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A N

INAUGURAL DISSERTATION

O H

Worms of the Human Inteftines.

SUBMITTED TO THE EXAMINATION
OF THE

Rev. WILLIAM LINN, p.d. p.t. Prefidentj

AND TO THE

TRUSTEES and FACULTY

O F

QUEEN's COLLEGE, NEW-JERSEY;

FOR THE DEGREE OF

DOCTOR of MEDICINE,

WITH THE RIGHTS AND IMMUNITIES THEREUNTO
APPERTAINING.

By HENRY M. VAN SOLINGEN,

OF NEW- YORK.

MISERIS SUCCURRERE DISCO,
VlRG.

NEW-YORK:

PRINTED BY T. AND J. SWORDS, NO. 2J, WIT-LIAM-STREET,

— I792.—

H4-!il

/L s-s

^ (0//

/79&

TO THE REVEREND

WILLIAM LINN, d. d.

Prefident, p. t. of Queen's College, New-Jerfey;

AND,

Minifter of the Reformed Dutch Church in the City of New-York;

WHO,

From affiduous Attention to the Duties of his facred Profeffion,
and by his eminent Learning and Piety, has contributed to

The Advancement of Religion,

AS WELL AS

The Good and Peace of Mankind:

DISSERTATION

IS INSCRIBED,

With every Mark of Refpecl,
By his obliged,

Humble Servant,

The AUTHOR.

A N

INAUGURAL DISSERTATION

O N

Worms of the Human Inteftines.

INNUMERABLE are the caufes that give rife
to difeafes incident to man : fome of them, whilft
they appear innocent, and portend little danger,
are, at the fame time, both ferious in their nature
and termination. For the truth of this, we need
only advert to the inflance of human worms \ the
consideration of which I propofe to make the
fubjecl: of the following differtation.

Every part of the human body has indeed
been known to be affected with worms ; but it is
only thofe infefting the inteftinal canal that arc
particularly to be confidered here. Their divifion
is generally into three kinds — Afcarides, Lum-
bricus teres^ and T^nia^ or Lumbricus latus.

Of

A DISSERTATION ON WORMS

Of the ASCARIDES,

THE afcarides, Galen has defined, as " be-
ing fmall worms, generated chiefly in the lower
part of the interlines.53 They are of a fmall fize,
and pointed at both extremities. The head, in
moil, is not eafily detected. Their colour is
generally white, but in fome it has been found
changed by the feces. They abound in great
numbers in the colon and rectum, and are frequent-
* ly thrall out with the excrements. Baglivius*
informs us, he knew a young man, who, being
fuddenly attacked with diarrhoea, voided an hun-
dred. They excite an intolerable itching, efpeci-
ally about the verge of the anus, tenefmus, and
other troublefome fymptoms.

The afcarides have a great refemblance with
thofe worms which we frequently fee in cheefe, in
point of colour, figure, and fize. Profefibr Van
Bceverenf believed them to derive their origin
thence ; and Van Sweiten J knew a man, who, as
often as he ate white cheefe, two days after felt a
troublefome itching about the anus, occafioned
by the afcarides.

But

* Epift. ad Andry, p. 698.
f Differtat. Inaug. p. 31.
% Com. in Ap. p. 1359.

OF THE HUMAN INTESTINES. . J

But cheefe worms are found to differ widely
from afcarides. They undergo a change in their
form, which the afcarides do not— They are blunt-
ed at the extremities, and the afcarides are fharp.

Of the LUMBRICI TERES.

THE lumbrici teres, or round and long worms,
with which children are ufually troubled, are (by
Hippocrates called fop*? rpyyvhaq, by Celfus Teres,)
commonly about fix inches long, and fometimes
a foot •, but the male is generally fmaller than the
female. They are of the thicknefs of a goofe-
quill. Their colour is white, and both extremi-
ties terminate in a point.

