit). Whether the eggs which reach the frontal sinus with the
vomit can develop into larvæ there is questionable, but the records
of v. Ziemssen 836 and Huppertz, 837 to the effect that in some
instances ancylostomes have been discharged from the frontal sinus,
are of interest. The five cases recorded by the latter had a fatal
termination from œdematous swellings of the face with severe
inflammation of the meninges. The tongue is furred, and extensive
catarrhal stomatitis and ptyalism are recorded. The appetite is
variable, increasing or diminishing, there is loathing of nourishment
or a marked longing for acid food and unripe fruit, whilst ordinary
meals are rejected. At first there is often constipation, later diarrhœa
with abundant mucus, and often blood in the stools; microscopically
eggs and Charcot-Leyden crystals were found.
In the further course of the disease symptoms due to increasing
anæmia predominate; the hæmoglobin of the blood diminishes from
one-fourth to one-fifth of the normal (Baravalle 838), the eosinophile
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