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^ A

TREATISE

ON

VERMINOUS DISEASES,

PHECEBEn BY THE

NATURAL HISTORY OF INTESTINAL WORMS,

AND THEIR

ORIGIN IN THE HUMAN BODY.

BY VALERIAN LEWIS BRERA,

raOFESSOR of clinical medicine in THJ5 UNIVERSiry OF PAVIA.

ORNAMENTED WITH FIVE PLATES.

TRANSLATED FROM THE ITALIAN, WITH NOTES,
BY MESSRS.

J. BARTOLI, M. D.

COBBESFONSINQ MEMBER OF THE MEDICAL SOCIETr OF EMPLATION
OF PAKIS, ETC. ETC. ETC.

AND CALVET, NEPHEW,

EX-SECBETABT OF THE MEDICAL SOCIETY OF EMULATION, MEMBEH OF THE
SOCIETY OF CLINICAL MEDICINE, ETC. ETC. ETC.

Quedejeunes Medeclns eussent mieux servi leur Art en s'occupant ^
traduire, au lieu de risqvier leur g-loire par des productions irreflcchies et
prematur^es ! J. L. Alibeht, p. 4.

Traduction du Traits des Pertes du sang, par Pasta.

PARIS, 1804.

TRANSLATED FROM THE FRENCH, WITH ADDITIONS,

BY JOHN g! coffin, M. D.

1816.

^ BOSTON :

JfUBL'SHED BY CUMMINGS AND HILLIARD, NO. 1,OORNHILL,
CAMBRTDCE HILLIARD AN© MEXtALF.

i8ir.

DISTRICT or MASSACHUSETTS, to wit.

District Clerld*s Office.

Be it remembered, tlial on the clijhteentli day of October, A. D. 1816,
and in the forty first year of the independence of the United States of Amer-
ica, John G. Coffin, of the said district, has deposited in tliis office
the title of a book, the right whereof he claims as proprietor, in the words
following', namely —

" A Treatise on Verminous Diseases, preceded by the natural history
of intestinal worms, and their orig'in in the hunsan body. By Valerian Lew-
is Brera, Professor of Clinical ^Medichic in the University of Pavia. Or-
namented with five plates. Translated from the Italian, with notes, by
Messrs. J. Bartoli, M. U corresponding member of the Medical Society of
Emulation of Paris, etc. etc. etc. and Calvct, nephew, Ex-secretary of the
Medical Society of Emulation, mcHihcr of the society of Clinical M<;dicine,
etc. etc. etc. Q'.ie de jeunes mcdecins eussent mieux servi leur art en s'oc-
cupant a traduire, au lieu de risqucr leur gloire par des productions irre-
flechies et prematurees ! J. I,. Alibcrt, p. 4. Traduction du Tr.ite des
pertes du sang-, par Pasta. Paris, 1804. Translated from the French, with
additions, by Joav G. Goffiic, M. D. 1816."

In conformity to tlie act of the Congress of the United States, entitled,
" An act for tlje encouragement of learning, by securing the copies of maps,
charts, and books, to t)»e autlmrs and proprietors of such copies, during
the terms therein mentioned ;" and also to an act, entitled, " An act sup-
plementary to an act, entitled, an act for tiie encouragement of learning,
by securing the copies of maps, charts, and books, to the authors and pro-
prietors of such copies, during the terms therein mentioned; and extend-
ing the benefits thereof to the arts of designing, engraving, and etching,
historical and other prints."

TOimW DAVIS jClerk of the district
JOHN \\ . UA Vlb, ^^^ Massachusetts.

MCZ LIBRARY
HARVARD UNIVERSITY
CAMBRIDGE. MA USA

^

TO

M. ANTHELME IIICHERAND,

Professor of Anatomy and Physiology, Ad-
junct Surgeon in Chief of the Hospital Saint
Le^vis, Surgeon Major in the Guard of Paris,
Memher rJ* the Medical Society of Emula-
tion, of that of tile School of Medicine of Pa-
ris, etc.

THE GRATEFUL TRANSLATORS.

TO THE

STUDETSTS OF IVIEDICINE

\ OF

HARVARD UNIVERSITY.

GENTLEMEN,

When you come to he enii'a«'ed in tlie res-
ponsible duty of conducting the sick to
health, or of alleviating their descent to the
grave, it ^ill then appear to you how impor-
tant it is that you should well understand the
profession you embrace.

To know less tlian can he known, wliere
knowledge is power, and where power can
never equal the impulse of benevolence, is
to be unjust both to ourselves and our pa-
tients. When you shall liave obtained this
information and faithfuU}^ applied it, you will
then feel that consolation which alone re-
mains in those cases where the healing art,
with all its improvements, still falls so far be-
low our wishes and eftorts.

To decide the uncertainty where worms
are suspected, and effectually to expel them

VI AMERICAN TRANSLATOR'S

where tliey arc known to exist in the human
body, is not the least embarrassment of the
ph^ sician's occupation.

If you shall be able in all these instances
to surmount this uncertainty, or to cure the
patient, you Avill be more fortunate than your
predecessors.

That this work will materially aid you in
such an attempt, I cannot doubt.

For twenty years I have been seeking
information relative to human worms, but
have never before found, in any single publi-
cation, what is at all suited to satisfy a medi-
cal inquirer whose purpose is to keep pace
with the progression of his art. For though
we have a number of good papers and com-
munications on tliis branch of medicine,
there is no systematic treatise on this subject
in the English language.

In our country, tliis chasm has been sen-
sibly felt and much regretted.

I contemplate the work of Professor Bre-
ra as well calculated to supply this deficien-
cy, and so far as I know, it is the only
one, accessible to us, that has any claim to be
so considered.

If it should not contain all we need, it is

DEDICATION. Yll

because medicine is not yet a perfect science.
I have endeavoured, by some additions, to
render it yet more full and instructive.

Having witnessed and shared the advan-
tages you now enjoy, permit me to congratu-
late you on the improved state of medical
education in I^ew England.

We have multiplied means, and increasing
facilities for the acquisition of every species
of knowledge, necessary to form intelligent
and accomplished physicians and surgeons.
In return for these privileges, in a great meas-
ure peculiar to this period, every individual,
connected with the profession, should be am-
bitious to contribute something for its further
advancement.

Any man of common industry and capac-
ity, can observe facts and record them, and in
due time give them to the public. Or, if the
habit of thus noticing the many phenomena
and events, wliich are constantly presenting
themselves to the attentive physician, and
which without it are too often suffered to es-
cape him, should not increase the number
of our useful publications, it would at least
improve the practice of individuals. That
you may attain eminence in the science you

Vm DEDICATION.

cultivate, and long and successfully apply and
extend its resources, is, Gentlemen, the sin-
cere wish ot*

Your friend and servant,

Tin: AMERICAN TRANSLATOR.

ADVERTISEMENT.

In the five plates of worms, some of the figures are rep-
resented as viewed with the microscope, and their increase
as to the diameter, the surface, and the whole hody, re*
lates to the glasses, that were used. Tlie proportion not-
ed helow has been settled "by 6lroe»e, in conformity to the
calculations of Hoffmann, a celebrated optician of Leipsic.

By the tube A they are magnified ;

In diameter. In superficies. In the entire body.

No. 6. — 16 times . 25 times . . . 4,096 times.

5 31 ... 961 29,791

4. — 52 . . 2,734 .... 140,608

3 78 . . 6.084 .... 487,552

2 154 . 25,716 .... 3,632,254

1. — 189 . . 35,721 .... 6,731,269
0. — 300 . . 90,000 . . . 27,000,000

[This work has already appea»ed in the Italian, Ger-
man, and French languages. The following recommenda-
tion of it is from the Medical Professors of Harvard Uni-
versity.

« This book appears to us highly valuable on account
of the numerous facts it contains, and as comprising the
information which is scattered throngli many volimiinous
works. The subject which it embraces is such as to enti-
tle it to the attention of every medical practitioner. It
seems to us to fill a space, whicli is not occupied by any
single work in the English language.
2

X ADVERTISEMENT.

« The accurate plates annexed to it must be considered
as adding greatly to its value.

Aaron Dexter.
James Jackson.
John C. Warren.
John Gorham."

TJie Notes of the French Translators are marked
F. Trs. The additions to this edition of Brcra will be in-
cluded between [ ] brackets, and the Notes of the Ameri-
can Translatoi* will be marked d, T.]

PREFACE

OF THE FRENCH TRANSLATORS.

Perhaps on no subject has there been so much writ-
ten as on the diseases arising from worms. Block, in his
treatise, which is one of the best, merely describes as a
naturalist, the worms of the human body, and he has mul-
tiplied their species without end.

Jltulnj is lost in a labyrinth of hypotheses ; and others
seem to have written merely to proclaim their success, and
to make known their specifics. The celebrated Brera,
professor of clinical medicine in the University of Pavia,
known by several excellent medical publications, which
have placed him among the first physicians who have
done honour to Europe, has recently analyzed the diseas-
es from worms in a work entitled, Lezioni medico practiche
sopra i principali vermi del corpo mnano vivente, e Lecosi delle
malattie verminose. Having no good distinct treatise in
our language on verviinous diseases, we have thought our-
selves usefidly employed in translating his work into
French. This treatise, to which tlie author gives the mod-
est title of Lectures, claims the attention of physicians and
naturalists. Tlic first part contains the natural history of
worms ; in the second, the autlior treats of their origin in
the human system ; in the third, he speaks of verminous
affections, both local and syni| athotic. Lastly, the fourth
Lecture is devoted to tlie dificrcnt methods of cure.

This, in a few words, is tlie plan of the author. Fur-
ther, Professor Brera gives us, in his preface, an account
of the method he has adopted ; little then is left for us lo

Hit PREFACE OF THE FRENCH TRANSLATORS.

add ; we hope however to be indulged in saying a ferw
words in order to justify an undertaking, which is perhaps
beyond our ability.

In translating from tlie Italian, we find it difficult to
render the text without disfiguring the ideas of our author.
This language, like all others, has peculiar turns, not ea-
sily adapted to the genius of our own.

We have however preferred monotony to elegance of
style, where the former seemed necessary to express clear-
ly the ideas of the writer. We hare added some notes,
which we hope will be pardoned from the interest they
excite.

END OF THE FRENCH TRANSLATOHS TREFACE.

\

THE AUTHOR'S PREFACE.

Called by the government, in the years 1797 and
1798, to the honourable office of professor extraordinary
of practical medicine, in the celebrated University of Pa-
via, I found myself obliged to read and explain, in the
shert space of two scholastic years, all those theoretical
and practical treatises, which furnished the best methods of
treating the various diseases that afflict the human race.

The doctrine of general sthenic f.rA asthenic diseases,
as well as of local morbid affections, was the*i expounded
with all the elucidations which the short period allowed
by the academic regulations would permit. As the prac-
tical school established in the civil hospital of Pavia, pre-
sented me an oppoiiunity of treating and examining, I
wiU not say all, but at least most of the principal diseases,
I am to this day very happy in having been able to lead
in practical medicine, by tlie light of experience, a great
number of pupils, who under my direction, have assiduous-
ly applied themselves to this useful science, and thus to have
contributed to the medical education cf a multitude of
young men, among whom not a few, in relieving suffering
humanity, already exercise, to the satisfaction of the pub-
lic, their useful but difficult profession.

It is not for me to apologize in this work for the med-
ical observations which were made and compiled by my pu-
pils in the clinical Institute confided to my direction.

They are already published, and ornamented with six
beautiful plates, ('»9miotaximi Medico-pracikhe sulle diverse

Xiv THE AUTH0R*9 PREFACE.

mdlatte traitate nelle clinica medica di Pavia negl* anni
1797 e 1798,111 vol. J I refer them entirely to the impartial
judgijient of the public.

Translations of them appeared in several foreign lan-
^^uagcs, and the satisfactory manner in which they have
been noticed, and extracts made from them, both in the
joijrnals of medicine and of literatuj^e, as well as the hon-
orary diplomas w'nich have been awarded to me by sev-
eral illustrious academies, so sDon as the first volume ap-
peared, encourage me to hope tluit the public will favour-
ably receive the result of my other literary occupations.

To reflections analogous to the cases observed, drawn
from the study of the best works of the most esteemed
writers, I was desirous of adding my clinical observations,
tiiat the pupils in surveying them, at the same time they
observed the diseases I described, might perceive the sour-
ces whence I derived the precepts that guided me in the
practice of medicine. A young practitioner, I was also de-
voting myself with ardour and confidence to the examina-
tion of those works, ancient and modern, to which medicine
owes so much of its present reputation, when my duty call-
ed me to initiate others in the healing art.

I think I have thus sufficiently justified the method I hav*
followed in the order of my Lectures, by explaining diffi-
culties as they rose, and by publishing the Jinnotaxioni
medico-pratichef in which my pupils might find a summa-
ry- of the leading precepts which should confirm the argu-
ments of our daily pursuits ; and as, agreeably to the im-
mortal axiom of Hippocrates^ art is long, life short, and
practice difficult, I still approve the method adopted to con-
duct the pupils to a practical acquaintance with the resour-
ces which medicine offi^rs to assist nature in triumpliing
over many diseases that oppress her.

The Treatise on the worms which inhabit the human
body, in conformity to the program of my observations on
practical medicine, should form a part of this work ; but
on reflection I thought it better to publish it separately,

THE author's preface. XT

because the theoretical part of it heing extensive, it did
iiot seem proper to connect it with a series of observations
which so intimately relate to the practice of medicine.

For though I have had occasion to notice diseases aris-
ing from worms, both in the clinical institute and in my
private practice ; yet perceiving no great importance in
bringing together observations thus collected, I judged it
proper not to communicate them to tl\e public, nor to speak
of them in this work.

Many of my pupils however who recollected the Trea-
tise on the principal worms of the living human body, as
well as on some diseases called verminous, which I had
composed for their instruction, and publicly exhibited in
the scholastic year of 1798, have frequently expressed to
me the pleasure they should derive from having it in their
own hands. It is not tlierefore an unbecoming ambition,
nor the desire of useless applause, that prompts me to pub-
lish the four Lectures whicli compose this Treatise, but
merely the obligation of yielding to the solicitations of
those who are to be instructed in so essential a part of
practical medicine, and who have not the means of con-
sulting the prodigious number of books in different lan-
guages, which treat of human worms, and which are not
obtained without much difficulty. I now resolve the more
willingly to publish these Lectures, as the late examina-
tion of the works of the Italian physicians has convinced
me of the deficiency of medico-practical instruction relative
to the principal human worms, and the diseases they ex-
cite, and which should be directed in conformity to princi-
ples which the philosopliical ])hysician knows how to ap-
preciate, because they are solid and incontestable.

Though the reader may approve my efforts, I am far
from flattering myself that I have obtained the end in view.

I have merely the pleasure of being able once more to
make known my zeal fur the good of humanity, and my
desire to contribute as much as possible to tho advance-
ment of the healing art.

Xvi THE author's PKEFAGE.

I have endeavoured to arrange these Lectures with clear-
ness and precision, in order to make myself intelligible,
and to avoid all confusion and uncertainty.

I have laboured to comprise in four Lectures, a num-
ber of very extensive subjects which are comiected with
Inany branches of natural history and medicine.

I have written them for practitioners and not for nat-
uralists ; I have in consequence, but sliglitly announced the
articles pertaining to tiie natural histvjry of worms, and
have uniformly aimed to speak only of those which are im-
mediately related to practical medicine. An exact view
of tlie interHal and external parts, composing the body of
worms ; the knowledge of the systematic characters in or-
der to distinguish the principal worms which inhabit the liv-
ing human body ; some reflccthrtis on tlieir origin, so far as
they relate to medicine ; the history of the morbid phenom-
ena, which at once originate from their birth, as well as
certain diseases which are often the cause of their devel-
opment ; and lastly a careful examination of the reme-
dies proper for their expulsion from tlie body, and suited
to prevent their reproduction ; these are the subjects I
have treated in these Lectures, which offer matter, for the
physician whe reasons, sufficiently vast to enable him to
multiply their number as far as he pleases.

I have not fafled to avail myself of all that the most
celebrated writers, naturalists and physicians, have pub-
lislied on human worms. To render these Lectures more
instructive to my pu|Mls, I have appropriated all the know-
ledge of others, and have printed ii without alteration.
J have tliought proper to subjoin to each Lecture a num-
ber of citations, as it will thence appear from what sources
I have derived the most exact information.

The reader will then he enabled to consult the best pub-
lications on the topics I have treated.

I have annexed to these Lectures five superb plates,
engraved with all possible skill and exactness by one of the

THE author's preface. XvU

tnost excellent artists. In this manner the reader will the
more easily recognise the parts which characterize the
worms h.ere described.

I can guaranty tlic fidelity of the plates ; they exact-
ly resemble the originals, liaving compared them with tiie
samples, still visible in the celebrated collection of the il-
lustrious Goez.e, and which is preserved in the museum of
natural history of the University of Pavia.

Estimating with impartiality the merit of tliosc natur-
alists and physicians who have devoted themselves to the
productions of nature, I have made it a sacred duty to re-
exhibit in my plates, such human worms as they have ex-
amined and described with great fidelity.

The plates in the works of Bonnet, Marx, Fallas, Goeae^
and Werner, are the most valuable and instructive of any
which have yet appeared relative to human worms.

Of these plates, I have selected the most interesting,
and uniting them with the eniiravings of other worms
which I have found described, and which still remain in
the pathological Museum of the University of Pavia, I flat-
ter myself that I have presented in these five plates a rep-
resentation of the principal worms of the living human
body, in conformity to the Lectures, and which will be very
advantageous, particularly to those physicians who do not
possess the interesting works of the naturalists and phy-
sicians already cited.

JEXD OF TIIE AUTIIOk's PUKVACF..

A TREATISE

VERMINOUS DISEASESe

LECTURE FIRST.

AN EXAMINATION OF THE PRINCIPAL HUMAN WORMS,

§1 I. The subject we propose to examiue is
doubtless very extensive, if we would form an ex-
act idea of all the worms which are occasionally
found in the living human body.(l) If we admit all
that has been said by a number of distinguished
and faithful observers, worms of various sizes are
met with in almost every part of the human body^
even the most hidden,(i ) and which physicians have
described in a manner too satisfactory not to secure
attention.

If we reflect however that most of these worms
do not preserve at all times the same form, that
they do not always occupy the same parts of th©
body, and that we are not acquainted with any pe-
culiar phenomena arising from their presence in
any particular organ, their history seems rather
interesting to the curiosity of the naturalist, than
important to the physician, whose chief attention is
devoted to what may be immediately useful to suf-
fering humanity.(8)

1 See the Notes at the eud of this Lecture..

PJd OF THE PRINCIPAL WORMS

I omit therefore what would be a useless exam-*
ination of those worms which may be called anom-
alous, and proceed to the description of those which
are constantly found in the human body, and which
are sometimes the cause, and sometimes the effect
of severe and long continued diseases.

An acquaintance with the history of those w^orms
which I call principal, is the more important^ be-
cause experience has clearly proved that each ge-
nus of these worms, requires for its expulsion, some
peculiar modifications of the general treatment.

§ II. Till the time of Linnaeus, physicians knew
only three sorts of intestinal worms. (4) Naturalists
since the new discoveries have increased their
genera.

Latterly, several well informed writers have
multiplied the number of human worms, but have
classed them obscurely.(5)

If, admitting the conclusion of the most accu-
rate observations of the best naturalists, consulting
the classifications they have given of worms in gen-
eral, and in particular, I compare them with the
models preserved in our museums, and with those
I have found in the examination of dead bodies, or
have seen expelled alive by my patients, I think I
have sufficient motives for presenting to physicians
the principal worms of the human body reduced to
a single class.

For, besides their presenting a multitude of ob-
jects worthy of contemplation, such as their singu-
lar origin, and their prodigious multiplication, they

OF THE HUMAN BODY. £1

iiioreover authorize the method I have adopted to
separate them from other worms, and to form them
into one particular class which comprehends ;

1. Taenia,

2. Vermis Vesicularis.

3. Tricocephalus.

4. The tlscaris Vermicularis,

5. TJie Lumbrico'ides,

§> III. Our worms, like other animals, have
red hlood, which, according to the observations of
Midlerj{^>) circulates in an artery, and a whitish se-
rum flowing in a vein. Their external texture is
admirably organized. (7) The construction of the in-
terior organs is surprising to human imagination. (8)
It is proper to remark in this place, that we
should not trust to an examination of these worms
when dead, stiflT from cold, and hardened by the
spirit of wine, or injured by hot water, if we would
ascertain the singularity of their internal or exter-
nal structure : under these circumstances the parts
of the worm are changed, irregularly contracted,
and of a size larger than natural. Immersed in te-
pid water, they are better preserved, altered less,
and are more conveniently submitted to observa-
tion.

FIRST GENUS.

TAENIA.(9)

^ IV. This is a very long worm which seem«^
to be formed by a chain of flat articulations, unit-
ed together by means of a l^order or edi:;e, varyinii;

63 OF THE PRINCIPAL WORMS

in breadth and thickness. The joints of the taenia
when united, present at first sight, remarkable pe-
culiarities both as to their width, bigness and tenui-
ty, and also in regard to the perforated papillae on the
lateral border of some of them, as well as the lon-
gitudinal lines which traverse the centre of their
bodi{'s.( 10) I am however confident that all these
pretended peculiarities do not always exist in the
same species, but that they are mere signs of the
age of the worm, and of the richness and abun-
dance or poorness of the nourishment which it re-
ceives at the expense of the animal machine.