The number prefent in the bowels at a time is
very various, fometimes only one, two, or three.
But if we may judge from the furprifing number
of eggs which have been feen in them by means
of the microfcope, we will not be aftonifhed at
the amazing number of worms prefent in fome
perfons, which we find related by fome authors.
Clericus mentions the cafe of a boy and girl, who
were killed by taking arfenic, having upwards of
an hundred of the teres lumbrici in their inteftines.

Gabucinus

8 A DISSERTATION ON WORMS

Gabucinus faw one hundred and feventy-feven that
were voided at one turn by a girl •, and, to come
nearer home, a woman in this city, a patient of
mine, pafTed, in four and twenty hours, consider-
ably more than an hundred, and moft of which
were pretty long.

Of the TMNIA.

THE taenia, or lumbricus latus, by fome is
called the Solitary Worm^ becaufe it has been be-
lieved to be always alone. Hippocrates called it
Tumx ; hence its denomination, Tape-worm.

No fpecies of inteftinal worms is more deftruc-
tive to human nature, or more difficult to be to-
tally deftroyed: It fometimes equals in length
the whole inteftinal canal; the breadth of it is
various, both in the fame worm, and in different
worms.

It confifts of a great number of joints, fimply
connected together ; and thefe joints are fo articu-
lated, that the extreme edges of the preceding
come over the fubfequent. The extremity where-
on the head is fet, is fmaller than the other, and

feme

OF. THE HUMAN INTESTINES. 9

fometimes not an eighth part fo broad : the joints
towards the head are confiderably fhorter than to-
wards the tail, arid they feem gradually to grow
longer from the head.

The colour of the taenia is very white, being
moftly turgid with chyle,

Four fpecies are enumerated by Linnaeus. The
firft is diftinguifhed by fmall orifices, or mouths,
placed alternately on the margin of each joint, and
is called Solium Andriiy Lumbricus latus Couleti et
Vermis cucurhitinus Plateri.

The fecond differs in having two openings on
one fide only of a joint, and is called Taenia vul-
garis Andrii^ Taenia primi generis k Clerc,

The third has only one foramen to be difcover-
ed in the fide of a joint, and this fpecies Linnaeus
mentions to have been very rarely found.

The fourth, and laft fpecies, has two little
mouths in the margin of each joint, one oppofite
to the other.

Vast quantities of this -worm are voided by

patients for feveral years together-, it is rarely

B ever

IO A DISSERTATION ON -"WORMS

ever (ten whole. We have lipon record inftances
of many yards having been voided at a time.*
Glaus Borrichius, a. celebrated, phyfician of Co-
penhagen, of U\q laft century, tells us of a patient
of his who paiTed eight hundred feet of this fort

of worm, in feveral pieces, in the fpace of a year.

-

Doctor Tyfon, of London, had a mnilar in-
itance of great quantities of this worm being
voided for feveral years together, in pieces from
two to fix yards in length *, which all put together
would exceed the length of that of Borrichius.

But though the exact length of this worm can-
not be afcertained, yet it is undeniable that it is
prodigiously long, as appears by thofe pieces men-
tioned above. The illuftrious Van Dceveren re-
lates the cafe of a young man, who ejected a bro-
ken piece of the taenia that meafured 40 cubits. f

In the Philofophic'a! Tranfaclions we have a
description of apart of this worm that contained

507 joints •, and, to conclude this part, we mall
inftance one other cafe that the illuftrious Boer-

haave

* Doclor Buxton, a.phyfician of this city, has in his poflef-
fion, a broken part of a tsnia, 24 feet long5 and with its
he?d cemp'ete.

■f A cubit is 18 inches.

OF THE HUMAN INTESTINES. II

haave defcribes, which he fays meafured 300
cubits, and confuted of 21,600 joints.

It is unknown, as yet, whether each joint fe-
parately conftitutes a whole animal. It is won-
derful that each part poiTeiTes the fame power
within itfelf as the whole animal :* it fupports life,
moves, and adheres to the other parts. Some in-
jections, tending to afcertain this truth, k^m to
prove that thofe many joints we fee in each taenia
conftitute only one worm. -f-

Ofthe ORIGIN and NOURISHMENT of
INTESTINAL WORMS.

THE various opinions which have been hand-
ed down of the origin and nourijhment of worms,
are not expedted to be prefented in fo fmall a work
as this. Some ancient authors believed them to
arife from putridity, % and others to have been
coeval with the body. Galen, writing upon this
fubjedfc, fays, " That thofe worms do not arife
from a feed, but from putrid matter." The
celebrated phyfician, De Lrfle, obferved m his

own

* A fimilar in (lance is in the Polypus.
f Doflor Monro's Works.
t Galen.

12 A DISSERTATION ON WORMS

own daughter, a child eleven weeks old, whole
nefts of worms ; and the mother, as yet, had af-
forded no other kind of nourimment but that of
the breaft. Hence he concludes the worms to be
congenial with the body. The eminent phyfician
Van Dceveren, collected many obfervations of
fcetufes that had worms in the interlines whilft yet
in the mother's womb. It is however believed
to be a univerfal law of nature, *< that every ani-
mal is generated from an egg." This appears
efpecially to be the cafe, fince eggs have been dis-
covered in the ovaria of viviparous animals. — 5
From the great variety of opinions delivered to
us concerning the generation of worms, it will
not be wondered at, that the mod learned
men in natural hiftory have found fo much diffi-
culty upon the fubject. In Baglivius we read of
worms {Qtn in the pericardium equalling in length
the whole palm of the hand.

Du Verney tells us of a child, five years oldv
that conftantly complained of a pain about the
root of the nofe •, fhe kept her bed with a flow
fever — convulfions at length feized her, and me
died : after her death a worm was found in the
longitudinal finus of the brain, five thumbs
breadth long, and not unlike an earth worm.

SWAMMERDAM,

OF THE HUMAN INTESTINES. jB

Swammerdam, who was fo fkilful and quicks
lighted, after carefully ccnfidering all things, con-
feftes " it is the moft difficult thing in the world
to explain by what means worms are generated in
living bodies, &c. — I acknowledge," fays he,
" for my part, that I have met with fo few
fatisfactory experiments in this matter, that I have
not yet any thorough knowledge of the fubjecT. :
although I have feen many worms, and worms
of various forms, in the living and moving bodies
of terreftrial as well as aquatic and serial animals,
but I cannot, in this matter, come to any folid
and certain determination.5*

When worms are prefent in the inteftines, they,
no doubt, muft be nourifhed, as they are fupport-
ed and grow ; and this nourifhment is afforded by
our aliment. Some are of opinion that they live
upon the chyle •, and others think they live not
only on the chyle, but on the blood likewife. —
Van Doeveren mentions a taenia, which a friend of
his faw expelled, where a drop of blood was if-
fuing from the orifice, or mouth. We have like-
wife a defcription of a worm* a foot and a half
long, and an inch and a half diameter, which was
voided by the anus ; it was full of blood, and,
for feveral days after its expulfion, the perfon loft,

to

* Med. Eff. and Obf. vol. ii. p. 336.

14 A DISSERTATION ON WORMS

to appearance, fome pounds of blood. The worrr*
was dead, and made up of a number of rings
like the earth-worm.

It appears they draw nourifhment fometimes
from the fubftance of the ftomach and bowels, for
we very frequently difcover them in the cavity of
the abdomen, and a perforation made into the in-
terlines. Heifter opened the corpfe of a boy,
kvm years old, who had been troubled for fome*
time with grievous pains of his abdomen-, and
although he had an excellent appetite, yet he ap-
parently died of emaciation. In the abdomen was
found a quantity of yellow water, which being
abforbed, he difcovered many round and long
worms ; and though the body was opened the day
after its death, he found only one living worm
among the great number prefent. The fmall in-
terlines were perforated with many holes, and con-
tained yet many more worms, but every one dead.*
We have the hiftory of a young woman's cafe
who had furTered under many difeafes, and died
in confequence of worms -, her abdomen was found
abounding with them. In other cafes not the in-
terlines alone were perforated, but the heart and
liver were eroded. — The late Doclor Bond,-f of

Philadelphia,

* Morgag. Let. xxxlv. Art. 36.
+ Med. Obierv. voh i. p. 72.