^ V. The length of the taenia is sometimes
so considerable as to appear incredible. In mam-
miferous animals it is ordinarily from nine to twelve
Paris fbet (four metres*), and in man from twenty-
five to thirty (from eight to ten metres.) Mosen-
stein{ii) once saw a taenia voided, which surpassed
in length one hundred and twenty eight metres.

Vu7i-Doeveren[i2) relates the history of a
peasant, who, after taking an emetic, evacuated
sixty metres of taenia, and who probably would
have voided more if he had not broken the worm
from an apprehension that he was discharging all
his intestines.

If i?aZfZi?i^ei' does not exaggerate in his work, ( IS)
he speaks of a taenia which was more than two
hundred metres long.

* The metre of France is equal to 39,3702 inches, or threSf
feet and nearly athird of a foot, of American long measure. Ji.T.

OF THE HUMAN BODY. 23

In the cabinet of the University, one is pre-
served exceeding the length of seventy metres.

§ YI. This worm is divided into head, neck,
body and tail.

The head is sometimes so small, that It cannot
be distinguished without the microscope. It re-
sembles a small tubercle,(14) which rises on the
anterior extremity of its body, called neck.(iri)

It is furnished with four apertures,(l6) which are
eminences in some worms and depressions in olh-
crs. From each of these four openings proceeds a
canal for nourishment, which extends to all the ar-
ticulations.

Block has remarked that the head of some tae-
niae is armed with a sort of tube, which it can elon-
gate or retract.( 17) If we examine very careful-
ly the head of the taenia of man and of animals,
we shall see in some of them very small hooks ;(t8)
if these are viewed with the microscope, they are
seen to be arranged in form of a double crown ;(19)
while others inspected with the same instrument are
found to be quite destitute of this peculiarity, and
appear on the contrary to be furnished with a mouth
and a number of filaments all around the neck. ( 0)
The neck is formed by the assemblage of small
articulations which become broader, longer and
larger as they approach the body of the worm.
It may be said that in this way, tlie joints of the
taenia diminish in size as they recede from the cen-
tre to either extremity of the animal. (21) I regard
this fact as very important information, since the

24 OF THE PRINCIPAL WORMS

neck of a very long taenia, compared with its body
does not seem to pertain to the same animal ,(^3)
in tliis manner several naturalists have been deceiv-
ed, and subdivided the same worm into, two par-
ticular species. The body of the taenia is form-
ed by entire articulations, which we call perrect,(23)
iu which the papillae are clearly visible and open at
their summit, whether they are symmetrical, (34)
or irregularly situated in the lateral edges of
the taenia. (35) Finally the tail terminates by a
piece quite truncated, or cut off and raised on its
sides in. form of two hooks, rounded at their sum-
mit. Both the hooks or crotchets have the same
small holes or apertures, which are observed in
the papillae we have mentioned.

The border or edge of each, which connects th»
articulations, is slightly concave towards the tail,
and a little convex tov/ard the head.

In this manner the diameter of the body of the
taenia gradually lessens as it approximates either
extremity of the worm.

§, VII. The bigness and external form of the
taenia of the same species also vary. A patient in
the Clinical Institute of Pavia, voided in several
pieces, in the winter of 1797? the taenia represent-
ed, PI. I. fig. 1, 3.

In these pieces we discovered the head, with
the fangs or hooks above named, as well as the
posterior extremity of its body, which we have con-
sidered as the tail.

These pieces taken together were from fifteen
to sixteen metres in length.

OF THE HUMAN BODY. 25

The same patient, in the following summer,
discharged a taenia represented also in PI. 1. fig.
3. In this collection of pieces, we also found the
head armed with fangs, as well as the tail : its
length was about thirty eight metres. We can-
not suppose tw^o taeniae of different species to have
lived together in the same individual. It is mor&
credible that both were developed at the same time,
that the former was evacuated when young, and
that the second grew larger merely because it was
about four months older. This admitted, we can-
not doubt that if the worm Ijad remained some
months longer in the intestines, it would have be-
come longer and larger, like that represented PL
II. fig. t, and that it would have acquired the
form of the large Taenia cucurhitina seen in the
plates of J.7idry,{27) of Clerici,[Z8) and of VaUis-
7ien,(S9) the joints of which exceed half an inch
in width. If animals, and even vegetables in in-
fancy, at puberty, in adolescence and old age, ex-
hibit great variety in their forms wliich are pecu-
liar to these several periods of their life, how can
it be pretended that taeniae must preserve the same
forms at the moment of their development, and af-
ter the full growth of their body ? The human
taeniae do not generally remain in the intestines
a sufficient time to come to their perfection ; seeing
that before this epoch they are expelled by art or
are accidentally killed and evacuated.

For this reason the large taenia cucurhitina is
rarely obtained, such as Vallisneri{SO) particular-
ly

g6 OF THE PRINCIPAL WOllMS

ly describes, and wliich, from their Large size, have
by some been considered as a different species. (31)

The diversity of the external structure of the
taenia of the same species, does not depend solely
on the difference of a2;e.

The nature of the soil, climate and food, vary-
ing in different countiies, explains the great influ-
ence which produces the changes and varieties of
form of all living beings.

It is thus, as I believe, that the natural consti-
tution of the animal structure, which we see alter-
ed in a thousand ways, contributes much more
than is commonly supposed, to the variation of the
exterior forms of the taeniae of the same species.

In fact, the inliabitants of the north are much
more subject than other people to the gray taenia ;(3S)
the Swiss to the flat taenia ; the Italians and the
inhabitants of Lower Saxony to the taenia cucurbi-
tina, etc. The feebleness or strength of the pa-
tient, the soundness or diseased state of the worm
itself, are circumstances which affect the size, soft-
ness or fiirraness of the worm, and its development.

The winding of the intestinal canal, the pres-
sure of the contiguous viscera, and other similar
accidental causes, obviously aff'ect the growth of
some portion of the taenia.

^ VIII. We have no exact description of the
interior organs of this worm. (33)

We only know that it belongs to the class of
oviparous animal?, because in every joint there is
an ov.n y of a peculiar nature, sometimes having

OF THE HUMAN BODY. 27

the form of a tubercle, ami sometimes that of a
small cluster of i^-rapes, or entirely deudroid or ar-
borescent. If these ovaries are examined with a
microscope, they are seen to contain a prodigious
quantity of cggs,(84) of divers sizes and diflerent
contour or outline, and perfectly dark "when near
their period of maturity, (.35)

The articulations of the taenia, in some instaii-
ces, are long or narrow, in others, short and broad ;
we sometimes see them almost square, slightly ilat-
tened, — these ovaries expel their eggs through the
perforated papillae observed on the lateral" parts,
and which, according to Block, communicate by
means of two canals with the ovaries. Certain
naturalists assure us that the seminal vessels open
near the ovaries, aud that the worm bedews the
©va with the seminal fluid the instant it deposites
them.

It has from this been concluded that these
worms are hermapiuodite, and this idea has been
the Fiiore readily adopted, because among these
worms the distinction of the two sex<is has never
been discovered. (S6)

Block has often observed two of these eggs so
closely united that they seemed to be but one ; he
could not separate them till he had steeped them
sometime in tepid water.(87) This sagacious au-
thor has however remarked, that this adhesion of
these eggs, miglit arise from an abundance of vis-
cous humour. This observation is not therefore
sufficient to prove tlie existence of two sexes iu the

28 • OF THE PRINCIPAL WORMS

taenia, and an argument like this, not ^ct freed
from douht, presents to our modern naturalists a
vast field for consideration.

§ IX. Some learned writers have pretended that
the taenia, like the Sertiilaria Czoophytes J ^rows
longer by means of tlie apposition of new rings.
This opinion however is proved to be unfounded,
and it may be affirmed with certainty, that the tae-
nia, like all other living beings, increases in length
and size by the addition of a homogeneous matter
received into its vicera and prepared or animalized
by them. The various parts of the taenia exist-
ing in miniature in the egg, begin to be developed
from their leaving the ovum and continue to grow till
they acquire their natural bigness. Block having
examined several small taeniae, with an excellent
microscope, discovered in them a prodigious num-
ber of very minute articulations, which could not
be seen by the naked eye. (38)

§) X. The taenia is very tenacious of life. Coit-
^ef(3i)) asserts, that they can live more than twelve
hours in boiling veal broth, and come out as brisk
and active as they went in. Dr. JPfl.r(40) caused
a taenia to simmer over a slow tire, and observed
that he died so soon as some common salt, muriate
of soda, was added.

In general, these worms, like others, sustain a
very high degree of temperature bef(»re life is de-
stroyed ;(1? ) this is not much in favour of that per-
fection of the senses which some writers have as^
cribed to them.(4£)

OF THE HUMAN BODY. 29

^ XI. This worm usually occupies the small
intestines ; some few are occasionally found in the
stomach. Most frequently the head is turned up-
ward, while the posterior part of the body and tail
extend along the interior portion of the intestiiial
tube. It is said that the head is insinuated in a sur-
prising manner, into the mucous membrane of the
intestines, and that the worm remains firmly attach-
ed to them.

Dr. Tijson relates his having seen a living tae-
nia in an opened dog, who^e tail was pendent from
the rectum, while the head of the worm was so
deeply fixed in the small intestines, that he could
scarcely detach it with his nail. (43) We should
hence conclude v/ith Moseiitifiii and all practition-
ers, that no one can be freed from the taenia till
its head is evacuated.

§ XII. The motion of this worm is singular
and spiral. The posterior articulations are separat-
ed from the anterior, they stretch out and contract
by turns, in such a manner that the worm becomes
sometimes narrow and sometimes broad : in a word,
in its movement it rolls as by undulation, and from
this cause it at times appears longer than it really
is.

This worm sometimes passes out from the rec-
tum without producing any sensation ; more com-
monly, the head being attached to the mucous mem-
brane of the intestines, the motions of the body in
different directions excite those peculiar morbid
phenomena which shall be pointed out in the third

30 OF THE PRINCIPAL WORMS

Lecture. It is from these irregular motions of the
^ody of the taenia, here and there compressed by
the duplicatures of the intestines, that those knots
arc formed in the course of its body, which arc
seen when the worin is voided, and which have
the appearance of being artificially produced.
These knots are sometimes single, sometimes dou~
ble.{44)

^ XIIT. xVll the taeniae found in the intestines
oT man, are not of the same species.

I cannot however embrace the opinion of those
physicians and naturalists, who, admitting as the
distinctive character of the taenia, several vague
and uncertain marks, have multiplied their species
without end, and thus exceeded the bounds of pro-
vident nature.

Hippocrates speaks of one sort of taenia only,(45)
and asserts that the maladies hd produces are not
always mortal. Physicians since his day have ad-
mitted but one species, till the time, of P/afer, who,
without distinguishing them, has announced two
species. (4(i)

Andnjy after having examined the two human
taeniae, adopted as the specific character of one,
the small knots fnoeuds) which traverse the whole
length of its body, and which he denominated
ike taenia imthoiit thorns, and the other the taenia
with thorns, {taenia epineux). (47)

Bonnet considered this distinction as too gen-
eral ; without augmenting their number, but liav-
iag regard to the length and smallaess of the a-r-

. OF THE HUMAN BODY. SI

iiculatlons, he caUecl one species the taenia with
long articulations f the taenia without thorns, and
that with thorns, the taenia with short articuld'
tions,(iS)

Xrin^aejts, presuming he saw a peculiar charac-
ter in the position and numher of the papiUae, has
descrihed three species,(49) calling the first of
them Taenia solium osculis marginalibus solita-
riis,{?0) the second Taenia vulgaris oscidis latere
alibiis geminis,[5i) and the third Taenia lata oscu^
lis lateralibus solitariis.{^2)

Pallas^ not wishing to deviate from the charac-
ters of Andry, of Bonnet and of Linnaeus, has
adopted six species(53) of them, the two last of
which, according to the celebrated ^/ocA, can by no
means be included in the genus of the taenia.
Goeze having ascertained the fifth and sixth spe-
cies of taenia described by Pallas to be incorrect,
he admits only the four first,(54) announcing at
the same time some uncertainty as to the fourth
species (Taenia tanella,) which be believes to be
rather a variety of the flat taenia,(55) and to con-
stitute the third species.

Without detracting from the merit of three great
naturalists, such as Linnaeus, Pallas and Goeze,
in reflecting on their writings, and contemplating
tlieir figures of the taenia, we perceive that tlie char-
acters they have drawn of the diversity of the spe-
cies, are liable to weighty objections. The broad-
est articulations may, in certain circumstances, con-
tract, shrink, and again possess a width and size

52 OF THE PR[NCIPAL WOUMS

which vary in the different periods of the life of the
worm.

The same may be said of the lateral papillae
and of the borders, as well as of the knots, parts
which are not seen in the joints of the young tae-
nia without a good microscope ; thfty become visi-
ble only as the worm grows. It is equally true that
those who would establish systematic divisions,
on characters not less vague and uncertain, have
fcast a shade over those questions which they ought
to have elucidated.

Thus several celebrated naturalists reposing
too much confidence in certain vague characters,
have confounded the species, and that they might
follow the order of nature, they have been anxious
to make these characters too distinct.(.T6)

If there are in the taenia certain fixed charac-
ters, immutable in every age of the worm, visible
to the naked eye, we see them in the head of some
armed with fangs or crotchets, as we have noticed

above. (57)

On these characters, which may be called spe-
cific. Block formed the division of all the intestinal
taeniae, into the armed and unarmed taeniae, a di-
vision still more appropriate for the human taeniae.
This division, besides that it is not subject to uncer*
tain changes, is much more beneficial to physicians.
Practitioners are not ignorant that the armed tae-
nia, by insinuating itself into the mucous membrane
of the intestines, with greater force than the unarm-
ed taenia, produces in parts thus sensible sharp

OF THE HUMAN BODY. S3

prickings, and sometimes occasions alarming symp-
toms, requiring the most efficient remedies to ex-
pel the worm from the intestinal canal.

I proceed therefore to the examination of tliose
two species, which are the only ones found in the
human intestines.(o8)

FIRST SPECIES.

THE HUMAN ARMED TAENIA.

§ XIV. The worm known by the name of tae-
nia cucurbitina, or solitary worm, (59) though de-
scribed and figured in several classical works of
natural history,(60) has nevertheless been the
cause of much uncertainty from the writings of sev-
eral men really illustrious, and which, in the opin-
ion of Blochn must be sufficient to humble the pride
of the human understanding. This worm is com-
mon with us,(6l) since the taenia most usually dis-
charged by our patients pertains to this species.

This taenia, altogether peculiar to man, (62)
varies according to its age, food, length of its whole
body, and the bigness and dimensions of the ar-
ticulations or iuternodes, as Werner chooses to
call them.

We see that these iuternodes are very slender
and delicate in the neck ;(63) almost square in the
body of the younger, and next below the neck in
those more advanced in age ;(64) in form of a paral-
lelogram in the oldest worms :(fi5) of the same
form and very broad in the largest taenia ;(6&)
oval and oblong in some '.(67) and lastly in others

34 OF THE PRINCIPAL WORMS

half an inch in leugth,(68) etc. We perceive that
the external form of the young worms thus differs
from that of tlie more aged, and that the external
appearance of the latter seems quite different from
tliat of the taenia when arrived at its full size and'
perfect growth.

This accidental diversity has therefore been
very improperly regarded as a characteristic index
of particular species, as we have already remark-
ed ;(69) and naturalists have fallen into a great er-
ror, especially those, who, blinded by the authority
of the Arabian physicians, have believed that they
saw in each, great articulation of this taenia, a par-
ticular worm. (70)

§ XV. The head of this taenia has been the
subject of many inquiries.

Welc}iius{7 i) and L{nnaeiis[J'2)ha.\& regarded
this worm as being acephalous,

MJwdius[7S) and Forestii;s{74!) are the first wha
mentioned, described and figured the head of this
worm as altogether monstrous antl remote from
truth. Jllalpighi afterward presented it to us as
having eyes, nostrils, a mouth, and teeth, as may
be seen in a truly grotesque figure, cited by Le^
clerc.{'7§) We are indebted to Andry^ Tyson, Bon-
net, and to Jloederer,[7^) for a more careful and-
elaborate description of tlie head of this worm, still
further improved by Leske, Pallas, Midler, Block,
Goeze and Werner, With the naked eye, we sot^
tliis head armed with two pointed and protuberant
appendages, which, by analogy, arc called crotch^

OV THE HUMAN BODY. -35

ets or fangs, (77) and which constitute the specific
character of this species, as the other species is
without them. If the anterior part of the head of
this taenia is examined with the microscope, stretch-
ing it a little^ the fangs, which are seen hy the naked
eye, are extended into a small crown perfectly cir-
cular and stellated, in the centre of which is the
tube.(78)

§> XVI. Laterally into a square, open the four
lateral canals(79) which traverse the whole length
of the worm. (80) The centre of the taenia is also
traversed by a canal called the middle c?.nal,(81)
which begins near the tube of the head and reach-
es quite to the tail, sending ]>ranches to each artic-
ulation very much resembling in figure the horns
of the stag, and v/hich anasfcomoze in a wonderful
raanner, as may be seen by the naked eye in fully
formed articulations. (S* )

It is not yet clearly decided by naturalists,
whether the middle canal of a ring communicates
with tlie other, though Winsloic,{hS) Vaiideh'o{8^)
and PaUas,{85) affirm t!iat they have injected it
through the whole length of the worm. (86) We
only know with certaintj^ that the canal contains
a humour composed of a globular and albuminous
substance : the former has great resemblance to the
yolk, (87) and tlie latter to the white of an egg.(88)

Goeze describes the eggs as enveloped in a
yellowish substance, which, macerated in water, is
separated into small grains.(89)

We farther know with certainty tluit in the ar-

S6 OF THE PRINCIPAL WORMS

ticulations wiiicli contain the ovaries, full of eggs,
the most mature are these which, from the middle
of the body of the worm, extend toward its tail. (90)

^ XVII. The lateral edges or- margins of each
articulation of tlie armed taenia, are provided with,
a papilla at the extremity of which is observed an
oblong opening.(91) which Goeze represents as se-
parated by a line.(i)2i)

These papillae, with their small mouth, occu-
py only one of the margins of each ring ; their
disposition is however such, that we sometimes see
them in the right lateral part of a ring, and in the
next in the left lateral part,(&3) and at other times
they rise in two, three, four, live, and even six rings
on the same side, and immediately after in one or
two articulations on the opposite side. (94)

It is probable that the internal structure of these
papillae results from a tissue of fibres, since, if we
are to credit Rosenstei7i,{Q5) the living worm has
the power of thrusting them forward and of retract-
ing them.

The small apertures of the papillae communi-
cate with the ovaria. and on this account they are
to be regarded as the last extremity of the egg-
ducts. (9*i)

Goeze, though persuaded that the taenia sucks
up its nourishment by means of the four openings
situated in the head, nevertheless believes that the
lateral papillae absorb the nutrition requisite to
support the posterior division of this very long
>vorm.(97)

OF THE HUMAN BODY. i7

If this is true, their orifices must be double, for
we have remarked that tlie eggs of the taenia may
be pressed from them,(y8) as all naturalists a-
gree.(99)

§ XVIII. That these worms originate directly
from eggs, deposited by the same species, can no
longer be doubted. (100) PaUas[iOi) introduced
into the belly of a small dog some ova of a taenia
canina ; a month after he laid open the belly of the
animal, and in his viscera found several small tae-
niae, having very short rings, which were not
above an inch in length.

We are indebted to Werner for the discovery
of the parts of generation of this taenia.

He has demonstrated that the organs consti-
tuting the two sexes exist in each riug,(10S) and
he has thus verified the doubt of some naturalists
in relation to the hermaphrodite species of this
worm. (103)

According to his observations, two canals open
into the marginal papillae of each ring ; the supe-
rior terminates in a round tubercle, which seems
to be the male ; the inferior is tortuous and filled
with eggs, and whose lower extremity, enlarged in
form of a cul-de-sac, seems to form the female.
There is nothing therefore wonderful if the eggs of
the taenia are fecundated at the instant of their be-
ing deposited.(lOl)

1?fi OP THE PRINCIPAL WORMS

SECOND SPECIES.

THE UXARMED HUMAN TAENIA.

§ XIX. The greater number of physicians and
yiaiuralists liave given to this worm the name of
Taenia lata ;[iO-y) we owe to Bonnet{iOQ} the first
accurate description of it. I therefore deem it pro-
per to present in this place his own figure of
it,fl07) because I find it the bestof all those which
niodern times have produced.

It possesses also the further advantage of being
true t(» life.

§. XX. The external form of the unarmed tae-
nia is flat, resembling a riband: its colour is white,
which Pallas regards as one of its specific char-
acters ;f 108) its ordinary structure is rather coarse,
dense or membranous. Its articulations are dis-
posed in so peculiar a manner, that it may be clear-
ly distinguished with the naked eye from the arm-
ed taenia. From the neck, the body is sometimes
regularly intersected by transverse margins, not
differing from those which unite the joints of the
taenia cucurbitina ; from this cause it might at first
sight be confounded with the latter, if it were not
flat and slender. Such is the flat taenia describ-
ed by Marx, and which on account of this singu-
larity I submit to the examination of my rea-
ders.(t09) In general the joints of the neck are
very thin and delicate, being almost imperceptible :
those that follow approximate the figure of a square,
gradually increasing in width in the body;, and be^

OF THE HUMAN BODY. S^

eoming a little longerj they thus continue to the
tail, which resembles a truncated piece. The lat-
eral margins become irregular and are said by nat-
uralists to be closed.