OF THE HUMAN INTESTINES. Ij

Philadelphia, relates a cafe of a Quaker lady who
had confiderable part of the liver eroded by a
worm.*

Of the CAUSES of WORMS.

INFANTS labour more frequently and griev-
oufly under worms than adults-, hence arife m
them other difeafes : their interlines being replete
with a glutinous matter from the nature of then-
aliment, which affords a nidus for worms. It is
daily to be noticed that children of the poor, far
more often than others, labour under this com-
plaint, on account of the want of proper food.

Many crude indigestible vegetables, immature
fruits, legumina, fweets, cheefe and frefh fifh,
tend exceedingly to produce the pituitous matter
which favours their production, particularly In
perfons of debilitated habits.

The feafon of the year favours much the pre-
difpofition to worms. It is mentioned by Van
Swieten,f that it was obferved at Beziers, in the

year

* I am informed the celebrated Doctor Monro (hews pre-
parations of inteftines which were actually eroded by worms.
f Com. in aph. 1362.

1 6 A DISSERTATION ON WORMS

year 1730, to have feized many in the manner of
an epidemic, Although worms were frequent at
other feafons among the inhabitants, yet, in that
year, perfons of both fexes, of all ages and confti-
tutions, were afflicted with them, and that to fuch
a degree as to prove mortal to fome. Remedies
were administered in vain, if not given very ftrong
and powerful, that the worms might be forced
out, either upwards or downwards — many of
which came alive from the body.

The SYMPTOMS of WORMS.

IT is not furpriflng that worms produce {0
many evils, if we only confider the great fenfibility
of the interlines, which exceeds that of almoft
every other part •, and the fympathy, which fubfifts
between them and every other part of the body :
Then, if we confider the ufes they are deftined to
in the animal ceconomy, with the affections that
are attendant on worms, as fordes, gnawing pains,
fpafms, flatus, tormina, &c. it will fufnciently
appear that this difeafe is at times exceedingly
diftr effing.

The numerous fymptoms which are attendant
on worms in the bowels, affect much more fenfi-

bly

OF THE HUMAN INTESTINES. IJ

bly infants than adults, which is plainly enough
understood by perfons who are acquainted with
the animal ceconomy. Thefe are as follow: —
The abdomen becomes hard and diftended with
air, rumbling noife takes place frequently in it,
fetid breath, naufea and vomiting -, the appetite
is at times impaired, then again it is ravinous and
infatiable \ heart-burn, hiccup, and tranfient pains
of the belly, which are fevere and lancinating
v/hen the ftomach is empty : a Deflation or remiflion
of thefe pains after taking of food, great thirft and
palenefs of the countenance. The adnata of the
eyes is tinged with a leaden colour- — the inferior
palpebral become tumid, are circumfcribed with
a bluim ring, and the pupils are dilated j* an itch-
ing of the nofe — the upper eye-lid becomes enlarg-
ed, as if inflated — frequent ftarting in fleep, and
grinding of the teeth — febrile fymptoms occur
throughout the day, with pain of the head, and
fometimes delirium — an involuntary difcharge of
faliva, particularly during fleep.

Doctor Friend enumerates, among the moft
frequent fymptoms of worms, a dry cough, which
is excefTively troublefome.

C The

* It may be doubted whether the dilatation of the pupils
may be confidered as a fymptom of worms, as the fymptoms
of hydrocephalus are very fimilar to thofe of worms, and are
often confounded.

I 8 A DISSERTATION ON WORMS

The belly is moftly bound — The urine is
frothy and of a whitilh appearance.

Many other worfe fymptoms arife from thek
prefence, as eroding and perforating the inteftines3
as mentioned already : nor are examples wanting
to mew that worms give rife to various convulfive
and nervous affections.