This worm varies in length. The longest hu-
man taeniae which Pallas ever saw were fromi
eighteen to twenty Paris feet, (from six to seven
metres.)

Block sent one of these worms in several pieces
to Goezpf discharged by a woman of Berlin, whose
entire length was eighty two metres. The big-
ness, length and breadtli of this worm vary with^
or are in proportion to its age and nutrition, as we
have said of the first species. (1 1 0)

§^ XXr. The head of this taenia is very minute ^
like the other species, the head of this is also fur-
nished v/ith four lateral papillae, and with a sin-
gle papilla, in the centre of which Werner has-
likewise seen the tube. (Hi)

This central papilla has not the crown of fangs
which encircles the tube of the armed taenia.

These four papillae are also in this taenia, the
orifices of the four lateral canals which pervade
the margin of all the joints of the worm to the tail.
The middle canal also passes through the centre
of each articulation, but it is not known to commu-
nicate with that of the next rings, since neilhei.'
Pallas nor Goeze was able to push an injection
through its whole length, as Winslow assures us-
he has done.(llS)

The neck is quite covered with whitish fila-

40 OF THE PRINCIPAL WORMS

ments,fll3) which render it laiiuginous, or downy.
Beginning with the narrowest part of its body and
proceeding to the tail, the surface of each ring is
made distinct by farrowed lines(li4) which, if ex-
amined with the microscope, present a cord of
three lines. (115.)

Both lateral margins of each ring are provid-
ed with a perforated papilla leading to the ovaria,
inclosed within the substance of the above mention-
ed rings.(ll6)

§. XXII. In the centre of each ring we discov-
er the ovaria, uniting in a nodus of an oval fig-
ure,(ll7) and pointed at one extremity. These
ovaries, grouped together, were taken by Bonnet
for so many glands, to which he gave the name of
blossomed fields.(118)

On the superior part of each ring opens a small
round canal corresponding with the centre of the
ovaries.

Pallas asserts that the worm deposites its eggs
through this canal. (119) It is possible that the
opening of the marginal papillae may serve as the
male sex of the worm, as well as to suck in nutri-
ment, as we said of the armed taenia. From the
great difficulty of procuring this worm among us^
eitlier living, or in a fresh state, we have not yet
been able to pursue the various researches neces-
sary to obtain an exact knowledge of its internal
structure.

OP THE HUMAN BODY. 41

SECOND GENUS.

VESICULAR WORMS.

§ XXIir. Joseph Ricci, of Paria, about fifty
five years old, of a feeble temperament, ami poor-
ly fed, having been for three months subject to at-
tacks of intermittent fever, and tormented by vio-
lent ajffections of the mind, was seized in the road,
on the morning of November 26, 1797? with great
torpor of the lower extremities. Dragging himself
along with a reeling and uncertain step, he was
suddenly taken with a severe pain of the upper
part of his head, and at the instant he cried for
help, he fell senseless to the ground. He was im-
mediately conveyed to the clinical hospital, where I
found him in an apoplectic fit, of a character altogeth-
er asthenic or nervous, as most physicians call it.
Excitants were applied both externally and inter-
nally without eJQPect, as the man died the following
midnight.

On examining the body and finding nothing re-
markable in the external substance of the brain,
we attempted to open the two lateral ventricles,
and found them filled with a bloody serum. Here
an unexpected phenomenon presented itself ; two
large clusters of hydatids extended along the branch-
es of the plexus choroides to which they were
intimately attached, so closely that to separate
them I was obliged to tear the substance of the
plexus. (ISO) Each cluster of hydatids was about
two inches in length, large and extended at its in-

42 OF THE PRINCIPAL WORMS

ferior extremity, which floated at the bottom of
the ventricles ; the summit terminated by a long
Gord folded in various directions, (ISl) and was
strongly attached to the partition whicli separates
auteriorily the two ventricles.

This double collection of hydatids so regular-
ly disposed, being removed from the brain and at-
tentively examined, we saw that each little blad-
der contained a real worm, of a structure quite sin-
gular.

§> XXIV. It was composed of a head similar
to that of the taeniae, and of a vesicle full of wai-
ter, and organized in a wonderful manner.. 1S2)

Tlie vesicle seemed to be formed of three dif-
ferent membranes ; the first external, thin, transpa-
rent, and very shiny or glistening ; beneath this
was seen an arrangement of very slender circular
fibres, — these were extended over another velvet
membrane, which lined the inner surface of the
vesicle or little bladder. Each small bladder was
therefore one of those worms to which Block gives
the name of hermits, (1^3) to distinguish them from
the vesicular social worm, which is also a blad-
der filled with three hundred or even four hun-
dred small worms.(lM^) The internal part of the
bladder contained nothing but some water, and not-
withstanding every examination we could make,
we could not discover the least sign of any organ
which might serve for the natural functions of this
animal.

A very singular species of worm truly ! The

OF THE HUMAN BODY. 46

figure of the small bladder is sometimes round,
sometimes oblong, sometimes angular, etc.

Wliile the worm is living, by slightly com-
pressing the end of its long neck, the head seems
to be furnished with fangs, and a little mouth like
that of the armed taeniae.

^ XXV. Among authors we find our vesicular,
worm confusedly described under various names.
It was called ILjdatis animata by Peyerf(i25) Ova
in poinds by Bartholin, (i^Q) Lumhrims Jiydropi-
ciis by Tifson,[i"Z7) Hydra hydatula by Lin-
iiaeus,(i28) Taenia hydato'ide hy Pallas,{i2^) Tae-
nia vpsicularis by Goeze,{iZO) Taenia hidatigena
by FiscJieriiSi) and by Werner,{iS2) I have
called it vesicular won:;, because this name seems
to me most appropriate and convenient. (133)

§ XXVI. This worm has been several times
found, not only in the brain, but also in various
other parts of our body, by a number of illustrious
physicians. (134) According to the observations of
Koelpin{lS5) and of Walther,{V3Q) the greater
part of hydatids may be reduced to real vesicular
worms. (137) Pallas is induced to believe that en-
cysted dropsy may be produced by a cluster of ve-
sicular worms. (138)

§ XXVII. It seems probable from observations
already made, that this worm commonly resides
in those parts of the body which abound in lymphat-
ic vessels ; its bead is attached to their branches,
absorbs the lymph they contain, and thus fills the
small bladder that constitutes its body. Its eleva-

44 OF THE PRINCIPAL WORMS

tioiis resemble crotchets or fangs, like the armed
taenia ; the head has these fangs imitating a coro-
net of wrinkles which serves firmly to secure the
papillae which opens in the centre of its head, to-
ward the parts of our body, and which draws its
nourishment at our expense. This worm is there-
forer a very singular animal ; it is only found iu
the most concealed parts of our body, that are en-
tirely secluded from external substances. Not the
slightest trace of its eggs have yet been discovered.

May they not be developed in the interior of
the lymphatic vessels ?(139)

§. XXVIII. Our vesicular worm differs from
those seen in the liver of hares, of mice, and in the
brain of sheep, though the latter resembles it very
nearly.

In man, a single worm is contained in each lit-
tle bladder, w bile in the vesicular worms of other
animals, there are several small worms in each
vesicle. The head of the human vesicular worm
is without the bladder, to which it is united by its
neck ; in the vesicular worms of other animals,
these small worms live within the parietes of the
common bladder.

Lastly, the small bladder of the human vesicu-
lar worm seems to form^ the body of the worm,
while in the vesicular worms of animals, it is
merely the common recipient to contain the worms.

The figures of the vesicular worms of hares
and sheep, as given by Goeze, are very exact ;
they merit attention,{i40) in order to notice the

OF THE HUMAN BODY. 43

particular diversity between the latter and the hu-
man vesicular worm.

Block only has been capable of distinguishing
them accurately. (141)

THIRD GENUS.

THE TRICOCEPHALUS.

§ XXIX. Dr. Wagler was the first writer who
described this worm ;(1 43) it was found by pro-
fessor Roederer and himself in the intestinum coe-
cum of some French soldiers, who in the year i7'i0,
were attacked at Grottingen with a contagious epi-
demic. The celebrated Blnmenhach found it sev-
eral times afterward in the dead bodies of some
miserable and half starved subjects. '143}

Among us it may b3 said to be very rare, since
so far as my information extends, no practitioner
has' had occasion to notice it.(144) JVagner sliuI
Block inform us that they have uniformly seen it
in the coecum : others have seen it in the course of
the large intestines, and Werner'^i-l^) says he has
found it in the lower portion of the ilium.

§ XXX. We find the tricocephalus described
by various authors, under the names of Tricii-
r?s,(146) tlscaris tricuiray{i'i7) of Taenia spi-
WZ/e,(146) and of Fuseragnelo codi s<'fo/rt,(149) or
worm with a tail. The name of tricocephalus Is
the most appropriate. (IjO)

§ XXXI. Several naturalists, among whom
we may count Linnaeus, Leske and Werner, have
improperly classed it with the genus of the asca-

46 OP THE PRINCIPAL WORMS

rides, though its figure has little resemblance to
them. Still less caa it pertain to the class of the
taeniae, among which it is ranked by Pallas.
Jiloch and Goeze afterwards formed a particular
genus of these worms, immediately following that
of the ascarides.(15i.)

§> XXXII. The form of our tricocephalus is
that of a spiral line,(153) and its largest part does
not surpass half a line in diameter. The external
surface presents an assemblage of small transverse
lines, like rings.

Its length is from an incli and a quarter to two
inches. One part of the body terminates in a fila-
mentous elongation, as fine as a hair, and coiled
round in a very surprising manner. The other
part, turning in a spiral form, most commonly ter-
minates in a hook, broad and obtuse, and similar
to the pistil of the liliaceous flowers. From this
extremity the worm can put forth a sort of tube, en-
veloped in a sheath.(iri.3)

Its extremity, terminating in this very fine fila-
mentous elongation, and one half longer than its
body, has been taken for the tail of the worm by
Roederer, Wagler and Wrish erg, [15-1;) and for
this cause has been called trichiiris. On the oth-
er \mm\ Pallas,{iCi5) Muller,{i56) and Goeze'ioY)
Lave demonstrated that this part is the real head
of the tricocephalus. (158) Werner has also con-
troverted the opinion of these three naturalists, but
liis arguments are too weak to prove it incor-
rect :(159) and we have reason to admit tlie licad

OF THE HUMAN BODY. ^

of the worm to be at its anterior filamentous ex-
tremity, which serves as a neck.

In the opposite extremity terminates the intes-
tinal tube, and for this reason, it should be regard-
ed as the tail of the tricocephalus.

§ XXXIII. The tricocephali which are found
in the iutestiaes of men are of different sexes.

Tlie tail of the male is turned round in a spiral
form ; while that of the female, on the contrary, is
oblong and flat, like that of the beaver, larger than
the body and bent.(l60)

We discover the internal organization of the
male of this worm by opening it and subjecting it
to the microscope. It is provided with an alimen-
tary and intestinal tube, and with spermatic ves-
sels.(I6l) The tube of this worm, according to nat-
uralists, may appear externally :(15S) may it not
constitute one of the parts of generation ?

The female tricocephalus has not in fact this
tube, or cylindrical invagiuated body, which some
authors have given it ; it is the end of its tail which
is quite obtuse. (163) Besides the intestinal canal,
its ovaries, so well described by Midler, [iQ\) may
be easily seen ; they are filled with a great quanti-
ty of eggs, which Wagler has observed(l65) to be
deposited by means of a particular canal.

These eggs, deposited by the female,(l66) are of
an oval figure, and pointed at botli extremities, lu
the male not the least trace of them is seen.

^ XXXIV. Pallas has described a tricocepha-
lus which he found in the intestines of the Lacerta

48 OF THE PRINCIPAL WORMS

apoda.liGy) It has been pretended that this was
the same worm as that found in men by Waaler
and by Roederer ; but the last examination has
evinced that the head of the tricocephalus of th^
lacerta apoda was crowned with small fangs, be-
sides other peculiarities of structurej(468) never ob-
served in the human tricocephalus.

On this subject Goeze says that the tricocepha-
lus of Pallas should be regarded as a link, which^
in the series of intestinal worms, unites the trico-
cephali with the G ratteurs, {iQQ) or Echinorynchi.

FOURTH GENUS.

THE ASCARIS VERMICULARIS.

§. XXXV. This worm, like the lumbricoides,
of which we shall presently speak, belongs, accord-
ing to naturalists, to the same genus ; they ought
consequently to be described under the same arti-
cle. If we however inspect these two worms, when
brought together, we shall perceive material differ-
ences between the size and length of the body of
the ascaris vermicularis and of the lumbricofdes,
and in the place these worms occupy in the intestines,
which is not common to both, as well as in relation
to the symptoms which they severally produce ;(170)
it seems to me that physicians should examine
them separately, as has been done by most practi-
tioners who have spoken of worms.(171)

§ XXXVI. The ascaris vermicularis, which
has received divers names by authors.(47S) is a

OF THE HUMAN BODY. 49

I'oiind, filiform worm, fine an«l slender at both ends,
from four or five lines to an inch in length. The
vivacity with which it moves, skips and bounds, is
singular. If touched with a finger, or brought
near the flame of a candle, its boily contracts some
lines in a surprising manner. It is perhaps to this
contractility that we are to attribute those enormous
irritations of the intestines, and particularly of the
anus, which torment the sick, especially children^
who are most subject to them.

The surface of this worm is full of wrinkles^
which seem to be formed by a multitude of rings.
Its anterior extremity is obtuse, its posterior end;,
or tail, is shiny and slender.

^ XXXVII. This worm resides in the large
intestines, commonly in the cavernous cells of the
colon and rectum. Widf discovered an infinite
number of them in a small sack between the coats
of the stomach. (I73)

I remember to have found several masses of
ascarides vermiculares in the oesophagus of a
woman, who died of a slow nervous fever. This
worm is often found in the vagina of women.

It is remarkable that the ascaris vermicularis
is never found alone, but in congjlobate masses of
other worms of the same genus. It may be said
tiiat they love to dwell in groups.

§ XXXVI 11. This worm lives longer than
any other in the human body ; it can exist an al-
most incredible space of time. Fabricius re-
7

50 OF THE PRINCIPAL WORMS

lates((74) tlie case of a man who was tormented
for iQn years by the ascarides vermiciilares.

§ XXXIX. The nature of the aliment which
supports this worm has been the subject of vari-
ous opinions. (i 75) But it has at length been
observed, that the mucous matter which lubricates
the intestines and the vagina of women, is the sub-
stance for which it has the strongest predilection.
Agreeably to this, it is not wonderful that we find
the ascaris vermicularis in other parts of the body,
in which the mucous fluid abounds, as those of the
bladder, stomach, oesophagus, etc.

§ XL. Though Van-Phelsum{i7^) has treat-
ed at large of this worm, but Goeze has all the merit
of teaching us its internal structure. (177)

This animal is very small ;( i7S) seen through
the microscope, it clearly appears that its obtuse ex-
tremity is its real head.

It is furnished with two lateral oval protube-
rances, and divided in the middle, which is the
mouth. (I79) its body gradually enlarges one
third of its length from the head, and proceeding
toward the tail, it becomes more slender and deli-
cate, till it terminates in a cetaceous point.

A small canal opens into the mouth, which by
dilating and contracting is connected with the stom-
ach and intestinal tube. The opening of this
canal is seen at that part of the body where it be-
gins to iliraiiiish, in order to terminate in a very
tine point, forming the tail.

This point is considerable in the female ascaris

OF THE HUMAN BODY. 51

vermicularis ; it is considered by some naturalists
as a characteristic sign of the female sex.(lSO)

§ XLT. In the male ascaris vermicularis we
observe under the intestinal tube, a very small and
very white canal, which extends quite to ihe end
of the tail. (181) There is no doubt that the or-
gans of generation, which characterize the male
are situated in this part, and that it passes out in
common with the posterior extremity of the in-
testinal tube. (IS::) Van-Phelsum found it filled
with a whitish albuminous substance. He is how-
ever deceived when he pretended to have observ-
ed that the course of this canal was spiral, and that
the tail of this worm terminated iu a broad sack,
distended with eggs.

Werner has also fallen into the same error,(183)
for confiding in the remark of Van-Phelsum, he
has given the figure of it without subjecting this
worm to that rigorous examination, which he has
bestowed on all the other worms, which he has
drawn and described with exactness.

The figure of tiie nvale and female vermicu-
lar worms, given by Goeze, is the most perfect,
and on this figure rests our description of them.

^ XLII. The intestinal tube of the female as-
caris vermicularis is surrounded by a membranous
canal containing nothing but fetuses, and which by
pressure merely, can in great part be expelled
through an aperture situated at about one third of
the length of tlie body. (184) If a small portion of
this membranous canal is subjected to the micro-

s:* OF THE PRINCIPAL WORMS

scope, we see it filUd with iniiiiraerahle embrios
ilisteiuled in various forras.(f 8ii) The figure of
these embrios seems to be oval.(t8R)

The extraordinary quantity of fetuses in the fe-
male ascaris vermicularis need not be at all sur-
prising, since tliese worms, according to the obser-
vations of Goeze, are viviparous ;(i87) the fe-
male expelling very small ascarides in a living
state, after which she dies. (188)

Thus the opinion of Kratzenstfin is equally re-
futed,(18i)) who pretended that the flies, habituat-
ed to draw food from excrements, deposited their
eggs in the anus of children, and in this manner
gave rise to these worms.

FIFTH GENUS.

.LUMBinCOlDES.

§ XLIII. Naturalists are no where so much
divided in their opinions as on this worm.

Linnaeus{i90) reduced to the same species the
lumbricus terrcstris with that which inhabits our
intestines, and for this reason Vallisneri called this
worm lumbricus humaiius, and we more convenient-
ly have called it lumbrico"ides.(191) It has been
sufficiently demonstrated that these two worms
are strikingly different, in regard to the external
structure of their bodies,(f9S) as well as in rela-
tion to their internal organs. (193)

The opinion of Linnaeus and of the writers
ivliQ have copied him is greatly erroneous, as is that

OF THE HUMAN BODY. 55

of those who pretend that the human lumhrico'idcs
is different from the lumhriciis that inhabits the in-
testines of other animals, notably those of the horse
and dog.(19t) The length and the extraordinary
size of this worm are regarded by some as an essen-
tial mark of different species ; but this may depend
on its different nourishment. And have we not ev-
ery day examples of animals, whicii, abundantly
fed on highly nutritious substances, become inor-
dinately large above their natural state ?

Vallisneri found a very large one in the intes-
tines of a calf ;( 19-^) ^a^tfyi describes another of
these worms, thirty feet long, vomited up by one of
his patients by smelling garlic ;(196) and Itosen-:
stein, in the space of eight days, expelled nearly
ninety of tliem, quarter of an arm fhras^J long,
from a little girl of eight years.

This question docs not therefore seem to be
solved, since analogy and observation can furnish
several arguments sufficiently satisfactory, which-
ever of these opinions we embrace.

§ XLIV. The lumbricoides is perfectly round,
commonly about the size of a writing quill : most
frequently it is from six, seven and eight to ten fin-
gers'' breadth in length. (197) In each individ-

* The French v/ord hras is probably berc a translation of
the Italian braccio botli from tlie Latin brachium arm ; Itut in
neither of these languages any more tlian in our own, does the
word seem to import a definite measure length. The French
translators sometimes use it for one and a half njetre prcciselj',
and sometimes for rather lees. Jl. T.

54 OF THE PRINCIPAL WORMS

ual the sex is distinct : the male is smaller and
shorter than the female.

Its colour is white, sometimes resembling flesh
colour. The canal, which passes through the ab-.
domen of the worm, is yellow and transparent.
Goeze[i9'S) regards this as a characteristic sign of
this species. But this circumstance can be nothing
more than accidental, because this canal being the
alimentary tube, its colour must change with that
of the substances it contains. Hence its appear-
ance is sometimes white, black, yellow, ect.*^

The whole surface of the body is wrinkled and
annular, and tapers to both extremities. Most
naturalists have supposed that the circular fibres
embraced the whole circumference of the body,
Werner has however demonstrated that the fv ur
longitudinal fibres arc the only ones which per-
vade the whole superficies of tiie worm, and that
those reputed circular are mere fragments of trans-
verse fibres, which inclose the longitudinal fi-
bres.( 11^9)

This arrangement of fibres in the lurabrico'ides
is precisely like that of the human intestine colon :
for this reason, Werner considers all the fibres
which form the surface of this worm, as true lon-
gitudinal and lateral muscles ;(200; and, in this
way, he very well explains the serpentine motions
of its body.

* In some lately examined, the colour of this tube was pur-
plish. These were expelled without life, and exhibited this ap-
pearance twelve hours after being discharged. t4. T.

OF THE HIBIAN BODY. 55

The transverse fibres are connected together by
means of an abundant cellular tissue, which being
moistened is greatly relaxed, and lengthens the
body very cousiderably. Goeze asserts, that a
piece of this worm one line long, after being mace-
rated, acquired the length of an arm. What an
extraordinary length may not this worm attain in
the living human body !

§ XLY. It is to be remarked, that the external
structure of the head and tail of the lumbricoides,
is peculiar.