The fymptoms of afcarides, though not very
dangerous, yet, if their number become great,
and happen to perfons of fenfible, delicate habits,
they produce much uneamiefs in the body. They
induce an intolerable itching in the inteftinum rec-
tum, and this itching may increafe fo much that,
by the confent of the different parts, it may be
propagated, and excite fpafmodic affections in the
neighbouring parts, as difficulty of voiding urine.
ftrangury, hemorrhoidal flux, &c.

DIAGNOSTIC SIGNS of WORMS,

THE many dangerous fymptoms induced by
the prefence of worms in the body, render it very
necefTary that a phyncian mould understand tht
fymptoms indicating the real nature of the difeafe,

leafl

OF THE HUMAN INTESTINES. 1 9

leaft he prefcribe remedies proper for worms, when
the complaint requires very different medicines.

In infants worms are mamfeftly more eafily de-
tected than in adults.

Each fpecies of worm are faid to have peculiar
iigns and fymptoms diftinguifhing their prefence :
Thus pains, gripings, heart-burn, and trouble-
fome . fpafmodic fymptoms, more frequently indi-
cate the teres lumbrici than any other. The
taenia, it is faid, is accompanied with a much
more depraved appetite, emaciation and iyncope,
with an enlarged abdomen, &c. though this latter
often happens when the teres alone are prefent.
The proper iigns of the afcarides are a vehement
itching of the anus, tenefmus, and frequent incli-
nation to ftool. Notwithstanding, all thefe fymp-
toms may occur, yet no worms may be prefent ,
but, when worms are difcharged from the bowels,
it is prefumable that the fymptoms proceed from
that fource.

In the Edinburgh Medical Effays, Profeffor
St. Clair* relates a cafe of this nature — A boy,
four years of age, complained of pains of his
ftomach, itching of the nofe, ftartings in deep,

and
* Vol. ii. p. 294.

2o A DISSERTATION ON WORMS

and would wake very much terrified ; and after-
wards, fleeping or waking, he kept continually
rubbing his nofe— convulfions fucceeded, and he
died the fixth day — -having tried many remedies
indicated in fuch a cafe. The body was opened,
and the ftomach and inteftines difTeeted through-
out their whole length — no worms appeared^
but about two ounces of a vifcid fubftance, like
gelly, was found fituated at the beginning of the
inteftinum jejunum.

The Illuftrious Morgagni* mentions another
cafe of the falacy of fymptoms— A boy, feventeen
months old, was fuddenly feized with a diarrhoea,
attended with cough and itching of the nofe:
in a few days he died. Upon infpecling the body,
there were no worms found in the interlines.

Doctor Armftrong-f" relates a cafe of a boy
u who lay very ftupid, pulfe low and quick, tongue
foul, and breath fetid, he had no found fleep,
but flumbered with his eyes half fhut ; he grind^
ed his teeth, had inward fits, and was fometimes,
threatened with convulfions- — after a few days he
died. The body was opened, and the ftomach
and the whole inteftinal canal examined, but not
the leaft appearance of worms."

* Epifc. xxxi. art. 5. de caufis et fed. rnorb.
T Difeafes of Children.

*

OF THE HUMAN INTESTINES. 21

The CAUSE of the SYMPTOMS.

ALMOST all the fymptoms of worms may be
explained from the wafte of the chyle, a certain
matter furnimed by the worms, and from irrita-
tion of the interlines.

By the worms confuming the chyle, may be
explained the hunger, paienefs, emaciation, debi-
lity, and bound belly, with the belching of wind,
and rumbling noife of the bowels.

From the matter furnimed by the worms, we
may underftand the caufes of diarrhoea and fetid
breath.

By irritating the inteftines, they caufe naufea,
vomiting, fyncope, itching of the nofe, and va-
rious convuliive affections, as epilepfy, convul-
sions, &c.

The METHOD of CURE.

FROM the nature and fituation of worms, the
following indications feem aptly to arife.

I. To

22 A DISSERTATION ON WORMS

1, To deftroy the neft of worms, diflodge them
of their lurking-places, and kill, or induce
fuch a ftate of the ftomach and inteftines, as
is incompatible with their existence.