If we observe the head with the naked eye,
we see three beautiful hemispherical eminen-
ces,(20l) which insensibly terminate in a very
sharp point.

Under the microscope we perceive that these
three eminences are perfectly hemispherical, 205)
and that Vallisneri described them with accuracy,
when he compared them to three small hills. (^03)

To a triangular aperture in the centre of these
eminences, Pallas has given the name of a mouth
with three lips, trilabiata,

AYe cannot perceive all these appearances in
the dead worm, because every part of the body is
then relaxed. In the living lumbricoides, these
three hemispherical eminences change their aspect
as Goeze informs us, (204) who had the good lor-
tune to see one of these worms at the instant it was
sucking. In the living worm, on the contrary, we
see that these three hemispherical protuberances
are pyramidal, with a convex base truncated cxte-

56 OF THE PRINCIPAL WORMS

riorly with a very sharp piei'cing point, in such
fitshion as to be compared to the divisions or
claws of common pincers. With these protube-
rances the 111 rabrico ides attaches itself to the mem-
brane of tlie intestines, and even penetrates it, and
when sucking up the mucous secretions, it moves
these eminences alternately like three jaws ; thus
the worm opens and shuts its triangular mouth,
furnished with a tube which it can put out or draw
in. A mechanism so well understood proves that
these protuberances are tissues or textures of mus-
cular fibres.

AVhen the mouth of the worm is closed, these
eminences approximate and form together a cone
hard and firm at its summit, terminating in a sharp
nipping point, and with this instrument it can even
perforate the intestines, and make its way to oth-
er parts of the body, as into the gall-bladder,(205)
into the cavity of the abdomen, (^06) into the kid-
neys, the urinary bladder,(207} the brain,(^08) as
well as into other viscera. (209)

§. XLVI. This worm lives in the intestines,
with other worms. JRosenstein mentions(2l0) an
infant of four years, feeble and emaciated, who
voided several ascarides vermiculares, four arms of
a taenia, and ten lumbrico'ides. A similar case
is related by Montinf[2ii) and practioners have
frequent opportunities of noticing the lumbrico'ides
associated with other worms.

§> XLVII. Children are much disposed to this
worm, and adults are not always free from them.

OF THE HUMAN BODY. 57

In general they prevail most in persons poorly
nourished and full of viscous humours, or attacked
by some severe asthenic disease.

It has been observed that the more numerous
these worms are, the smaller is their body.

These worms arc generally found collected to-
gether in great numbers ; some sick persons have dis-
charged a hundred and fifty of them at once,(21S)
a hundred and seventy, (313) and a thousand in the
space of some days.fSll)

§ XLYIII. Tijson, Redi^ and VulVsrerihuxQ
been distinguished by their description of the or-
ganization of the lumbrico'ides.

Werner has latterly given us a more exact de-
scription of this worm, ornamentrd with excellent
and perfect plates of it. The reader may consult
them in plate V, here subjoined, and thus ascertain
the organs serving for nourishment, and those des-
tined to the propagation of the species.

§> XLIX. On opening the body of the female
lumbrico'ides,(21'^) we immediately discover the in«
testinal tube, commencing at the head, and envel-
oped with other parts by cellular tissue.

It is thin and slender at its origin ; afterward it
gradually increases in order to contract and dilate
into a sack, which may be called stomach ; this ter-
minetes in an intestine, which adheres, like the
oesophagus and stomach, to l!:e abdominal line,
extending quite to the tail, where is seen a very
small aperture, which forms| the anus of the
worm.(Sl6} Its colour is ordinarily dark and vel-

58 OF THE PRINCIPAL WORMS

lowisb, and in some places greenish. It is form-
ed of wrinkles and valves similar to those of the
human intestines.

The white line, reaching from the head to the
tail, along the direction of the intestinal tube which
is situated above it, is, according to Werner^
the great artery, which he has observed,rsi7) as
well as Willis,[2i8) to be full of red blood in the
lumbricus terrestris.

§ L. About two inches from the head, in the
abdominal line, is a small hole which is the aper-
ture of the vagina, or egg-duct.(Sl9) This hole
opens into a canal (the vagina) nearly at a right an-
gle, which, bending in form of an arch, dilates into
two small sacks, forming the two horns of the ute-
rus, the structure of which is truly wonderful, (3^0)
"with regard to the extremely delicate slender pro-
ductions, turned and folded in various ways, in
which each horn of the uterus terminates.

Here a w^hite tenacious fluid is contained, simi-
lar to human semen, in which are suspended many
granulated particles.

Werusr imagines (2Si ) that the uterine process-
es of the female lumbricoides communicate with
the small vessels filled with a whitish fluid sur-
rounding the intestinal tube, as has been observed
in frogs by Swammerdam,(VJl^) and by Caoi-
per.(3^3)

§ LI. The quantity of eggs enclosed in the horns
of the'uterus is immense.

Their external sniface seems to be ])risi]v and

OF THE HUMAN BODY. 59

villous : very shining on their inner part, they pre-
sent to the eye of tlie observer a spiral circumflex,
line in the centre of them.(a24)

Werner calls this line spiral, and regards it as
the germ of the future worm. (255) The existence
of real eggs in the female lumbrico'ides being prov-
ed, is no equivocal refutation of the opinion of
Frisch, who, supposing that these worms were
transformed like insects, considered them as so
many larvae of the taenia.(326)

^ Lll. The internal structure of the male lum-
brico'ides, diflfers only from that of the female in the
sexual organs. (S37)

At the distance of some lines from the tip of
the tail, commences a small canal of a conical fig-
ure, named penis by Tyson, uhich, tortuous and
large, reaches a third way up the length of the
worm, where, contracting and dilating, it forms a
vesicle, (compared by Werner to the seminal vesi-
cle,) and again narrowing like the horns of the
uterus of the female, and tapering like a hair, in-
terlaces with the intestinal tube, folded in a surpris-
ing manner, and terminates in several loose and
floating filaments. (^28)

The fluid, which fills this system of spermatic
vessels, is not so glistening as the fluid of the ute-
rus, nor, as in the latter, do we see any granu-
lated particles swimming in it.

§ LIII. Several distinguished naturalists have
maintained, by observations altogether illusory, that
the lumbrico'ides was viviparous.(229) Pereboom

60 OF THE PRINCIPAL WORMS.

even believed that lie saw a small lumbrico'ides
come forth from the body of the female already
dead. (230)

Tijson, VaUisneri, Van-Swieten, Van-den-
Bosch, Goeze, and several other naturalists of mer-
it, have proved that this opinion was without foun-
dation, and they have demonstrated that the visce-
ra, and particularly the very slender spermatic ves-
sels, having passed out by some accident from the
belly of the female lumbrico'ides, and turned in
form of an arch, in consequence of the natural elas-
ticity of these parts, have been erroneously taken
for fetuses of the same species.

APPENDIX

PRINCIPAL HUMAN WOiniS,

§ LIY. Several eminent naturalists(231) have
spoken, in their writings?, of some other Avorms
which are rarely found in the human body, and
they have described them as particular species.

Though tlVe liistory of these worms does not per-
tain directly to medicine, yet I deem it very impor-
tant that physicians should know all the varieties ot
the worms of the human body, besides those which
are peculiar to it, and may prove hurtful, agreea-
bly to the observations which have been already
collected.

In my opinion all these worms may be consid-
ered as varieties of those we have described, or as
accessory worms,(S82) which are not indigenous to
the human system, but which sometimes introduced
there, occasion peculiar and severe diseases.

§ LV. We should regard as varieties of the
worms indigenous and peculiar to the human body,
the membranous taenia,fS33) the ascarides vermic-
ulares, discovered by Brugnatdlii^iLZ^) in the va-
gina of a woman, the ascaris lumbricoides of Ro-
sensteinf{2S5) the stomach worm of Pereboom/2SQ)
etc.

02 APPENDIX TO THE

§. LVl. Among the accessory worms, or those not
native to the human body, but which are sometimes
found in it, we may reckon as chief the Douve of the
intestines ffasciola intestinalisJ.[zS7) the ascarides
cf the stomach,(238) the ascaris of the nipple, the
biting or pricking ascaris,{?i39) the Crordius or Cri-
720,(210) the vena mediaensis, dracunculus, or Gui-
nea-worm,*(341) the exatiridion of Treuilery{2^2)

* M. Larrey has had occasion several times to observe, in
Euvpt, iuilauimatory tumors, which are generally attributed
in Africa to the presence of a worm which had penetrated tKc
sSin, t!ie ulceration of wlilcli cannot be cured till the extrac-
tion of this pretended worm is completely effected.

Accordingly the mode of curing this singular malady con-
sists in twistin;5 about ? small piece of wood a tender whit-
ish filament, which is regarded as the body of the worm.

T!ie greatest precaution is always taken not to break this
thread or worm, for if unfortunately it should break, it is believ-
ed to produce such distressing symptoms, by penetrating deep-
er, as to require the amputation of the limb to save the life of
the patient.

M. Larrey supposes (hat the morbid symptoms which attend
these tumors, which he considers as mere furuncles (biles) or
mild enthraccs, arise in fact from the operation of extracting
the Guinea-worm fdragoneauj, and that these symptoms are
aggravated when the operation fails.

He has very attentively examined this whitish filament, but
did not find in it the smallest resemblance of a worm.

He was convinced, by dissection, that this thread is dead
cellular substance, which they succeed to spin, as it were,
through a hole in tlie skin, when a small portion of it is taken
hold of and rolled round a piece of wood. M. Larrey believes
that it is by this ill-judged manoeuvre that certain cylindrical
portions of the cellular tissue are obtained, long enough to be
confounded with a real worm.

PRINCIPAL HUMAN WORMS. 63

and also the insect scolopendra, sco]oppndre.{'S.'i^3)
It should be remarked that men, by swallowing the
eggs of worms, which inhabit the viscera of animals,
are exposed, in certain circumstances, to have these
eggs developed in their own intestines.

In this way we are liable to be preyed on by
worms, which are not proper to our species.

Afterward he had an opportunity of convincing himself of
the truth of this persuasion hy pinching the celluKar scar of sim-
ple hiles, as he tliereby obtained the same result.

M. Larrey has acknowledged that without knowing it at the
time, he found himself in opinion with Dr. Labor^Je, who being
at Cayenne, had expressed the same sentiment, after a great
number of observations.

See Le Bulletin des sciences de la Societe Phllomatique de
Paris, pluviose an 12. F. Trs.

EXD OF THK FIRST I,F.CTU«K,

NOTES

TO THE FIRST LECTURE.

(1) Among the great number of publications of
naturalists and physicians of all periods and na-
tions, on human worms, the following deserve to
be consulted, and it may be added that they are
truly classical,

1 Salandi, Ferdin. Trattato sopra li vermi;
Verona, 1607, 4°.

3 Redi, Franc. Osservazioni intorno agli an-
imali ^viventi che si trovano negli animali viventi ;
Firenze, 1684, fol.

3. Vallisneri, Ant. OjJere fisico-mediche ; Ve-
nezia, 1733, fol. torn. 1, p. 113.

4. Leclerc, Dan. Historia naturalis et med'ca
latoram lumhricoriim intra hominem, et alia anima-
lia nascentium, ex variis auctoribiis, et propriis oh-
sei'vationibiis, etc.; Genevae, 1715, 4°.

5. Andry. J)e la Generation des vers dans
le corps de Vhomme, ect. ; third edition, Paris ;
1741, torn, il, 8°.

6. Van-Doeveren. Dissert, de vermibus inti^s-
tinalibus hominum ; Liigduni-Batavoram^ 17^3,
4,0.

7. Pallas. Dessert, de insectis viventibus intra
viventia ; Lngduni-Batavoriim, 1760, 4°.

FIRST LFXTT^RE. 65

8. Bloch. Traite dp la Generation des vers des
inteatins, et des vermifugpi^ ; Strasbourg, 178!^? 8*^.

9. Werner, D. E. F. Vermium intestinalhim,
prapsertim Taeniae humanae breviif exiwsitio ;
Leij)siae, 1783, 8°.

Continuatio prima, secunda, et tertia, ciirante^
J. L. Fischer ; Leipsiae, 1782, 17^6, 17S8, 8^

10. Gocze, J. A. K. Versiicheiner JWhirges-
chichte der E in e^eiaeide warmer thierischer Koer-
per ; Leipzi*^, 1787.»4°-

11. Hetzius, Aud. Jo. Lectiones piiblicae. de-
vermihts intestinalibuSf imprinils humanis ; Sto-'
ko:miae, 17*^8, 8°.

43. Zeder, J. G. K. Erster JS^achtragzitr
^aUirgeschichte der Eins;eweideiciirmer von J. A.
E. Groeze ; Leipzig, 1800, 4°.

13. Joerdeus, J. H. Enfomolos^ie und HeU
inintlw^^ogie des menscliliclien ICoerpers ; iii torn.;
Huf, 1801, 1805>, fol.

This magnificent and expensive work, which
comprehends the description of all the human worms,
I have not yet been ai)le to obtain, though I have
desired it, that I might make it known to my rea-
ders.

[To this catalogue may be added the following^
Work in 3 vols. 8vo.

14. Eutozoorum, sive Vennium Intestinaliinti
Historia naturalis; Auctore Carolo Asmundo Ru-
DOLPHT, Philos. et Med. Doct. Hujus in Universitata
Litt. Gtyphiswald, &c. &c. &c. Cum Tabb. iEneis.
Parisiis et Argentorati, et Amstelodarai. 1810.]

S6 NOTES TO TIIET

(S) lu looking over the observations of pliysi-
cians, we see that ■worms have sometimes been found
in the ventricles of the brain fsee p. 41, vesicular
worms J, and even in tlie substance of the brain,

BartJiollmis, Histor. anatom. rar. cent. i. Histor,
64 ; in the tissue of the conjunctiva of the eye,
Mongin; dans la Journal de Medicine, T. xxxii f
in the angle of the eye, acta natur. ciiriosor. V. n.
observ. 116 ; in the nostrils, Angeliniy de verme ad'
mirando per nares egresso ; Ravenn. 1^70, 4°;.
in the sinuses of the jaw-bone, Bordendve, dans les
memoires de l\lc. de Chirargie, torn, v ; in the earS)
J\lorgagni, de sedibus et causis morhorum, etc. E-
pist. XIV. art. 7 j in the breasts, Baldinger^ JSTeves
magazin fiir practische Aertze, Leipzig ; V. B ;
in the cavity of the thorax, Biirseriusy Instit. Med-
"icin. practic. vol. iv. p. 421 ; in the lungs, Redi^
observazioni intorno agli animali viventi, etc. ; m
the heart, Senac, Traite de la structure du coeurj.
de son action, et de ses maladies^ Paris, i77% ton?.
II. J). 437 ; ill the glands of the trachea, Treutler,
Observaiiones patologico-anatomicae, etc. in the
tunics of the intestines, Stoerck, Annus medicus,.
II, p. S^S ; in the epiploon, Wegelin, Observa-
iiones circa vermes ; Argentorafi, i77^:> ^° 7 in the
liver. Acta naturae curiosorum, vol. v. obs. 112 j-
vol, VIII, obs. 10 ; in the panereas, MaucJiart, Lmn-
hrici teretis in diictii pancreatics imperii hisloria
et examen ; Tiibingae, 1738 ; in the kidneys,
Schacher, Pr. de Lumbricis in renibus repertis ^-^
LeipsiaCf 1719. — Blasli, observ at. medicae, rarior.

FIRST LECTURE- «$/

i)bse7n\ XXII ; in the urinary bladder, Brera, SijU
loge ojjusculorum selectorum, etc. ; Ticini, 17i;9)
vol. IV. p. 1. Comm. Jliict. KuJin ; in the uterus,
Merciirialis, de morbis miilierum lib. iv. cap. 2. ,
in the vagina, Brus;nateUi, Giornale Fisico-med-
hco, Pavicif ij^jj, tome iv. 2?. 71 ; i» abscesses of the
abdominal muscles, Acta Helvetica, vol. i. p. 7^ ;
m those of the arms and other parts, Bartlwlinus,
Histor. anatom. cent. v. Hist. 43 ; and even in the
marrow of the bones, ijommevcimn Litter avium ^
J\*orimbergense, ann. 1741,2?. 71*

(3) Some writers have made mention of sever-
al worms peculiar to the human body, of an exter-
nal structure so extravagant, that they have been
questioned by other obsers'ers. Such for example
are the rough bristly raacroc( phalous worm of ^0-
rely Ohservationiunmedico-j/Lysicarum. cent. 11. obs.
70 ; the worm (^ Gaminariis^ J of Fabriciiis Hilda-
niiSy Of era omma, cent. ni. obs. 53 ; the villous and
cruciform worms of Pare, (Euvres, lib. xxiv.
caj). 19 5 the shaggy worm of Gallo, Hell' use del
latte, tome 11. p. 133 ; the worm with feet, of HoJ-
enSf Mfectiium totius corporis hmnani pra.ecipu-
orum Theoria et Praxis, Fraucofuvti, 1664, 4°, p.
S19 ; the worm of several feet, of Heister, Medi-
cinische tmd chirurgische und anatomische iVahrne-
hmimgen : Jiostock, 17^3, 4°, 11, B; the serpents

* It is doubtless by mistake that Dr. Brera makes this ci-
tation here ; for in the observation of Fabricius Iliklanus lie
alludes oalj' to tb.c fatal syinpton>s orr n-ioned bv sw allowing-
a-livi«g lobster. /'. Trii.

Q8 NOTES TO THE

and lizards of Gesner, Historia animal., de qiiadru-
jped. ovijmr. j}. 41 ; the iiorned worm of Salmiith,
observat. medic, cent. ii. obs. 7 ; and muMV others
like them too numerous to relate in this pi<ice.

(4) Before the time of Lhmaeus, physicians
were only acquainted witli tlic liimbricus longus,
lumbricuslatuSj andascaris vermicularis.

(5) In the classification of the human worms,
we should include those only which constantly in-
liabit the human system, the varieties of the spe-
cies, such as those of the taenia, of the lumbrif
co'ides, as well as the worms which, by some acci-
dent, have found their way into the human body,
such as the viviparous gordius^ or crino, the insect
known to naturalists under the name of scolopon-
dre, the fasciola intestiaalis fdoiivej, the gordiu^,
loedinensis fla veine dp medinej the ascarus pso-
ricus, (see the appendix of the principal human
worms,) and other similar worms cannot be said to
be peculiar to the human species, and therefore
cannot make a part of the order of real human
worms.

(6) Vermiiun terrestrium et Jluviatilium Uis-^
ioria, vol. u. jp. 2S,

(7) Cast your eye over the collection of the
principal worms in the annexed plates, and ob-
serve their external structure which is truly admi-
rable in each species.

(8) There have been many disputes among natu-
ralists respecting tlie existence of the brain of worms;
Inifc they have established nothing with certainty oe

FIRST LECTURE. i>J)

this subjecfj unless we consider as a bvain, tliafc
protuberant mass analogous! to the substance of the
spinal marrow, which is seen on the head of some
worms. It is nevertheless certain that these ani-
mals are endowed with sense or feelins;, and there
is suiTicieut reason to believe that they have nerves,
especially since Professor Maiigili has proved the
existence of a nervous system in the Leeich, in the
Lumbricus terresiris, and in other worms of a na^
ture like that of the human worms.

See Brugnatelli, Gioniale fisico -medico, anno
1795 ; torn. u. p. 249 : *^ Be sijstemate nerveo hi-
riidinisj Liunbrici tevvestris, aliorumqiie vermiiim ;
celeberr. viro A. Scarpa, Joseph Mangili.''

(9) The word Taenia signifies a band ; this
worm is also thus named I^^^ause of its flatness,
length and breadth. Latterly Zeder has changed
the name of Taenia to that of Ahjselmenthus.

See Zeder, JEvster J\'achtrag •zur J\f*atiirges-
chiclite der Eingeweidewiirmer, von Goe-ze^p. %'Zi.
fAlyselmenthiis, id est Taenia auctorum.J

(10) Those naturalists, who have admitted
these accidental signs as characteristic marks, and
have founded on them their systematic division of
the species of the taenia, have fallen into an error.
See sections vi and vii.

(11) Traite des Maladies des en fans.

It is probalde that this worm may acquire sucli
a size as not to be contained in the intestines, and
may thus in part be expelled from the body. It
dies, or some, portion of it piitrefies, and is evaru-

?• NOTES TO THE

fitecl with the excrements. This is the real cause
of t!ie expulsiou of certain pieces of the taenia,
without the use of any remedy.

(12) Dissert, de vennibus intesiinalibiis liomin-
um ; etc.

(13) Arzneyen, ii. JB., Langensalza, i^&T-
(.l-i) See pi. I, fig. 1, V. vi.

A (15) See pi. I. fig. 1, a c c d. fig. v, AB, fig. vi.
a h.

(16) See pi. L fig. viii.

(17) Traite de la generation des vers des in-'
testin8,etc. p. 15.

J 8) See pi. I. fig. i. ab,

(ly) See pi. I. fig. vii, f e.

(r20) See pi. 1. fig. vii. ix.

(ti) See pi. I. fig. i, a c c d. fig, iv. a b. fig. v.
AB.