II. Being diflodged or killed, they are to he
expelled from the body.

The firit. indication very often fuffices alone, as
worms being removed from their Situations, and
weakened, are often expelled with the fceces, by
the periftaltic motion of the inteftines -, but as this
is not univerfally the cafe, it becomes neceffary to
form another indication for their expulfion.

THWemedies recommended for the firft inten-
tion may be divided into fuch as act,

i. By their poifonous quality -,

2, By their mechanical power ; and,

3, By the conjoined action of each of thofe.

Those which act by their poifonous quality are
cabbage-tree bark, Indian pink, male fern, worm-
feed, and common fait.

Cabbage-tree bark.] It has a mucilaginous
fweetifn tafte, and a difagreeable fmelU it is given
in form of powder, decoction, and extract. It

produces

OF THE HUMAN INTESTINES. 2j

produces fome ficknefs and purging, fometimes
violent effects, as vomiting, delirium, and fever •,
which are fuppofed to arife from an over dofe,
and are faid to be relieved by taken warm water,
carter-oil, or a vegetable acid. In the Well-
Indies, where its ufe is better underrtood, they
ufe it by way of infufion, and begin with fmall
dofes, and when cautioufly and properly adminis-
tered, it affords an excellent anthelmintic, e Speci-
ally for the expulsion of the lumbrici.

Indian pink.'] This plant is made very fre-
quent ufe of in this country, and it proves a pretty
certain vermifuge. It is commonly adminirtered
in infufion j and its purgative effect, aflirted by
fome fuitable medicine.

From the experiments of Doctor Francis
Home, it appears, that it produced the expulfion
of worms, when they had evaded other remedies.
He fays he found it necenary to continue the me-
dicine eight or ten days, and, during the ufe of
it, he never difcovered any giddinefs, blindnefs,
convulfions, or other dangerous fymptoms enu-
merated by authors, to arife from the ufe of it.
—-He gave to a boy, eight years old, ten grains
twice a day, and to an adult, an half a drachm
four times a day.

Male fern.']

24 A DISSERTATION ON WORMS

Male fern. 1 This remedy is the celebrated
fpecific of Madam Noufer, of Switzerland, for
the cure of the taenia — Having attracted the no-
tice of the practitioners of France, her fecret,
after being tried at Paris under the direction of
fome eminent phyficians, was purchafed by tltiQ
French King, and publiihed by his order. The
virtues of this plant were well known to the an-
cients, as early as the days of Diofcorides ; but
it is laid to have been entirely neglected. Galen
mentions the fuccefsful uie of it, -and orders it to
be drank with mead.

In the Academy of Sciences of Paris, in the
year 1701, Marchand made many experiments
upon its ufe, and declares it to be a certain remedy
in expelling all kind of worms.

Doctor. Duncan, in his Medical Cafes, has
exhibited a cafe of taenia, wherein the powder of
the male-fern proved fuccefsful. He adds, " If
the prefent practice lhall confirm the opinion of
the ancients, the restoration of this article, to the
lift of the materia medica, may be confidered as a
circumstance of importance in the practice of me-
dicine." He fays alfo, he has every reafon for
prefuming that the expulilon of the taenia was, in
a great meafure, ov/ing to the influence which the

fern

OF THE HUMAN INTESTINES. 2$

fern powder exerted, as a degree of ficknefs at
the ftomach arofe before any other medicine was
exhibited.

The root of the male fern, in powder, is di-
rected to be taken in water, to two or three drams
in the morning, no fupper having been ate the
preceding night — It generally fickens a little — A
brifk cathartic is given a few hours after, confirm-
ing of calomel, fcammony, and gamboge. This
frequently brings off the taenia entire ; if not, the
medicine is repeated at due intervals.

The French phyflcians recommend fome pre-
cautions, which they affirm are elTential to the
fuccefs of the remedy, as giving fome panada and
an injection, which they prefcribe the night be-
fore, to lubricate the inteftines, and prepare the
prims viae.

^Form-feed.] This feed has an unpleafant fmell,
and a very bitter tarte ; and, on account of thefe
qualities, the form of powder and decoction is
rendered inconvenient — It is celebrated as a
vermifuge, and is readily taken mixed with
molarTes.