(S3) Let us consider for example the taenia
which Baldinger says he saw, seven hundred feet
in length(§. V). Admitting the neck to be fifty feet
long, its head beiog cut off, and the rest of the bo-
dy observed apart, it would have been taken for
the entire body of a taenia by every observer.
The same uncertainty would ai*ise from the other
part of the body separated from the neck. The
length might lead one into a mistake ; and the same
worm examined superficially, would be described
as two different species. We find this conjecture
realized in a number of naturalists who have divid*
ed the same species into several.

FIRST LECTURE. 7f

(23) See pi. I. fig. iii. fig. iv. c e. fig. v. C B,
and pi. II. fig. i.

(2^) See pi. I. fig. iii. fig.x.

(35) See pi. I. fig. xi. and pi. II. fig. i.

(26) See pi. I. fig. V.

(27) De la generation des vers dans le corps de
Vhomme, etc. T. i. p. 198, S6S.

(38) Historia naturalis et medica latorum liim-
hricorum intra liominem, etc. tab. prima, Jl, B.

(§9) Opere jisico-mediche T. i. tav. 18.
, (30) The work cited, pi. XIX.

(31) AVe are accustomed to attach to things un-
common an idea of singularity which does not ex-
ist ; we even forget all delicacy in order to induce
belief. It has accordingly been imagined that each
joint of a large taenia could live when separated
from its contiguous joint. From this idea has orig-
inated the name of taenia cucurbitina, by which
some have chosen to distinguish one species of the
taenia, since it has been thought that this worm
was formed by the union of a number of vermes
cucurbitinae, or worms resembling gourd seeds.

This error, which for a long time prevailed in
the classification of worms, is now acknowledged
to be incorrect, though it has been countenanced by
some excellent naturalists.

If we conrjider that taeniae, like other animals,
must gradually obtain their full size, it necessarih
follows that their external form must vary with
their age : thus a young taenia must differ from a.
middle aged tannia. and from one of full ac^e or of

72 NOTES TO THE

tbe largest size, though all pertain to the same spe-
cies.

(33) The Swiss, as has been said, are princi-
pally subject to this taenia, which has been describ-
ed as composed of a delicate, lax, and membranous
substance. Linne, Jhnoenitates acedemicae, vol, ii,
J), 7, tah. 1, fig. ii. ; and Pallas, Elenchus Zoophy-
iorum, p. 408, no. 3, call this taenia vulgaris.

The same P.illas in another of his writings,
•Veue J\*urdische Beytrag, I B, I S,p. 54, calls it
taenia grysea.

Goeze, Versucheiner JSi^'aturgeschichte, etc. p.
S96, gives to it the name of taenia memhranacea.

The head of this taenia has not yet been de-
scribed, because it has not been seen. Its length
does not exceed eight arms. Its body is narrower
than that of the flat taenia (unarmed taenia). Each
of the rings has marginal papillae at the sides, en-
closing an ovary in the centre. These are the prin-
cipal characters of this pretended new species of
taenia, I think however with Werner, Vermiiun
intestinaliiun, praesertim taeniae humaniae brevis
expositio, etc. p. 49, that it should be regarded as
fallacious, or as described from badly preserved sub-
jects.

Or may wc not again suppose that it was a flat
taenia, young or poorly nourished, or not yet de-
veloped ?

(33) Authors in their turns have frequently
contradicted themselves while describing its inter-
nal parts.

FIRST LECTURE. TS

111 truth, the generative organs are but very lit-
tle known. The others have not been clearly ex-
hibited, and are in fact but very imperfectly under-
stood.

(31) The time requisite for the fecundation of
the e2;gs has never yet been determined. JBloch,
Traite de la generation des vers etc. p. i^, assures
us that taeniae have eggs before they are four mouths
old.

(35) See pi. IT. fig. iv, v, vi, vii. Bonnet views
them as particles of fat. Andry was the first who
recognised them as genuine eggs.

(36) § xvin.

(^7) The work cited, p. 17.

(38) The work citGi\^ idem.

(39) JDe Ascarlde et Liimhrico lato ; Lugdimi-
Batavorum, 17^9, S°.

(40) Osservazioni de' mcdicl provlnciali di
Svezia, p. 28S.

(41) They bear also cold with iudilTcrence.
Bosenstein, Maladies des enfans, etc. p. 301, after
having left a taenia in a plate for twenty four hours,
put it into a vessel, pouring hot water upon it. The
taenia began to move and to wind about ; he then
bathed it with fresh water; the worm seemed to die.
In this manner he saw it die and revive alternately.

(4*i) Besides the sense of taste, of touch, and of
sight, which have been attributed to these worms by
various writers, Konig, Acta Helvetica, T. 1, is led
to believe that taeniae possess also the sense of
smell.

10

74 NOTES TO THE

(43) Fhylosophical Trans. oftJie Royal Socie-
ty of London, anno 1683, no. 14(3.

(44) See pi, I. fig. iii, c c, iv, c d (1, XVI.
(1-5) Stte Hidler, Artis medecae principes to*

miis III, Hippocrutis de morbis, lib. iv, cap. 16 ;
*' De Lumhricis latis ac teretibus, Lumbricos tere-
tes pareref latos non 'parere, sed abrnmpi ; Lum-
bricorum latoriim ortiis, species et signa diagnos-
tica, et jn'ognostica.^^

(46) Ohservationiim, lib. iii, Basil, 1641,^.883.

(47) De la generation des vers, etc. tome i, p.
195.

(48) Bonnet also called that taenia with later-
al marks or points, which had long joints, and tae-
nia with umbilical marks, that which had short
joints. See his Xraite d^ insectologie, as well as his
Memoir e sur le ver soletaire insire a la page, 47^
des Memoir es Mathhnatiques et Physiques presen-
tes a Vacadamie royale des sciences par divers sa-
'eans, et Ins dans ses assemblees^ tome i, Paris^
1750, 4°.

(49) Linnaeus admits four species of them ;
but one does not belong to man, and this we have
not mentioned, in order not to confound human
v/orms with those of other animals.

(50) Systema JSTaturae, edit, xii, p. OSS, spec.
1. ; " Articuli huic speciei longissimi." Amoenitat.
academicae, vol. ii.p. 7> tab. i,jig. i.

(fil) Systema natiir., p. iS^S ; " Articuli huic
speciei, ex ohlongo quadrate :" Amoon. academ.
vol. ii, p. 7? tab. i}Jig. ii.

FIRST LECTURE^. 75

(5S) Systema nat,,j). 33S1, " Articuli Imic spe-
ceiei brevissimi sextuplo;-' Amoen. acad. vol. ii.
J). 81, tab. 1, fig. iii.

{5S) Elenchus Zoophjtor,, etc. The three first
species are the same as those described by Linnae-
us ; his fourth species is the taenia tenella ; the
fifth and sixth species by no means belong to the
genus taenia.

(54) Versuchiner JS^aturgeschiche der Einge-
weidewiirmer. Tiie taeniae constitute the tenth
genus of the worms of the viscera. The species of
human taeniae, which he has admitted are four;

1. Taenia ciicurhitina ;

2. Taenia vulgaris, grysea Auctorum ;

3. T. lata ; and -i. T. tenella, F alias.

(55) Goeze, the work cited, p. 303, tlms ex-
presses himself: '"The taenia tenella, which Fal-
las saw discharged from several sick persons at
Petersburgh, has great resemblance to the fiat tae-
nia, except that it is more slender, and in some
of its parts more transparent ; I therefore regard it
as a variety of the broad taenia, or as a small flat
taenia, not yet fully developed, or arrived at its
natural size and growth.''

(56) Other writers, for example, consider the
long rings as characteristic of the broad taenia.
Vogel admits them in the taenia solium. No nat-
uralist has yet found the head of the taenia vulga-^
ris. We cannot think with those who have believ-
ed that provident nature has refused to this taenia

76 NOTES TO THE

a part so essential as the head; this is repugnant
to good sense.

Vogcl notwithstanding regarded tins privation
of the head as the distinct and specific character of
the taenia vulgaris.

The existence of the liead was on the contrary,
according to liira, the characteristic mark of the
hroad taenia.

For this reason, Jloederer felt himself compel-
led very puhlicly to remark, that the taenia soli-
nm had a head. Certainly Vogel was not a fool ;
hut sometijies the errors of great men seem to rise
in proportion to their celebrity !

(57) See § VI.

(58) Plater, Andry, and Bonnet v/ere assured-
ly not deceived in admitting but two species of in-
testinal taenae.

As to the taenia, called common by Linnaeus^
gray by Pallas, and membranous by Goeze, vve
must agree with Werner, p. 49 of the work cited,
that it is also a variety of the flat taenia, or a taenia
described from subjects badly preserved. The fol-
lowing reflections of this distinguished observer are
worthy of notice; I here use his own words:
''Quae enim illi (taeniae vulgari) optimi Auctores
diiplicia in alterutra superficiei orificia tribuunt, ex
quodam errore hue convenisse videntur, si quidem
ego gemina tubercula quidem, ad latera posita, nun-
quam vero in superficie, deprehendi. Qnamvis ego
autem is nullo modo sim, qui meas observationes
borum optimorum virorum auctoritati opponere au-

FIRST LECTURE. 77

derenij potui tamen ea propter cum iis non consen-
tire, quoniam uti in multis veris opinionibus, ita
etiain in erroneis Linnaeum nimis presso pede se-
qiii videbantur, quapropter exiiule illos optimos
viros, Linuaei auctoritatem etiam in hoc propriae
experientiae anteposuisse verebar. Non nego duo-
bus tubercuiis instructas Taeniarum species, quae
tamen non ita, uti Linnaeus posuit, mediam super-
ficiem occupant, verum potius ad latera, in utroque
nimirum unum, coUocata sunt.

" Possit ne igitur quadam observantis festina-
tione factum esse, ut ex aliquo exemplo, qui vel
casu uniiis lateris tuberculorum series abrupta erat,
illad soiitariura tuberculum, quod in aliis duplex et
oppositum observaverat, in mediam superficiera
eollocaret, novamque speciem Iritam, videlicet oscu-
lis solitariis, inde conderct ? Qaae mea qualis cum-
que conjectura eifecit ut latam cum vulgari con-
jungens, banc tantum ceu unicam verara speci-
em describendara esse existimavera.'' The same
GoGZP, Versucheiner Naturgeschichte der Ein-
geweidewiirraer, etc., p. 296, affrms, that he has
no knowledge of this common or membranous
taenia.

Supported by the authority of Linnaeus and of
PallaSy he admits it into the class of human taeniae
published in his work. It is proved then that the
taenia tenella, sec § Xill, J\'*ute 35, and the taenia
vulgaris pertain to the flat taenia. There are but
two real species which can be regarded as distinct

rs NOTE* TO TilK

and cliavaetistic among the taeniae observed in the
livins: human bod v.

(59) This has been described by authors under
difterent names; they have called it, 1. Vermis
ciicurbitinuSf Plater, Praxis medica, f. 99^;
Chaine de cucurbitains, Vallisneri, Opere jisico-
medichef tome i. P' 177 ; Cocchi, dei Vermi cocur-
biiini delV uomo ; Pisa^ 17^8, 8°.

2. Taejiia without thorns, fepinesj Andry, de
la generation des vers, etc. tome i, chap. 8.

3. Taenia with long rings, Bonnet ; see Jour-
nal de Physique, an 1777? avril, p. 257 j Goezep
Versucheiner Jfaturgesch., etc., p. :S69.

4. Taenia cuciirbitiua, Pallas, Elenchus Zoo-
phytor., p. 269, no. 1, Dissert, de infesiis, etc. p.
38, no. 4 ; Goeze, the work cited, p. l60.

5. Taenia solium. Linnaeus, Systema J^atU'
rae, edit, xii, p. iS^S. sp. i, Werner, Vermium
intestinalium praeserfim taeniae humaniae, etc.
p. 18 ; Taenia solitaire, Leslie, Elimenti di StO'
via J^atnrale, vol. ii ; Milano, 1785, p. 233 ; sol-
itary worm, Bloch, Traite de la Generation des
vers, etc., j)- 4^'

6. Taenia articulos dimittens, Diouis, Disser-
tation sur Ic Taenia ou le Ver plat ; Paris, 1749, 8^

7. Lumbricus latus, Tyson in Philosophical
Transactions, etc., no. 146 ; De Haen ratio me-
dendi, p. xii., cap. 5, p. SIO ; Leclerc, Historia
naturalis, et medica Lumbricorum latorum, etc. ;
Marx, observata quaedam medica ; Berolini, 177^>
8^. p. IS.

FIRST LECTURE. 79

(60) See Heyde, Experimeyita circa sanguinis
missionem ; Jlmstelodami, I6b6, 8°. p. 4*7; Tyson
in Philos. Trans. I66S, tab. 1 ; Vallisneri, the
work cited, tab. 18, 19 ; LeclerCf the work cited,
tab. 1, a, tab, S, b ,• Linnaeus, Amoenitates aca-
dem. tome 11, fa&. 1,/^. i. ; dndry, the work cited ;
Limbiirg, in Philos. Transactions, I766, jp. 128,
ifa6. 6 ; Marx, the work cited, fig. A.

(6i) ^ee ^ VI!, p. 9.

(65i) Linnaeus, Amoen. Academ., etc. ; and
Dr. TJnzer ; see Tentamen herpetologie^ auctore,
J. T. Klein, accessit J. A. Unzeri Observatio de
Taeniis ; Leidae et Gottinguae, 1755, 4°., p. 67,
declare that they have found this same species out
of the human body. These observations excited
animated debates among the naturalists, to decide
whether human worms were innate in man, or
whether their eggs were introduced into the human
system with our food. See the second Lecture.
The taeniae which are nourished in the human
body acquire so great a size, that they are never
seen of like magnitude in other animals ; it is for
this reason that the human taeniae are peculiar to
our race.

(HS) The articulations or internodes of the neck
of this taenia have great resemblance to very small
folds., See PI. I, fig. i.

(04) Plate 1, fig. ii, xvi.

(65) Plate I, fig. iii. The largest articulations
have this peculiarity, that their figure no longer
presents a paralcllo£;ran}. but rather a trapezium

80 NOTES TO THE

with a truncated extremity in the lateral part to-
ward the head.

(66) PI. I, fig. xi.

(Hr) PI. I, fig. X.

(68) As they are seen in aged taeniae. See
Vallisnerif O^ere Fisico-mediclie, T. 1, tav. 19, jp.
177.

(69) See § IV, Goeze, Versuclieiner Jfatiir.
der Eingeiceidswiirmerf etc., p. 278, remains in
some measure in doubt on the vague and incon-
stant appearances of the articulations of this taenia,
as he has subdivided his taenia cucurbitina into
two species ; he called the first taenia cucurbitina
grandis saginata ; and the second, taenia cucur-
hitinaf plana, pellucida.

After a deliberate examination of these two
taeniae, for they are preserved in the museum of
natural history of the university of Pavia, w ith the
collection of other worms made by this illustrious
naturalist ; I believe the first species to be a tae-
nia cucurbitina more advanced in age and better
fed than the second.

(70) See ^ VIII. The articulations of the wi-
dest extremity of these taeniae may be easily sepa-
rated from each other.

It was from this circumstance thati)/ow2S nam-
ed them taeniae articulos demittentes.

According to Block, this separation has been
the source of numberless errors. The Arabian
physicians, and after them several moderns, among
whom we find Vallisneri and JRosenstein, recog-

JTRST lecture. 81

nised in the articulations a particular life, and af-
terward distinguished by the name of Yerraes Cu-
curhitinae, on account of their resemblance to the
serds of the cucumber.

(71) Devenamedinensi; Augusta Vindel.iQ7%
p. 230.

(7^) Amnenitates academ.nVol. u^p. 85.

(73) Observat. medic, cent. i,observ. 59.

(74?) Observat. lib. xxvi, cap. 33.

(75) The work cited, pi. III. fig. iv.

(76) Program, de Taenia, Goettingiie, 17^;
4°.

(77) See pi. T. fig. i. c, b. It is preserved ia
the Museum of the University of Pavia, where the
two appendages of the head, in form of fangs or
crotchets, are still clearly visible with the naked
eye. I notice these appendages, because Werner^
Vermium intestinalium praesertim Taeniae hiuna-
nae^ etc. f. 25 asserts, that these crotchets are real
blisters f ampoules J situated laterally on the cen-
tral papilla, still called the middle canal of the
head.

(7B) We follow the central papilla within which
the tube is concealed. See pi. I. fig. viii, C; 15
See Werner in the work cited, p 2Q — 31.

(79 j See pi. I. fig. viii, abed.

(SO) These canals are not interrupted at each
ring, as has been believed. If a taenia is macerat-
ed in a coloured fluid, the whole extent of the ca-
nals is coloured in proportion as the fluid has filled
them.

11

82 NOTES TO THE

(81) See pi. I. fig. xi, d e.

(S^) See pi. I, fig. iii, xi.

(8.3) EpistolaadAndryum: iu the Journal des
Savans, av. 1731, jp. 446.

(84) Dissert, de Taenia canis, Patavii, 1758,
8°.

(S."") J\^oi^dische Beytrage, i Band^ p. 52.

(h6) Werner supposes the contrary, the woi^k
eited, p. 33.

(87) These parts are, according to Goeze, so
many ovaries full of eggs. See pi. II, fig. vii.

(88) We may view, says Block, Traite de la
generation des vers, etc., p. 46, as a peculiarity of
this species, the ovaries resembling the form of a
trunk, from whose* sides issue branches, which are
the more visible, as the skin is white, thin and
transparent.

The same observer is convinced that these ram-
ifications are real ovaries, because if we compare
them, the eggs advance toward the marginal pa-
pillae.

These observations, related by Werner iu his
w'ork which we have quoted, are worthy of atten-
tion. Seep. '^\ and following.

(89) Versiicheiner JSTatiirgeschiclite der Ein-
geweid., etc., p. S79.

(90) The articulations of about half the body
rise toward the head ; and besides that they have
no visible marginal papillae in their internal sub-
stance, they present an immensity of very small
atoms, which are, according to the conjectures of

FIRST LECTURE. BS

Pallas , J^ordische Beytrage, S Band. p. 77? must
probably be so many of tiie future embrios of the
ovaries.

(91) See-i^]. II, fig. ii, a b.

(9.e) See pi. II, fig. iii.

(93) Alternate papillae. See pi. I. fig. iii.

(94) Irregular papillae. See pi. II, fig. i.

(95) Maladies des enfans, etc. p. 500.

(96) See note 88.

(97) Versiicheiner J^atiirgescliichte, etc. p. S74.
This celebrated observer aflBrms, that he found a
taenia sucking, and was thus assured that the lat-
teral papillae of this worm serve also for nutrition.
Rosenstein, Traite des maladies des enfaus, p.
30S, had already remarked, that this taenia attach-
es itself firmly to the parietes of the intestines with
its papillae, which lie considered as absorbing ves-'
sels.

(9^) See note 88.

(9y) Except Vallisneri and Linnaeus, they
took the ovaries of the taeniae for so many chy-
lous vessels, their eggs for large and small glo-
bules of fat.

(100) See § YIII.

(101} JSTeve JVordische Beytrage, 1 Band, § I,

p. m.

(103) Vermium intestinalium, etc. p. dS3, tab,
t>, fig. 37.

(103) See §, VIII, Bianchi, de generatione
vermium, p. fidS, was one of the first to assert, that
each articulation of the taenia was hermaphrodite.

84 NOTES TO THE

(104) This manner of feciuid.iting the eggs,
though it seems extravagant, is n<it beyontl nature,
since we know, from the beautiful experiments of
S^allanzani, that frogs are thus fecundated, etc.

(105) Linnaeus, System, iiatur. edit, xii, p.
33?.4, spec, 4; Pallas^ ElenchiLS Zooiihytor.^ p.
450 ; Dissertafio de infest'is viventihusy etc. j?. 85,
no. 4 ; Lioch, Traite de la generation, etc., xvi.
species de Vordr. 1, p. 38 ; Goeze, Versucheiner
JK^atiirgeschichte, etc. no. 3, p. £9S. Plater, Prax-
is tnedica, cap. 14, names it Taenia prima.

Jlvdrij, de la generation des vers, T. 1, chap,
iii. art. 2, called it Taenia with thorns, (Taenia,
a epines,J

Bonnet in the Memoires de Mathematiques et.
de Physique presentes a Vaccademie royale des sci'
ences, etc., T. 1, p. 418, gave it the name of Tae-
Tiia with short articu/ations,

Dionis, Dissert, de Taenia, called it, Taenia
articidos demittens,

Leske, Elementi di Storia naturale, etc. vol. ii,
p. S33, Werner, Vermium intestinaliiim, etc. p. 49,
have described it under the name of Taenia vulgaris.

Bonnet, in another memoir inserted in the Jour*.
Tial de Physique, anno 1777? p. 26S, again gave it
the name of common taenia,

(106) Memoires Mathematiques, etc., torn. i.
p. 478.

(107) See pi. I, fig. v, vii, ix, xii, xiii, xiv, xv.

(108) " Taenia lata, Candida, articulis brevissi-
mis, medio-nodosis, uniosculatis. Corpus longie-

FIRST LEGTUHE. 85

simum. Articuli multoties breviores latitudine cor-
poris transversini striati, medio glandula tumidi.
Oscula ab altero latere corporis, in media glandu-
la in idem latus turaidiore, solitaria/'' See Pal-
laSj the work cited.