In the Medical Commentaries, vol. viii. page

213, the fuccefsful effects of the anthelmia ber-

D mudenfis,

26 A DISSERTATION ON WORMS

mudenfis, or common worm-grafs, is mentioned
as an anthelmintic, while, at the fame time, it is
perfectly inoffenfive. It is fuppofed to be the fame
plant from which the femen fantonicum, or worm-
feed, is taken: It may be given in infufion;
but the author found the following a pretty certain
vermifuge — R. Ayth&fm: Occident alis (common
worm-grafs) unciam unam, CanelL Alb. fcrupulos
duos, puh. jalap, fcrupulum unum, vitriol, cceral
grana decern M. From ten grains to two fcruples
may be given once or twice a day, according to
the age of the perfon.

Common fall .] From the experiments related
in the Medical Commentaries, vol. viii. page 342,
and thofe of the ingenious Doctor Rufh, of Phi-
ladelphia, of the fudden and powerful influence
of this fait in killing worms out of the body, I
have been led to mention it here. In the experi-
ments alluded to, a watery folution of this fait be-
ing applied to earth-worms ftrongly convulfed
them in one or two minutes, in three they became
motionlefs, and in four minutes they died.

Doctor Rufh fays, he " adminiftered many
pounds of common fait, coloured with cochineal,
in dofes of half a drachm, upon an empty ftomach
in the morning, with great fuccefs in deflroying

We

OF THE HUMAN INTESTINES. 2'/

We might go on to enumerate many more ar-
ticles which act by their deleterious quality, but
the limits of this dirTertation will not permit.
Thofe of the moft approved efficacy have been
felected, and briefly treated.

2. The mechanical medicines act directly and
indirectly upon worms.

Those of the hrft kind are cowhage, filings
of fleel, and powder of tin.

?.] The efficacy of this plant is now
indiiputable, and the dangerous confequences ap-
prehended formerly from its contact with the
coats of the ftomach and inteftines, are now hap-
pily removed.

The parts of this plant which are made ufe of,
are the fpiculs or hairy fubflance growing on the
outfide of the pod. Thefe are given mixed with
rnolarTes or common fyrup. The fpiculas of one
pod are faid to be a fufficient quantity for an adult.

A Practitioner* who reiided in the Weft-
Indies, previous to the late war, made feveral ex-
periments to determine whether the innocency of
the remedy, when taken into the ftomach, was to
be attributed to the mode of its exhibition, or to

the
* Doftor Samuel KifTam's Inaug. Eflay,

28 A DISSERTATION ON WORMS

the mucus with which the ftomach is lined ; judges
ing its activity might be blunted by the fyrup of
the one, and mucus of the other, which, however,
proved not to be the cafe. He applied to the back
of one of his hands a fmall portion of the dry fpi-
culse, and to the other a like quantity mixed with
fyrup, without being able to perceive any difference
in their effects, in point of duration or feverity :
Hence he concludes the ftimulating properties of
cowhage are conveyed into the ftomach with it.

In the next experiment he blended a fmalj
quantity of the fpicujse with fome faliva, and put
it to the back of his hand ; at the fame time he
took fome dry cowhage into his mouth, and ob-
ferved that what he had applied to his hand quick-
ly produced conhderable uneafinefs, while that
which was taken into the mouth had no feniible
effect.

Finding its ftimulating effects to be fo gentle
and inoffenfive upon the parts lining the mouth
and inteftines, and not knowing any other quality
to which its properties as an anthelmintic could be
attributed, more particularly as he had adminifter-
td it in tincture and decoction, without any evi-
dent advantage, he made the following experi-
ment, which removed the objections: —

To

OF THE HUMAN INTESTINES. 29

To a number of earth-worms, when quiet
and undifturbed, he applied Tome cowhage, and
as foon as it came in contact with them, they
manifefted figns of uneafinefs, by their violent
agitation 5 and the fame thing was noticed when
applied to them united with molafles or iyrup,
and it eventually proved their death.

Filings offteeW] This preparation is exhibited
againft. the lumbrici and taenia. Some phyficians
have adrniniftered it to the quantity of a drachm
in. a day, which was repeated for fever al fucceiTive
days.

Powder of tin.] This has been fuppofed to
act. as a poifon to the worms, from the ar'fenic
that is combined with it in its pureft ftate \ but
from tliQ length of time a worm can live in a folu-
tion of white arfenic, it is more likely that the tin
ads entirely by its mechanical property upon
the worms.

Professor Alfton publifhed in the Medical
EfTays, vol. v. page 90, an empirical remedy of
tin againft worms, from which he experienced great
fuccefs. The method he prefcribes for ufing
it was as follows : — For an adult perfon, to have
£wo ounces of the pureft powder of tin mixed

with

5'0 A DISSERTATION ON WORMS

with eight ounces of common fyrup or molaues^
and previoufly to its exhibition, to have the bowels
well emptied by an infufion of fenna and manna,
&c. The day following, fuppofe Monday, he
directs one half of this mixture to be taking early
in the morning, upon a farting ftomach. On
Tuefday, at the fame time, he orders a fourth
part of it ; and, on Wednefday, the remainder,
in like manner as the former -, and laftly, on
Thurfday he again directs the patient to be purg-
ed by the above purgative medicine, to evacuate
the worms in the body.

The celebrated Doctor Mead* found the file-
ings of tin a moft efficacious remedy againft the
taenia, and made ufe of it for a very long time
before he publifned it. He took equal portions
of filings of tin and red coral, reduced to a very
fine powder ; a drachm of which he directs to be
taken, made into a bolus, with conferve of the
tops of wormwood, twice in a day.

The mechanical medicines which act indirectly
upon the worms, are vomits, purges, and thofe
remedies that give tone and vigour to the ftomach
and bowels.

3. The

* R. Mead's Picerepta Med. cap. de Lumbricis.

of the human intestines. 31

3, The remedies which act by their mechanical
and poifonous qualities conjointly, are calomel
and jalap. Thefe are fafe and powerful •, they
often caufe an evacuation of worms when given
with other intentions.

II. The worms being diflodged or killed, they
are to be expelled from the body.

This indication may be fulfilled, by exhibiting
in constitutions that are pretty ftrong, all thofe
purgative medicines accounted draftic, as gam-
boge, fcammony, infufion of fenna and falts, &c,
&c. &c. But in children powdered rhubarb alone,
or united with mercurius dulcis, is an effectual
purgative, and anfwers extremely well.

From the fituation of the afcarides in the in-
teftines, medicines taken by the mouth very rare-
ly preferve their efficacy until they arrive at the
inteftinum rectum, as thefe v/orms are princi-
pally feated in it; hence they are more im-
mediately and effectually killed and expelled by
clyflers of an oily, acrid, or fweet nature, and by
acrid fuppofitories, with remedies of a like na-
ture -, but what many think more fafe and cer-
tain remedies, are clyftes of lime-water, injections
of fulphurious mineral-waters, and the vapours of
tobacco thrown up.

Clysters

^2 A DISSIXTA7I0X OX WORMS, &C.

Clysters admiuhtrred a^aiiirr. the aicarides
ought to be frequently repeated, as fometimes
thev do dot infeft thie reftum in great numbers;

and in that cafe the few that do, get (bated in the

folds of the rectum.

I:; the London Medical Transactions we have
an account of a boy, who, as often as he perceiv-
ed lymptoms of aicarides, immediately took an
half pound of common (alt, difiblved in water ;
in confequence of which he voided them, and af-
terwards recovered.

After having exhibited iome of the foregoing
remedies, and having expelled the worms, it will
be advifeable to give, at proper intervals, iome
gentle cathartic ; and mould the inteftines be much
debilitated, iome ilrengthening medicines ought to
be taken, as bark and red wine; at the fame time,
uf:rr£ exerciie : and indeed nothing feems to be
more delrru drive to worms, or more effectual in
preventing their generation, than eood living.

THE END

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