(109) See pi. I. fig. iv. The rings seem to be
circumscribed and long, as in the taenia cucurbiti-
na. We canuct deny this even with the naked
eye, but if one of these articulations is subjected to
the microscope, as Marx did, Ohservata quaedam
medicay etc., fig. D. we shall perceive that it re-
sults from other short rings, not differing from those
of the true flat taenia. It is possible that this tae-
nia is very young, badly nciirished, or not yet de-
veloped. " I must remark,'^ says Bloch, Traite
de la generation, p. 89, ^^ that the articulations of
this taenia sometimes ciccjuired the length "of an
inch, etc."
' (110) See ^ VII.

(IJl) Vermium intestinaliuin, tab, 3, fig. 47,
p. 135.

(11;^) Epistola ad Andryum jam cit.

(113) See pi. I. fig. ix.

(il-1) See pi. I. fig. V. c c c c c.

(115j See pi. I. fig. xii.

(116) The difference of tlie taenia cucurbitina
is, in some papillae, situated on one side only of
the rings.

(117) -Se^ pi. IT. fig. iv.

(118) Memoir, de Mathemat, etc, T, 1.

8G iNOTES TO THE

(119) ^eve J^ordlsche Beytrag,^ 1 Band. 1 sf.
p. 64, no, 4.

fl^iO) .Sfr'e pi. III.
(131) iS^ef^pI. II. fig. viii.
(l<2^^) .^eepl. U.fig.ix.

(123) Traite de la generation des vers des in-
testins, etc, 2 species, p. 52.

(124) Block, the work cited, p. 56.

(IS^i) Miscellan. natar. ciiriosor., dec. i^ ann*
vii. observ. 206.

(126) Ilistor. anatom. rarior., cent, ii, observ,
87, i?. J:93.

(127) Philos. Trans, of the Hoyal Society of
London, S. V. XVIL no. 193, p. 506.

(128) Sptema naturae, edit. xii. j). 1320, no. 5.
(14*9) Elenchiis Zoojjhijtor., etc., no. 413.

(130) Versucheiner J^aturg. etc. p. 248.

(131) Taeniae hydatigenae in j)lexu choroide^
inventae historia, etc. ; Lipsiae, 1780, 8 ,

(132) Vermium intestinalium, etc., p. 66.

(133) This being the only worm found in tlie
human body, (at least we know no other at pres-
ent,) I leave it the name of hermit, given by Block,
Traite de la generation, etc. p. 52, merely to dis-
tinguish it from the otlier vesicular worms which
are noticed in the body of animals.

I have not adoptetl the name of taenia kydatiSf
given to it by Pallas, nor those of taenia hydatige-
na and taenia vesicularis, used by Werner, Fis-
cker and Goeze, because all these are more pro-
per to designate the vesicular worm, resembling

FIRST LECTURE. 8*

the taenia wliich is sometimes found in the liver of
field mice, and the domestic mouse. See Block,
the work cited, p. 51, the first species, the taenia-
form vesicular worm, the name of cysticerci, late-
ly given by Zeder, Erster nachtrag zur vaturg.
der eingeweidewilrmer, etc. p. SOS, is equivalent
to that 1 have retained.

(IS-l) In the brain, Ludwig de hydrope cerebri
puerorum, Lipsiae, 1774. Hufeland ueherdie na-
tur, erkenntrissmittel und Heilart der skrufelkran-
theil, Jena, 1795, p. 3S9. Weikard Vermischte
med. che Schri^ten v st., p. 74, 76. Medical facts
and observations, London, 179-3, vol. iii. In the
liver, Baillie^s Morbid Anatomy, London, 1793,
no. 9. Under the pectoral muscles, Werner, Ver-
mium intestin. brevis expositionis rontiniiatio se-
cunda, ciirante Fischer, p. 7- In suppurated ab-
scesses, Hunter, in the Transaction of a Society
for the improvement of Medicine and Chirurgical
knowledge, London, 1793.

(135) Melanges, par le societe des Curieux de
la nature, a Berlin, vol. i. j;. 350.

(1.^) Bloch, Traite de la generation des vers,
^. 54.

Zeder, the work cited p. 310, Professor WaU
ter assured Bloch, the work cited, p. 51, (hat in ex-
amining some dead bodies, he saw a numbt r of hy-
datids and vesicular worms pass out of them.
Werner, however, in the work cited, p. 68, hav-
ing examined tiie membrane of the hydatids^ did

8S NOTES TO THE

not find it organized, as I found it in the vesicular
worm which I had occasion to observe.

(138) J^^ordische B<:ytrage, 1 band, p. 84, de
Hap/nratio medpnii, f. 3, vot. ii. cap. 16, §> II ; Ma-
raud, in the Memoires de Vacademie de Paris,
1"^:J3, p, 158 ; Wagler, lib. de Morbo mucosa, Gai-
tingae, 1763, p. J 90.

(139) Sometimes hydatids are true varices of
the lymphatic vessels. Sommering de morbis va-
sorum absorbentium corporis humani, Trajecti ad
Moenum, 1795, ^ XXII.

(140) It is well to have them before our eyes to
form exact ideas of the structure of the vesicular
human worm. See pi. II, fig. x, xi, xii, xiii, xiv,
XV, xvi, xvii.

(141) .See § XXIV.

(143) Dissert, de morbo mucosa praesidae, 1 g.
Roederero, Goettingae, 1762, 4\

(143) Handbuch der JSTaturg., etc., p. 410.

(144) It has been pretended that Mdravando
had given the description of this worm under the
name of small lumbricus. A minute examination
of his figure of this worm, clearly proves that he
did not intend to speak of the tricocephalus, but of
the ascaris vermicularis.

(tl5) Vermium intestin. etc. p. 84; ascaris

trichuira.

(116) Wagler, Dissert, de morbo mucosa, etc.

(147) Linnaei, Mantiss.jt*5^d, Werner^ ver-
mium intestinal, etc. p. 84.

FIRST LECTURE. 89

(148) Pallas, JSTeue nordiscJWf Seytrage ijBanA
if sriick, p. 3, no. 21.

(149) Leske, Elementi di storm nat. parte prU
ma, vol. ii. p. 231, no. 3.

(150) Tricoceplialos qt capillary head.

(151) This worm constitutes the seventh ge-
nus of Block, Traite de la gen. etc. p. 7~> and the
second genus of Goeze, in the ivork cited, p. 113.
The former speaks of one species only, that is — of
the human; the second describes a tricocephaius
with the simple head (others reckon three species of
them besides the human,) and one other having
the head with fangs, see % XXXIV.

(153) I say more frequently, because Bloch
has sometimes found it extended in a spiral line ia
the human coeciun, as may be seen in his work al-
ready quoted, pi. IX, fig. viii. The form of this
worm is very clearly represented in pi. IV. fig. i, ii.

(153) See pi. IV, fig. iii. 1 ra.

(154) Satura observationum de animalcalis in-
fasoriis, Goftingue, 1765, 8°, p. 6.

(155) Commentaria PetropoUt. etc. vol. xix,
p. 449.

(156) In the i2th part of his JWtur forscher,
p. 183.

(157) Versuch. JSTatiirg. etc. p. 115.

(158) See pi. IV. fig. iii, a.

(159) Vermiiim intestin. etc. p. 85,

(160) See pi. IV, and compare it with fig. i.

and ii.

IS

m JsOTES TO THE*

(161) See pi. IV, fig. iii.
. (15;3) See pi. IV, fig. iii, 1 m.

(163) See pi. IV, fig. iv.

(164) ^^Ovariuni magnum, elong^^.tum, globulis
minimis (ova cnim expriraere baud potui,) perfu-
sum, tiibo ab utraque extremitate instructum est.
Anterior varie flexa, ct inter intestina contorsta ;
posterior vcro spiralis sub initiuro partis filiformis
perditur.'*' See Goeze, Versuch. etc. p. ii5.

(165) See Goeze, the work cited, p. 116.
" Fragment of a letter of Dr. Wagler to Counsel-
lor JVichmaniif de Hannover.^^

(166) See pi. IV, fig. v.

(167) Comment, PetropoUt. vol, xix. tab. 10,

(168) See pi. IV, fig. vi.

(169) Versuch. etc. p. 123.

(170) Werner, Vermium intestinaliuntf etc. p.
72, says that the symptoms produced, whether by
the ascaris vermicularis or lumbricoides, are near-
ly the same.

I pray the reader however to bear in mind all
that has been said in the third Lecture on the varie-
ty of the symploais occasioned by these different
worms.

(171) It is however to be observed, that the as-
carides vcrmiculares being vivipcrous, and the luni-
biico'ides oviparous, have by naturalists been im-
properly ranked under the same genus.

(17^) Jiscaris vermicularis^ Limiaeus, System.
JS\tur. p. 1076 ; Eloch, Traite de la generation

FIRST LECTURE. 91

des vers, etc, p. 69, Sd espece. AVcrner, Vermi-
tun intestinal, etc. p. 7^ ; Jlscavis pollicaris, Lin-
naeus, Fauna suecica, no. 1S09 ; Ascaride, Vallis-
neri, opere Fisico-mediche, etc. torn, i, tav. "20, p.
178; Vermis Ascaris, Clerici historia Luihhrico-
rum latorum, etc. fi^. x. ; Ascaris graecorum, Pal-
las, Dissert, de iufectis viventibus, etc. ; xiv, p. IS 5
Ascaris cauda setacea, Midler, historia veim.\jlu'
viatil.f etc. no. 165 ; Ascaris vermic. cauda suhu-
lata, Goeze ; Versucheiner, J\*aturges., etc., p. 97;
Fiiseragnolo vermicolare. Leclce, Elimenti de Sto-
via naturale, etc. parte prima, vol. ii. p. 230.

(173) Observationes chirurgico-medicae Q^iied'
limburg, ±70% 4°. lib. 2,oos. iv.

(174) Dissert, de Ascaridibus et Lumbricis la-
tis, etc.

(175) Vandoeveren, Dissert, de vermibus in-
testinalibus, etc., is desirous of proving that the as-
caris vermicularis is nourished by the chyle which
IS not absorbed by the lymphatic vessels, but blend-
ed with the excrements.

But as this worm is found in the vagina of wo-
men, and in other parts moistened by the mucous
fluids, we must rather believe that our worm is
more closely connected with the mucus, etc.

(176) Historia pliysiologica Ascaridum, Leo-
wardini, 1763, 8 \ c. tab.

(177) Versucheiner JSTaturges. etc. p. 103.

(178) See pi. IV, fig. vii.

(179) See pi. IV, fig. viii. ix.

(180) See pi. IV, fig. ix. i.

«2 NOTES TO THE

(181) Seepl. IV, fig. viii, k 1.
(183) See pi. IV, fig viii, h i.

(183) Vermium intestinal, etc. p. 7% tab. 5y
Jig. 138.

(181) See pi. IV, fig. ix, k.

(185) See pi. IV, fig. x.

(186) See pi. IV, fig. xi.

(187) Versucheiner J^aturges. etc.ji. 103, 108.

(188) Goeze, the work cited, p. 109, Fiinste
anmerkung.

(189) Ahliand lung nouder Erzung, der Wiir-
mer in menscliilchen Corper, JlalUf 1718, 8°. pv

(190) Sijstema J^atiiraCf edit, xii, j7. 1076-

(191) III order to possess a figure of the lum-
biico'ides similar to the lumhricus terrestris, see
Tijson in the Philos. Trans, vol. xiii, anno 1683,
no. 147, this worm has been called ascaris lum-
hrico'ides, Linnaeus, the work cited ; Block, Traite
de la generation, etc. p. 63. Midler vermium terresi
trium et Jiuviatilium historia, etc. p. 35, no. 166 ;
Werner^ vermium intest^ etc. p. 7^- Lumhricus
intestinalis ; Pallas, Dissert, de insutis viven-
tihus, p. i5, no. 4; Lumhricus teres, Clereci,
historia nat. et medica lutorum lumhricorum, etc.
p. S24 ; Lumhricus intestinalis humanus teres,
Klein, tentamen herpetologiae, etc. p 62. Ascaris
gigas horainum ; Goeze, Versuch. J^aturges. etc.
p. 65. Fuseragnolo liomhrico'ide, Leske, Elimen-.
ti di storia nat. parte prima, vol.W. p. £30 ; Fu-
^arla Lumhrico'ides hominum ; Zeder, Erster

FIRST LECTURE. 93

nachtrag %ur JVatuvges, der eingeweidewurmer,
etc. J)' 26.

(192) Tyson, in Philos. Transactions , etc.;
Pallas, Dissert, cit. p. 13, no. 4.

(193) Willis, Exercitationes de anima bruto-
rum^ J). 201, edit. gen. Redi, osservazioni intor-
110 agli animali viventi, etc. jt. 133.

Those writers who have mantaiued that the hu-
man lumbrico'ides was exactly like the lumbricus
terrestris, have certainly been inattentive to the
species of the former, which are male and female,
while in the latter the worm is hermaphrodite.

(191-) Zeder, Erster nachtrag., p. 2G, has sat-
isfactorily made it appear that all the signs detailed
by writers in order to settle the points of distinction
between the human lumbricus and that of horses
and hogs, are equivocal.

(1Q5) Opere Jisico-inediche, tome i, p. 281.

(196) Epistola cit. ad Jlndryiim, etc.

(197) See pi. V, % i.

(lyS) Versuch. JSTaturgeschichte, etc. p. 67.

(199) Vermium intestinalium, etc. p.^Q; see
pi. V, fig. V.

(200) See pi. Y, fig. i. One of these fibres is
longitudinal and dorsal, the other abdominal, and
the two others may be called lateral.

Each fibre is composed of smaller filaments.
Vallisneri thought he discovered several dark
points in these, which he called spiral.

Van-Phelsum has fully demonstrated the fal-
lacy of this observation.

94 ^OTES TO THE

(201) See pi. V, fig. i. a.

(-202) See pi. V, fi§. iv.

(SOS) Ofere fisico-mediclie, tome i, tav. 34.

(204-) Versnch. naturges. etc, p. 67.

(205! This lurabrico'ides was five inches long.
The observation is from Dr. Maecker ; see Blocli,
Traite de la gen. des vers, p. 66.

(^06) Ludwig, Programma de Liiirihricis in-
testina perforantibus, Lipsiae, I762, 4°.

(*.'07) Blasii, Observationes medicae rariores,
Amstaelodamif 1677^ IS, j?. 79, observat. 10, p. 80,
obs. 12.

(208) In the brain of a sea calf ; see Block,
Traite, etc. p. 6f>.

(509) Schiiltz. Dissert, de Lumbricis effractor-
ibus, Halae, 1740, 4°.

(210) Traite des maladies des enfans, etc. p. 306.

(211) Vel. Acad. Handl. 1763, p. 113.

(212) Benivenius de abditis, etc. cap. 86,

(213) Mouteti, Theatrum insec.p. 299.

(214) Peredia de curandis morbisj etc. lib. 1,
cap. V.

(215) See pi. V, fig. viii.

(216) See pi. V, fig. ii, iii.

(217) Tractatus de anima brutorum, etc. lib. 1,
cap. iv.

(218) Werner, Vermium intestinalium, etc.
p. 79^

(219) See pi. V, fig. ix.

(220) See pi. V, fig. ix.
S21) Vermium intest. p, 80.

. IFIRST LECTURE. 95

(SSS) Bihlia naturae, p. 796,80,3.
(233) Ojmscula minora, Lipsiae, 1783> p* 131.
(324) See pi. V, fig. xi.
(225) Vermium intestinalium, etc. p. 82,
[z2Q) Miscell. Berolin, torn, iii, p, 47, torn,
VI, p. 139.

(237) See pi. V, fig. vi.

(228) See pi. V, fig. vii.

(229) AmatiisLiisitaniis, Curation ; med.cent.
5, no. 46, p. 513, relates the observation of anoth-
er physician, his cotemporary, who, by means of a
suitable remedy, succeeded in expelling from the
body of a patient, a very long lumbricoid worm.
Its head was crushed to pieces and other worms
€ame out of it.

Borel, Observationum medico-physicarum, cent,
1, ohs. 89, speaks of another lumbricoides which
he observed to be full of an immense quantity of
small worms. A similar observation has been sent
to us by Plater^ Observationum, lib. 3, p. 657,
and by Panarolo, Intrologismorum pentecostae
qidnque, Romae, 1653, 4°. obs, i5.

Thus has the imagination of several observers
been sometimes surprised, though they have been
enlightened men.

(230) Descriptio et iconica delineatio novi gen-
eris vermium stomachidae dictis in corpore huma-
no hospitantiura ; Accidit observatio medico-prac-
tica de Lumbvico per urethram excreto, nee non de
Lumbrico alvinout utraortuoparturiente ; Amstelo-
dami, 1780, b''.

96 NOTES TO THE

(231) We mast except the Ascarus scabiei,
since this, being the special cause of a peculiar dis-
ease of the skin, should be particularly considered ;
see Bonomo, Observazioni intorno ai pelli celli del
corpo umano. Florenza, 1683 ; Linnaei, Amae-
nit. acad.y vol. v. no. 82 ; Morgagni de sedibus et
caasis morborum^ etc. epist. L. v, art. 4 ; WicTim
mann Jletiologie vonder JCraze, Hanover ^ 1786 ;
Ilartmann, Dissert, sistens quaesliones super
Wichmanni aetiologiam scabiei, etc. Francofurti,

1789, 4°.

(S33) Happii, vermium intestinal* hominis Jiis-
toria, p. 7j § IV.

(233) See the note, no. 33.

(334) Giornale Fisico -medico, Pavia, 1795y
tome IV, p. 71«

(335) Traite des Maladies des enfans, etc,
p. 304.

(3 16) Goeze, VersucJi. JVatur^es. etc.p.'Ji*,
Werner, vermium intestinalium, etc. p. 87 j doc-
tor Pereboom, a physician of Amsterdam, pretend-
ed that he had discovered a new kind of human
worms, Descriptio et iconica delineatio novi gene^
ris vermium stomachidae dicti, etc., which accord-
ing to him inhabits the stomach ; this worm is of
a darkish colour, and seems to possess a more com-
pact texture than that of the lumbricoides.

Goeze and Werner have however made it ap-
pear that this stomachic worm is a real lumbricoi-
des, which may b& a little different in some of its
parts.

FIRST LECTURE. 97

(S37) Fasciola intestinalis Linnaei^'Sy sterna na-
turae, edit, xii, p, I078 ; Dr. Montin expelled
this worm from tlie body of a woman, and gave a
descriptiun of it in the Memoires de VAcadamie
Rnyale des sciences de Suede, in i*^Q3,p. 11^, etc.
This worm is found in the human body, and Sme-
%io had already spoken of it, Miscellan., p. 563.
See Goeze, Versuch. natiirges. etc, p. 186.

(238) Werner, Vermium intestinal, brevis ex-
posit. Contin. etc. p. 19.

(^89) Block y Trait e de la generation des vers,
etc. p. 68, 71-

(340) We have in the Traite des Maladies des
enfans, of Jlosenstein, an excellent description of
this worm : see also Block, Traite de la gen. etc.
p. 73 ; Goeze, Versuck, natiirg. etc. p. 1S3 ; Wer-
ner, Vermium intest. b/evis exposit. Contin. etc.
p. 5. When this worm insinuates itself into the
stomach it is very dangerous.

(241) Brera, Sijlloge Opuscidorum, etc. vol. iii.
Ticini, 1799, p. 254 ; opuscul. 5, de morbo Yaws
dicta et de vena medinensi. etc.

(S43) Aiict. ad Ilelmintkologiam cor'poris ku-

mani, Lipsiae, 1793, p. 19, 22, tab. 59 ; Zeder

calls it " Polystoma sphincteribus sex, pinguicola,

depressum, postice acuminatum sphincteribus sub

inargine antico retractililunatim positis, cauda cur-

vata ; habitat in adipe pone ovarium humauum ;''

Erster, J^Tacktrag, etc. p. 203.
18

9» NOTES.

(S43) Goeze saw two of them expelled from an
infant who died of atrophy ; Versuchemer JVatur-
geschtchte^ etc. p, 103.

END OF THE NOTES OF THE FIRST LECTURE.

SECOND LECTURE.

THE ORIGIN OF HUMAN \V0R:MS.

§1 LVII. The pliilosopliei\ surrouudecl by a
multitude of imraeose objects, has always sought
to raise that mysterious veil, wliich conceals the
cause of the most surprising phenomena of nature.
It is thus that the first useful discoveries have aris-
en ; these have opened the way to researches still
more wonderful, by the aid of which the fact has
beeu established, that natural things have between
them an affinity more or less remote or immediate,
direct or indirect.

The continued examination and assiduous study
of the great book of nature, have enabled us to es-
tablish several primitive laws, and led us to adopt
a number of immoveable principles, of which the
man of genius avails himself in order to elucidate
various phenomena peculiar to living beings.

Guided by this method entirely analytical, and
conducted by experiment, we arrive at just relations,
unequivocal analogies, and solid points of union.

In conformity to these philosophical principles,
I have laboured to investigate the prime origin of
those worms which inhabit the human body.

too THE ORIGIN OF

This subject, divested of the hypotheses of nat-
uralists, and treated with the evidence of facts,
merits the full attention of physicians, since it di-
rectly iujiuences the diagnosis and cure of vermin-
ous and other severe asthenic diseases.

§ LVIII. The origin of worms, not only in
man, but also in other animals, has been the theme
of profound meditations among the greatest natur-
alists and most eminent physicians.

On this subject tliire have been many disputes,
and much writing, and some have imagined that
much had been observed ; but little however has
heen determined, while it has, in fine, been judi-
ciously concluded to hold as doubtful ail opinions
liUhcrto adopted(« ) by the most fortunate observ-
ers, since they rest on suppositions which, though
ingenious, are rather slippery than solid.

§ LIX. Excepting only the vesicular worms/
the structure of all the other human worms has
not yet i)een suijicientiy studied. Iience we have
seen some of them furnished with the parts which
constitute both sexes ; others having both individ-
uals united in one, as the taeniae ;[^) while some
exhibit these parts distinct in the difierent individ-
uals, as in the ti icocephalus,(^} the a^cM-is vermic-
uluris.(4<) and the lurabricoides.(i?) This would
be saying that our worms, like all other living be-
ings less imperfect than they, proceed from eggs
peculiar to the analogous species. (6)

In effect, some multiply ])y depositing their
eggs, to be afterward fecundated by the passing of

HUMAN WORMS. iOl

the male without any preceding copulation : others
propagate by the union of the two sexes ;{7) while
a third kind fecundate themselves like the tae-
niae.(8) See the first Lecture,

These observations which have been many
times repeated and verified by approved writers,
leave no doubt of their correctness ; they are di-
rectly opposed to the equivocal generation admit-
ted by various naturalists as a cause of the origin
of our w,orras.(9)

We readily agree that the simplicity of the
structure of worms should exempt them from the
ordinary laws, relative to the functions of their
life.

It would however be improper to attribute their
birih to some more simple combinations, which
some persons have supposed they have seen by
means of the microscope, (10) in comparison of oth-
er more perfect beings, while the organs which
serve for their reproduction arc visible.

Neither the sex, coition, nor the eggs, nor gen-
eration were known to Aristotle and the ancient
philosophers, as they are known in our time. In
those remote ages, no other generation for imper-
fect beiugs was acknowledged, tiian the corruption
of substances.(ll) Putrefaction must then have
been considered as the cause of the existence of
these individuals.

At this period there was nothing more ingeni-
ous than the doctrine of equivocjjl generation, in-.

log THE ORIGIN OF

vented for the purpose of finding a cause for the
creation of animals !

Nevertheless this sublime hypothesis, to which
some have pretended to give weight in our day, af-
ter the surprising observations oU^eedham,{V^) and
the metaphysical reasonings of the very ingenious
jRez7,(13) seems by no means applicable here, since,
I repeat it, the generative organs of v.'orms, are
very evident, as well as in the more perfect animals.

^ LX. The quantity of eggs which worms de-
posit in our bodies, being prodigious, it must fol-
low, add the anti-ovarists and tlie partisans of pu-
trefaction, that in every man an immense number
of worms mu^t be developed, which is contrary to
experience.

This sage reflection, far from overthrowing the
system already confirmed respecting the origin of
worms, favours it in all its extension ; and, in my
opinion, it proves nothing, unless it be that certain
determinate circumstances are necessary to facili-
tate the development of the eggs and the rise of
worms. Koscnstein has pointed out these circum-
stances so well that it is proper to give them in his
own words :(14) "The eggs which are deposited
by human worms in our intestines are developed,
1. when there is a moderate heat; 2. when they
are not carried out of the body, which is often pre-
vented by the agglutinating mucus of the stomach
and intestines, especially when they are situated in
the folds of this canal, and when they are not dis-
placed by the peristaltic or antiperistaltic motions of

Human worms> los

these viscera, nor by tbe pulsations of the arteries
which pervade their texture : 3. when they are not
injured by the vapour which is continually diffus-
ed through the stomach and intestines by theexha-
lant vessels. In like manner sown Avheat does not
vegetate if it is inundated by incessant rains/''

^ LXI. Children, women, and persons of soft
and weak fibres, are more subject than others, to
worms. In asthenic diseases, according to practi-
tioners, worms are frequently voided with the fe-
ces, or discharged through the mouth. (15)

Cnildren who have suffered the operation of
cutting for the stone, are often tormented with
worms, which are developed in great numbers in a
a few days aftiir the operation.

The fear, occasioned by the sight of the appa-
ratus, seems greatly to favour the increase of these
animals, because it contributes to weaken the body.

From these practical observations, we may with
certainty infer, that the debility or consumption of
the parts of the human body in which the eggs of
worms are situated, is an essential condition of
their unfolding. This circumstance was fully un-
derstood by the estimable Redij who was notwith-
standing much embarrassed, when, in order to ex-
plain the formation of worms, he had recourse to
his famous hypothesis of the sensitive soul, inher-
ent in those parts of the human fabrick, from which
the worm was to originate.

This learned opponent of equivocal generation,
propagated an hypothesl'a still more metaphysical ;

104 THE OKIGIN OF

he lias at least the merit of having apprised us that
the addition of certain human animal particles, is
indispensable to the development of the verminous
germ, and for the nourishment of the hatched worm.
It is thus that human worms, supported by human
nutrition, acquire those differences of structure,
which are not noticed in the worms of other ani-
mals, though of the same species.

In this manner may be explained those epidem-
ics of verminous complaints, which being ordinarily
the effect of uncommon scarcity of food, or of some
putrid alteration of the atmosphere, commence with
a set of symptoms quite peculiar to a general asthe-
nic affection of the highest degree, and of a local
consumption of certain parts of the body attacked
with it. In fine, it is thus that certain individuals
who are well nourished, are exempt from these at-
tacks, and in whom the blood consequently circu-
lates with force, whose secretions go on with har-
mony and regularity, the parts of whose bodies are
maintained in a state of perfect cohesion ; in this
respect it may be said that health is general and lo-
cal. The worms which live at the expense of the
human body, thougli of the same species, reproduc-
ing themselves elsewhere, v. ill they not be indige-
nous to !t?(l6) Do the latter deserve to form a pe-
culiar and separate class(17) in the general histo-
ry of the worms which the naturalist meets, wheth-
er within or without the body of other animals?

§. LXII. The Taenia canina soli inn, (18) ac-
cording to Wci'iifr^ has great resemblance to the

HUMAN WORMS. 105

human Taenia cucurbitina ; differing from it only
in some singularities, by no means characteristic.

The same may be said of the short tailed tae-
nia, found in cats. Its articnlatio^is, according to
Bloch^s figure,(20) in the middle of the body, can
hardly be distinguished from those of a human tae-
nia cucuiliitina, somewhat advanced in age.(21)

In fact^ Pallas' 211) considers both as belon".
ing to the same species, and he attributes to tlie
diversity of food merely, the difference noticeable in
their articulations.

In the anitra clangula and the anitra fuligola,
we observe a taenia, which Block calls taenia artic-
ulis conoUeis,{2S) whose external form, excepting
the tail, differs in nothing from the young human
taenia cucurbitina, particularly from that represents
ed in plate I, figure ii.

Sheep are very subject to worms, because of
tlicir feeble and lax fibre, and have a constitution-
al tendency to diseases of debility ; they are often
tormented by a sort of taenia, which has been de-
nominated Taenia vasis nutriciis distincta.{C^)
Its exterior form has great resemblance to the broad
human taenia.

§ LXIII. We have already remarked that men
and other animals are likewise exposed to vesic-
ular worms/25) The difference however which
exists between the human vesicular worms and
these of animals, seems to be essential ;(26) it must

however be acknowledged that the history of these
14

106 THE ORICrN OF

worms is not yet well understood, since their or-
gans of generation have not yet been discovered.

It cannot therefore be ascertained at present,
whether the hermit vesicular worm belongs exclu-
sively to man, or whether the social vesicular worm
pertains exclusively to other animals.(S7 )

^ LXIV. The tricocephalus which Bloch{2S)
says he has found only in the human coecum, has
been discovered by Goeze,[2Q) in the intestines of
the male mouse ; by Wagler in the horse,(30) and
by Ruusch in the wild boar.(31) Another trico-
cephalus, having fangs at the head in form of
a crown, has been found by Pallas^ in the Lacer-
ta apoda, as we have already said elsewhere. (3S)
§ LXV. In passing from the tricocephalus to
the ascaris vermiciilaris, we must recollect that
this worm is found in the intestines of the Rana,
temporaria.

Its resemblance to the human ascaris is such
that Goeze pretends that our worms are innate in
us.

He could not perceive the least difference be-
tween them, and, as an exact and impartial obser-
ver, was obliged, perhaps against his opinion, to
reduce them to the same species, and to give a de-
scription of them together.(33)

This excellent and illustrious naturalist saw,
on another occasion, the ascaris vermicularis, in
tne. intestines of the pike and of the aquatic sala-
mander.(34) All the ascarides vermiculares are
viviparous like tlic liuman.

HUMAN WORMS. lOT

§ LXVI. The human lumbricoides is not at
all distinguishable from that of the horse or hog ;
and the distinctive characters which have been
adopted by writers, even the most modern, (35)
are very faint. If the lumbricoides are of but one
species, there is certainly no good reason for sepa-
rating them into three particular species. (36)

§ LXVir. If worms of the same species have
been found in the human system and in the body
of animals ; if the difference between them, though
slight, arises from the difference of their food; why
resort to hypotheses to explain the origin peculiar
to the worms of the human body? If we also ad-
mit that Linnaeus was deceived, it is by no means
-surprising that the bishop Menander, cited by Ros-
ensteinf that Unzer and Tissot declare they have
found in water the same species that are seen in man ;
may they not also be found in fishes and other an-
imals? Our researches respecting this genus, are
very limited. Perhaps in time some more fortu-
nate observers may discover the eggs of the prin-
cipal human worms in those animals which supply
our daily food, perhaps it may yet be agreed that
there are worms which are peculiar to animals ;
but we cannot admit that they are peculiar to each
species, as Bloch[S'7) pretended ; they will form a
separate class whenever the effects, produced by
the quality of the nutriment that is assimilated to
their parts shall ])e duly considered.

§ LXVIII. That a taenia and some lumbri-
coides have been found in infants, not yet come to

108 THE ORIGIN OF

full birth, by Hippocrates^ Brendel[SS) and by
Selle ;{9 that a fasciola hepatica has existed in
a lamb si'iW in utero ^ [40) that worms have been
found in inftmts who have died immediately after
they were born, 41) and in sucking animals ;(4:3)
it seems that all these favourhble arguments come
in support of the opinion of those who believe that
worms are innate in man and in other animals.

If we consider however that the eggs of worms
are so small that they are imperceptible even under
the tube B, no. 1, of Hoffman's microscope(43)
(these eggs are real ovaries or masses of small
eggs :) 44) nothing is more probable than that these
eggs are absorbed by the lymphatic vessels, that
they pass into the circulation, pervade the system
with the hlood; and are deposited in different parts
of the body.

We meet in fact with these worms in the deep-
est and most hidden parts of man and other ani-
mals, tiiough tiiey ordinarily inhabit only the in-
testinal tube.(4;7)

I think we may conclude with Dr. Panzani,('i:&)
that the worms of fetuses are engendered in the
womb of the mother by the development of their
g>^rms, provided the necessary circumstances wiiich
we have pointed out, there concur. (47) Convey-
ed with the maternal blood 48) into the humors of
the fetus, and accidentally deposited in the intesti-
nal cavity abounding in mucus, they are here un-
folded, favoured by their position and the viscosity
of the miconium. These verminous germs are more

HUMAN WORMS. « 109

prone to expand and grow(49) in the fetal and in-
fant body, than in older and firmer subjects, on ac«
count of their feebler organization. Hence the
reason why worms are more frequent in infancy
and weak persons, while they arc comparatively
rare at adult age, and still more so in robust aud
vigorous constitutions.

§. LXIX. Human worms, accustomed from
their origin to live in our viscera, resist their ordi-
nary motions, and grow there in an astonishing
manner ; and when expelled, they easily die like
fishes and other aquatic animals when taken from
their native element.

It should be remarked that these intestinal
worms, if removed from their usual place of resi-
dence, either perish or are evacuated.

Taeniae and lumbricoides, having once entered
into the stomach, are soon vomited up alive, or kill-
ed by the action of the digestive powers.

The lumbricuides, once passed beyond the
valve of Baiiliin, we may consider as destroyed,
and they are evacuated. (50)

^ LXX. We now see how the eggs of the prin-
cipal worms are introduced into the human body ;
since when once transported and absorbed into the
mass of fluids, iliey are diffused through and depos-
ited in the most concealed parts of the body, and
there enlarge and unfold when circumstances favour
their development.

Vallisneri sought for the origin of all worms in
the first min.(;il)

no THE ORIGIN OF

This opinion well considered, though after-
ward adopted by Van-Phelsum{52) and by J.n-
divj/\^cS) IS subject to all the objections advanced
])y the physiologists and naturalists, who have
proved by facts, how destitute of reason is it, par-
ticularly when applied to the universal generation
of oviparous and viviparous animals. The worms
found in fetuses and infants not yet come to the
full term of gestalion(54') leave no doubt that the
seed of the worm is communicated to the fetus from
the mother, wliether she may have contracted it
from her parents, or swallowed it accidentally with
the substances taken for her daily food. If, by
means of the placenta, the motht;r transmits to her
offspiiug the matter which uourisiies it and causes
its growth, why may she not also transmit to it the
seeds of the worms which are included in very
small germs(a5) and which circulate in her fluids?

Are not the personal qualities of the mind, and
the peculiarities of the features, or those of her
family, in like manner transmitted ?(^6)

Besides, the Avorms observed in the umbilical
cord cf the fetus,(57) in the uterus(58) and even
in the placenta,(59) as well as the disposition to
worms in the sons, mother and grandmother, re-
marked by llospu stein. (60) evidently prove that
the seeds of worms may be transmitted, not only
from the mother to the fetus, but also developed
in the parts contiguous to the route of commu-
nication.

HUMAN WORMS. Ill

§. LXXI. The oviparous animals, particularly
birds, are very subject to worms ; these increase
or grow insulated from all communication with
their mother.

It consequently seems that worms in them are in-
nate, and that for this reason, they may lilvewise be
so in man, since nature is uniform in her great ope-
rations.

This objection would certainly have great
weight if all that Block affirms were true, tliat is
to say,(6l) that in most animals, there are worms
peculiar to them. We have already observed
that we cannot strictly admit that there are v.orms
peculiar to each class of animals :[G2) but that there
are merely some varieties of them.

On the other hand it may be said that in ovipa-
rous animals, birds for instance and fishes, we meet
with worms proper to each species. In truth, the
fasciola, or small band fligidaj is common to fish-
es aud birds ;;_63) we find in these animals indif-
ferently the gordiiiSj{Q-^) the ca2nichoii,{Q)5) the
echinorinchuSy[6Q) the planaria cilindrica,[Qj) the
taeniae[^%) and the worm named chaos ivfnsori-
us miicosiis.[Q9) It is natural therefore that the
eggs of these worms should, witliout distinction, be
introduced into the animal body with its food, and
that in man they should particularly be insinu-
ated with the mother's milk. (70) Rosensteiii
says,(71) that with impure water v.c swallow an
immense quantity of very small worms, and that
it may be from this cause that many mi^Herable peo-

112 THE ORIGIN OF

]»le arc so frequently tormented with tliem/73)
Jn Sweden the third part of the sick poor, who are
hadly fed, and who use the waters of the Soetra,
arc very ofton attacluMl with verminous diseascs.

§ LXXII. Faithful to the maxims estahlislied
in the beginning of this second Lecture, 73) and
remote from all tlie charms of hypothesis, I have
only been solicitous to present such observations
as relate to the generation of worms in the living
liuman body, which, if not entirely satisfactory,
when philosophically analysed, throw some light
on a subject which has always been the object of
t'ne most Assiduous researches of physicians and

naturalists. (7-1)

If we unite all that has been hitherto said, it
seems that we may with reason establish sixfunda-
mejital principles relating to the origin of human
worms ; if they should not satisfy naturalists, they
at least m'jrit all the regard of practitioners, for
wliom this work is iutendi d.

We.shiU conclude, 1. That no worm can strict-
ly 1(3 said to be innate in the human body ; because
the verminous seed or germ is received into our sys-
tem, cither from the mother while the fetus is in
uiero, or from sucking mercenary nurses, (7^^) or from
the saliva of tlie nurse by the infant,(7t5) or finally
it may be insinuated into us with our food and
drink. In lliese ways, the eggs of worms are dis-
seminated througii our bodies. 2. That these seeds,
in whatever manner they may get into the human
1j »dy, are not developed unless deposited in parts

HUMAN WORMS. US

abounding in mucosity; in fact these worms are
found in tliose parts of the body which are most
liberally supplied with mucus ; 77) besides, infants
who have worms, commonly evacuate them with
thick, whitish mucus in form of small globules.

The taeniae are also most frequently discharged
in a mu(jilaginous canal, improperly regarded by
Lancici as an excrescence of the intestines,f78) and
which Biaiicliini, with more reason, has called tlie
verminous receptacle or nidus, (79) made up of a
great quantity of mucous matter^, tenacious and

Nature therefore is not so remote from the law
common to all oviparous insects, great and small.

These eggs do not become worms except in suit-
able places.

3. Besides the circumstance pointed out in no.
2, worms do not multiply except when the body is
weak, which is particularly manifest in those parts
where the worms are situated. Tiie debility of
the heart and arteries, and the extreme vessels,
the wasting of the body, the torpor of the muscular
and vascular systems, the excess of mucus, putre-
faction, weakness of the organs of digestion, and
diminished cohesion of the parts of the system, are
all effects of a prevailing asthenic diathesis. The
abundance of mucus being favourable to the devel-
opment and nutrition of worms, they necessarily
increase more rapidly in debilitated systems (80)
In fact, children are more subject to worms than

adults, and women than men ;(81) in fevors and
15

114 THE ORIGIN OF

other asthenic diseases, the patient is exempt from
them after the recovery of his health.

The mucosities and lymph which abound in
weak bodies favour the development of worms by
serving to nourish them. These humours do not
possess life, as Hunter supposed, and which the
illustrious Bliimenbach has so well refuted. (8S)

4. Worms once developed in the human body,
increase and multiply in the ordinary manner of the
other more perfect animals, because they possess
the genital organs of the two sexes ; and as in each
body and at all times, the circumstances which fa-
vour their development do not always take place;
a great number of eggs are evacuated before they
are unfolded ; hence it was requisite that the num-
ber of female worms of the intestines should ex-
ceed the males, and that the quantity of eggs should
supply the number lost, otherwise their species
might become extinct.

The pike, carp, tench, and other fishes which
we daily eat, deposite great numbers of eggs in fresh
water ; all these eggs do not hatch ; many are de-
stroyed by other fishes, and fail from circumstances
unfavourable to their multiplication ; these species
are nevertheless perpetuated, because in the great
quantity of eggs deposited, several are developed
and grow.

Nature is therefore uniform in her operations,
with regard to animals subjected to similar vicissi-
tudes.

HUMAN WORMS. il5

S. When worms have once been developed in
the human body, they take effect and increase, and
are nourished by the elements of our system, (doubt-
less by the most appropriate,) and they acquire a
larger size than those of the same species which
remain in the body of other animals, notwithstand-
ing the diversity of figure, since naturalists have
not yet been able to affirm a characteristic differ-
ence between them. (83)

It seems to be already proved, by an attentive
examination of the rudiments, or first forms, of
worms, whether human, or those of other animals,
and perhaps also those of the earth, that they are
formed and organized from the same matter, and
that they exhibit a structure more or less uni-
form.(84) It is therefore natural that if these
worms have acquired life in the human body, that
they should grow there, and perish when discharg-
ed from it ; but they can live in places where oth-
er beings would be destroyed or digested.

It is however demonstrated that the worms of
other animals, introduced into our bodies,(85) if
they do not multiply, like those proper to the hu-
man system, certainly live there and increase in
size.

6. Finally, worms, being foreign to the human
body, do not multiply or generate in it, except
when it is predisposed to the asthenic diathesis, or
when asthenia actually exists. It appears that
Block has advanced a proposition too general in
wishing to prove that worms are not always the

116 ORIGIN OF HUMAN WORMS.

cause of dispase in the human body;(S6) the pres-
ence of worms is at least a certain index of asthe-
nia, which is a state contrary to that of perfect
health. ("^7) Furthermore, the very extraordinary
diseases occasioned by worms are either idiopath-
ic or sympathetic, and they clearly admonish us
that worms cannot remain with impunity in the hu-
man system.

KND OF THE SECOND LECTURE.

KOTES

TO THE SECOND LECTURE.

(1) ^^ Ingenue fateor unam hypcthesim non mi-
nus obscuram esse quam alteram ; fateor etiam me
nescire, quae vera sit liarum, nee opinari me au-
clere, ob difficultates ab utraque parte mihi inipen-
etrabiles. Dies forte docebit.^'

Thus wrote Ret:z:y an excellent Swedish natu-
ralist, after having examined the different hypo-
theses published by several illustrious authors on
the generation of worms in the human body. See
Lectiones publicae de vevmihus intestinalibuSy im-
primis Jnunanis, etc. p. 55,

(2) See § XVIII.

(3) See § XXXIil.

(4) See § XLI, XLIII.
(;'>) See § XLIV.

(6) " From the egg of a fly proceeds a fly ;
from the egg of a hen, a pullet, and not a serpent ;
from the egg of a goose, a goose, and not a fish.
Thus from one worm is produced another worm,
and nothing else." Rosenstein, Traite des mala-
dies des enfans^ etc. ; chap, xxii, p). 293.

118 NOTES TO THE

(7) III this manner must the ascarides vermic-
iilares be fecundated, since, as we have remarked,
these worms are oviparous. See sect. XLII.

(8) See § VIII and XVIII.

(9) We ascribe to Aristotle the origin of equiv-
ocal generation. Eut before him, some ancient
philosophers, particularly Pythagoras and Anax-
agoraSy counting as nothing the male, female, coi-
tion, the eggs, and generation of beings, had al-
ready imagined a certain order of nature, by which
shapeless matter variously combined, tended to
produce an organized being. According to Aris-
tbthf there were three worms in the intestines, the
bi'oad worm, the earth worm, and the ascaris ; all
of them, agreably to this philosopher, derived their
ori2:in from the excrements contained in the human
tody.

The theory of IlijjpocrafeSf on the origin of in-
testinal worms, seems to reduce itself to equivocal
generation ; this great man supposed that worms
were developed in the fetus only, having remark-
ed that in aduts the excrements do not remain so
long in the intestines, as the meconium does in the
bowels of the fetus.

The system of generation, imagined by the
celebrated Buffon, does not differ much from that
of the ancient philosophers. This eminent writer
pretended that the primitive molecules of animals,
instead of being inert or dead, were deposited in
the bosom of nature, already organized and living,
and consequently more disposed to the generation

SECOND LECTURE. 119

of different animated beinsrs. The system of the
infusory animals, to which some naturalists have
had recourse in order to explain the origin of
worms in the human body, is essentially contrary
to the nature of those animalcules.

In fine the crystallization of salts, another ar-
gument of the partizans of equivocal generation, is,
in my estimation, something too gross and insignifi-
cant to occupy my time in refuting it. For this inor-
ganic production, the concourse of homogeneous par-
ticles is indispensable : before this is applied to
animals, it ought at least to be sliown how the com-
bination of heterogeneous particles can take place.

( to) The microscopical observations, on whicli
the moderns rest their arguments in favour of the
equivocal generation of some less perfect living
creatures, ought not, in my opinion, to be regarded
as certain proofs, because a subsequent examina-
tion has proved them to be false. For example,
the infusory worms of Bonnet : Considerations sur
les corps organises ; Amsterdam, 1762, tome i, j?. 3,
and of Wrisbergf Satura ohservationum de am.
malculis infusoriis^ ji. 95, strictly compared witli
polypes, and which it has been thought are repro-
duced like them, have been found of a different
sex by Goeze, Bonnet, JJnd an deverer naturfors-
cher ah handlung aus der ImeJdologie herausgege-
hen, von Goe%e ; Halle, lyy-*'? P' 457, u'ho has ob-
served that all the uteri of the females ivere filled
with living fetuses*

12S NOTES TO THE

(11) "^^ Alia auimalia spoiite procreanturj alia
in excrementis, aut jam in excretis, aut adhuc intra
unimantem contentis ut quae Taeniae, sive Lum-
brici appellantiir, quorum tria genera sunt, latum,
teres, et quod Ascarida apellatum est, ex quo nihil
procreari aliud potest." Aristoteles, Historia an-
imallum, lib. 5, cap. 19 ; see Jlr.^ Opera Graec»
et Lat. ; ed. Gulielm. dii Vail., Lutet. Paris, 17^9,
infol. p. 84'J.

Sic ubi tlcserult madidos septernfluus .igros

Kilus, et antiquo sua fiumina reddidit alveo,
Aetliereoque recens ex arsit sidere limus ;

Plurima cultores versis auimalia glebis
Inveniiint ; et in his qiiaedani modo coepta sub ipsum

Nascendi spatium; quaedain impers5cta ; suisque
Trunca vident numeris: et eodeni corpore soepe,

Altera pars vivit: rudis est pars altera tellus.
Quippe ubi tcmperiem sumpsere, humorquc, calorque,

Concipiunt: et ab his oriuntur cuncta duobus.
Cumque sit ignis aquae pugnax, vapor humidus omnes

Res creat, discors concordia faetibus apta est."

Or ID. Mdam. lib. 1, v. 422.

[The American Translator is neither prepared
nor disposed to enter at any length into the merits
or demerits of an hypothesis, which has already
occupied more time than it has rewarded with any
advantage. So far as he has examined the sub-
ject, or can conceive of it, he finds no reason to
adopt the opinion of the equivocal generation of
insects or of any other animals. But he would be
less wise than presumptuous to imagine that he had
any thing to offer which is likely to weaken the

SECOND LECTURE. 121

faith of those who can believe without reason. This
ever baseless and now declining supposition still
enlists on its side, or holds in suspense, some en-
lightened minds, whose talents and industry he
respects,* and this is the only circumstance which
leads him to bestow a moment^s consideration on
the subject. If these friends of the doctrine did
not hesitate to follow him, he would consider the
production of any animal, however simple or mi-
nute, without the aid of animal life, organization,
and action, as wholly incredible. The equivocal
hypothesis is neither specious nor probable ; it de-
rives no support from analogy, no aid from reason,
no countenance from facts. All these have anoth-
er aspect and another tendency. The whole fab-
rick we renounce seems to be nothing better than
an unsuccessful effort to conceal that ignorance
which its framers wanted magnanimity to acknow-
ledge.

In its operation it has been worse than useless,
tending to obscure truth by substituting for its
light a senseless conjecture. It ascribes to chem-
istry, or to <^ creative warmth," what pertains alone
to animal life.

In the natural sciences it has been thought a
defect sufficiently great to confound the animal
with the vegetable kingdom, which do indeed ap-
proximate and sometimes seem to run into each

** Among these are several of the \vi iter's medical acquaint-
ance. See Rudolphi, Cap. xviii, De generatione Muiozngrum
spontanea: vol. i. publis'ied ia 1810.
i6

H2 NOTES TO THE

other. But this error is still more enormous ; with
gross blindness, or the most vague and licentious
imagination^ it disregards the boundaries which
nature has set between the animal and mineral
divisions of her works.

Till this hypothesis arose, these sacred land-
marks had remained inviolate ; but now inert, life-
less matter, mere earth, is at once to be endowed
with all the properties and attributes of living,
animal bodies, — and all this without an agent or
a cause !

Whenever a disciple of the equivocal expedient
will show us an ascaris or an elephant, (for though
the examples differ, the labour will be the same,)
bred without parents, we will hold ourselves bound
to receive w hatever he may choose to advance on
the spontaneous production of animals. Till this
exhibition is made, those who reject the idea of
an effect without an adequate cause, as absurd
and unfounded, must be permitted to believe that
the generative .system of insects and worms is des-
tined to perform the same office which is assigned
to it in other living beings.

It is true that every class of animals have their
peculiarities, insects certainly have many, especially
in their sexual organs and manner of propagation.
The two sexes of the same species are so extreme-
ly unlike each other that they would rather be ta-
ken for completely different species than for ani-
mals that could pair together.

SECOND LECTURE. 123

Among the bees and neighbouring species the
greater number of individuals have no sex ; they
are conceived and born, without being destined, as
in the ordinary course, to conceive or produce im-
pregnation. Their copulation is performed in a
very extraordinary manner in many instances.
The act is performed on the wing, and some are
winged only during the short period of copulation.
Some copulate only once, and the act is very soon
followed by death ; in which cases the life of the
animal may be prolonged by deferring the copula-
tion.

It is said the hydatis, or vesicular worm, re-
ceives nourishment, like vegetables, from its exter-
nal surface, having no mouth. The polypus has
no organs of generation, as every part of its sto-
mach, or body, is endowed with the generative
power ; &c. &c.

But these fjicts, singular as they are, give no
weight to the feeble hypothesis m question ; for
here, as every where else, so far as we are ac-
quainted with the natural history of animals, every
one, it is immaterial however much the mode may
vary, is produced and continued in its successive
generations by the properties and actions of animal
life.

^'^AVhen the great Creator first gave being to
the natural world, every part of the vegetable and
animal systems was brought into existence by an
extraordinary exertion of productive power ; they
were not moulded and matured by the slow opera-

124 NOTES TO THE

tion of time, and the cooperation of physical and
mechanical forces, but ^ He spake, and it was done.'

" But since that first act of creating power, we
see that these creatures are propagated and perfect-
ed by processes more gradual, successive, and ope-
rose, many of which can be successfully traced by
human wisdom, and admit of being regulated, fur-
thered and controlled by the interference of human
culture and ability." Christian Observer, vol.
xiv. p. .^74. But it is said there are hard cases
in the natural history of worms and insects ; it is
true there are, but none of these are so hard as the de-
fence of the device which is set up for their solution.

These cases are already greatly diminished in
number, and the remaining difficulties are vanishing
exactly in proportion to our increasing acquaintance
with the forms, laws and operations of animated
nature ; and our progress in tiiese sciences will at
all times be accelerated by acknowledging the ex-
isting limits of our information, rather than by as-
signing false causes for known phenomena.

It is more fair and promising to admonish the
student of nature of his descent into the twilight of
doubt, or the darkness of ignorance, than to pre-
tend to direct him where he cannot be guided in
safety. Thus placed on his guard, if he cannot
open a clear path for others^ he w'ill at least be
more likely so to feel his way as to able to retrace
his steps to the point whence he started, and thus
avoid the risk of being lost himself, as well as the
hazard of misleading his followers.

SECOND LECTURE. J25

On the whole, there is every reason to believe
that the origin of all animals has been the same,
and that the laws and conditions which prevail in
the economy of other animals, take place also in
the reproduction of insects and worms; the only di-
versity in "elation to these animals is, that in these
classes of ler productions, nature accomplishes her
purposes by some peculiarities of structure, and
mode of action. I submitted this note to the criti-
cism of a friend, who favoured me with the fol-
lowing observations.

^^The doctrine of equivocal generation arose first^
I believe, from a want of accurate observation ; for
the Epicureans were not nice observers. It has
since been supported by ignorance and pride which
are commonly associates.

This subject is very well treated in the 7th
book of Cardinal Polignac's Antilucretius. Some
writers on intestinal vermes seem not to be aware
that it is necessary carefully to distinguish insects
from worms, as they belong to different classes of
animals. The former, it is well known, are pro-
duced from eggs vivified by the male influence.
In some of these the larvae are excluded witliin
the body of the parent, others after the eggs are
deposited, and in one genus both these modes oc-
cur. If you have an Encyclopaedia at hand (which
1 have not) read the article Aphis. Many of the
vermes, we know, are produced from eggs. I
have often found those of the common eartli worm.

126 NOTES TO THE

lumbricus tervestris, with the young voUed up in
thera.

Among tlie lower orders the increase is rather
by continuation than generation, and that by a di-
vision of the body, in some longitudinally into two ;
in others transversely, in which a portion of the
body separates and becomes a perfect worm, and
after a while another portion which becomes per-
fect like its predecessor.

In the polype tribe, both the common fresh wa-
ter ones and those which form the numerous spe-
cies of coral, the increase is by germs or buds ; in
the former protruded from the external surface,
which are developed while they adhere ; in the
latter they are thrown out from the intcriour, and
are developed after they are excluded : but they
are not eggs. On this subject you will be gratifi-
ed with the perusal of Ellis on Corals and Coral-
lines.

I doubt very much whether the authors, from
whom Tirgil learned the art of making bees, knew
that the bee differed from the flesh-fly in having
four wings, or rationally to account for the appear-
ance of the latter.

Blind philosophers ! exclaims Palignae, to main-
tain that the corruption of matter could produce
insects. You were ignorant^ of tlie invariable or-
der established in the generation of all beings.
Could you believe Nature thus capricious and in-
consistent, thus capable of straying from her own

SECOND LECTURE. 127

plan, and on this false notion build so monstrous a
system !

Learn, that primitive laws are immutable, noth-
ing can withdraw itself from their power; that
the impulse first impressed on the machine of the
universe by the hand of its Autlior can never
change itself. That chance can neither supplant
nor destroy it.

veterum stiipidissimus error,

Quasdam bestiolas sine progeiiittjribus ullis,

Materia ex putri et c alefac lis sonWlms ortas.

Coeci ! quas latuit reruin immutabilis ordo : '

Siccine, Naturam incertam, iiiorumrjue suorusn

Immemorem, et tautum potuistis faigore inonstrum ?

Discite primarum legum inviolabile numen,

Et semel incussos, quibus omnis machina mundi

Dirigitur motus, nulla vi posse retundi,

Nullo suppleri, nullo desistere casu. — Antiluc. lib. 7.

When we would treat of what we know not,
we must call in the assistance of facts, which we do
know and are well established. We must walk in
the path of analogy by the light of experience and
known laws. If we reject this light and stray from
this path, we are likely to grope our way to ab-
surdity."]

(12) Sommaire des experiences faites deniere-
meiit sun la generation^ la compositioiie et decom-
position des substances des animaux et des vege-

taiix^ etc,

(13) See Brera, Commentari medici, Pavia,

1797> Tom. i. j;. 1, 99, 195 ; Memoria sidlaforza
vitate di G, C, Reil. D'Outrepont, Verpetna ma-

128 NOTES TO THE

teriei organico-animalis Vicissitudo, HulaCf 1798,
8°.

(14) Traite des maladies des enfanSfp. 295.

(15) In the space of six weeks, a lad of twelve
years discharged more than a hundred lurabricides:
Blasiif Observationes medicae rariores, etc. p. 80,

(t6) See note no. Q2, of the first Lecture.

(17) See § II.

(18) Linnaeus, Amoen. acad. vol ii. p. Q8,tab,
1, Ji^. i. Pallas, Elenchus Zoophyt. p. 405 ;
JSTordische Beytrag, 1 Band, 11, S. l,Jig. iii.

(19) Verm. Intestinal., Taeniae praesertim
liumanae, etc. p. 5Q.

(30) Traite de la generation des vers des in-
testins, etc. p. 43, plan. Qyfg. i.

(31) See pi. I, fig. ii.

(32) JVeveJSTord. Beyt. i, Band, 1 Stiick .p. 47.
r23) Traite de la gen. des vers, etc. p. 29, pi.

Ill, jig. i.

(24) BlocJi, the icork cited, p. Sj, pi. Y,jig. i.

[25) See § X7vIV.
(38) See ^ XXV.

(37) The social vesicular worm has lately been
discovered in man by Zeder, Erster nach. zur JS^a-
turges.der Eingeic, etc. He described it under
tlje name of Polycephalus Jwminis. Goeze, be-
fore his death, having received from Professor Me-
kel of Halle, a group of human hydatids, recogniz-
ed in them the social v/orm which he called Taenia
midticeps : from all that can be collected from his
manuscripts, he seems to consider this worm the

SECOND LECTURE. 129

same as tliat found in the brain of slieep, in tiie
liver of hares, of mice, etc. But Zeder, having ex-
amined them very attentively, found that the crown
of fangs f crotchets J is single in the social vesicular
human worm.

See the itwrJc cited, p. Si2, pi. 11,/^. v, vii;
while in the social vesicular worm of animals we
see this crown double, as may be observed in the
figures published by Goeze, and which I have an-
nexed to these Lectures, see pi. II, fig. xv. e, xvi. e f,
xvii. f. Zeder has characterised the social human
worm in the following terms : " Polycephalus co-
rona uncorum simplici, capite imperforato, corpori-
busque pyriformibus."

(28) Traite de la generation, etc. p. 7^.

(^9) Versitch. JWitiirgeschicthe, etc. p. 111).

(30) See Goeze, the work cited, p. Ii7.

(31) Goeze,the work cited, p. i2i2,

(32) See ^ XXXiy.

(33) Goeze, the work cited, p. 97 and 103.

(34) Goeze, the work cited, p. iOS.

(35) Zeder, Erster JS^achtrag zur J\%turg.
der Eingew. etc. p. 25.

(36) See § XLITI.

(37) Traite de la gen. etc. p. 89.

(38) See Pallas, Acta Helvetica, torn, i, p. 59.

(39) Medicina clinica; Ticini, 1794/, v. i.
p. 142.

(10) Ilartmann, in Miscell. nat, cur. ; dec, 1,
ann. 6 and 7? ohserv. 189.

4 f^

130 NOTES TO THfi

(41) Doloeiis, He morhis infantiunif lib. 5, cajp,
10.

(43) JVepfer,deciciitaaquatica; Basilae, iQ7Q)
4i^. p. 383, found the intestinum ileum of a small
cat full of very long lumbricoiiles. The same ob-
servation has been made by Vallisneriy Opere, fis-
ico-medicJie, torn. i. p. S71j in a sucking calf. A
very long taenia was seen by Goeze ; see Zeder^
Erster JVach, ziir J\*atiirges,y p. 317 j it had been
evacuated by a lamb, still living on his mother's
milk. A case of taenia, somewhat similar, is re-
lated by Raiibin, Observations de medicine ; Pa-
ris, 1754 ; a young dog newly born had his intes-
tines filled with a prodigious quantity of taeniae;
Blumenbach ; Handhuch der JSTaturges., etc. p. 2i.

(43) The objects were magnified 5 '^9 times in
diameter, 312, 481 times in surface, and 174, 676,
879 times in the whole body, see Goe%e, Versu-
cheiner JSTatiirges. etc, vorride, p, 10.

(44) See, for example, pi. II, fig. vi. Block,
the work cited, p. 102.

(45) See note of the first Lecture, no. 2.

(46) Cistalgia almintica ; see Giornale per se-
voire alia storia rogionata d^lla medicina di questo
secolo ; Venesia, I780, 4°. j;. 441.

(47) See § LX.

(48) Anatomists, for a long time, have been
much divided on the question, whether the blood
of the mother passes to the fetus by means of the
placenta. Some, supported by observation, have
supposed the vessels of the placenta to anastomose

SECOND LECTURE. 131

with those of the uterus. A similar opinion has
been maintained by Vieussens ; Memoires de Va-
cademie de cJiirurgie de Paris, an. 1778 ; by Hal-
ler, Klenif jjhisiolos^iae, T. viii. lib. 19? sect, iii,
^ XXXIV ; by Denis, see Treivy chylos. foet.,
2). 18 ; by Merij, Hist, de Pacad. roijale des scien-
ces, I7O8? 2^.45, by Bonnet, Sepidcretum anatomi-
ciiin, torn. iii. lib. S, sect. XXXIX, observ. i, no,
5 ; by Ueister, Comjjend. anatom., torn, u, jj. 86,

Tliey relate several cases of pregnant women
■who died of uterine hemorrhage, and whose fetuses
had no blood in their vessels. Mercury injected into
the vessels of the uterus penetrates those of the fe-
tus inclosed by this organ.

Cowper has observed the same in his Anatomy
of the human body ; Oxford, lQ98,foL torn. 54;
Dracke, Jlnthropologia, edit. 3, Londini, 17^7? 8°.
vol. ii. cap. vii, p. 234 ; Vieussens, JSToviun vasorum
systema ; Amstelodami, 1705, p. 25 ; Verheyen,
anatomia, lib. i, cap. xxv, p. Si.

The injections of coloured wax into the ves-
sels of the fetus, when those of the mother were
injected, as is related by J\''ootwyck, Uteri humani
anatom., p. H; Hummel, see Stacklin. TJiesau.
anat. ed. diss. ch. ; Haller, p. 751 ; by Graaf
Opera, Amsteto. 8°. cajJ. xxv, p. S96 ; by Vogli,
Anthropogenie ; Bononiae, 1718, 4°. P. II, p. 162 ;
by HoeUing, Dissert, de officio obstetricantiu m in
partii naturali, Argentorati, 17c \ p. 16; hy Al-
binus, Jlnotat. academ*; Leidae, 1754, 4^ lib.i,
cap. X, p. 35 ; by Mekel, see Beaudelocque,^ An-

132 NOTES TO THE

leitin\^ ziir Enthlndumgskunstf 1, B. aus d.franz
vbeersets von ; by F. Melcel, Leipsi^, 1782, 8°. p,
llij, not. 3 and 4 ; and by Locler, see JMiiller,
Dissert, genital, sex. seq. ovi. niitrit. foetus, atque
nexus inter placentam et uterum histor. Jena 17&0j
§ 11, p. Sj.

One could hardly doubt of this iutimate con-
nexion between the vessels of the uterus and those
of the fetus, if the efforts of anatomists, even less
celebrated than these, had been requisite to deter-
mine the question with precision and certainty.

Riiisch, Opera anatom. medic, chirurg. ; Am-
stelod. 4 . V. i — iv. Monro, see Med. Essays of a
society of physicians at Edinburgh, vol. ii, art. IS,
§. XVI; R)ederer,de Utero gravido,p.25 ; Hun-
ter, GuUelmo, anatomia uteri gravidi tahulis il-
lustrata ; Birmingliamiae et Londini, 177 1, fol»
tab. xxiv ; Wrisher g, Exjjerim.et observ. anatom,
de iitero gravida ; Gottingae, 1782, 4°. p. 40 ; Ob-
servat. ds structura ovi et secundinarum humana-
ram in partes matur. etc. ihid. 17*>-5? 'l*'^* ^ XXI,
have in vain attempted to inject and propel the
fiiiids of tlie vessels of the uterus into those of the
placenta, and still less from the placenta into the
vessels of the uterus ; the question might not have
been yet settled, if Dessault and after him Reuss,
J^uvae quaedam ohservationes circa structuram va-
surum in placenta humana, et peculiarem hujus
cum utero nexum ; Tubingae, 1784, 4°. p, 44, had
not discovered some valves in the extremity of th«

SECOND LECTURE. 135

vessels of the placenta and of the uterus, which
sometimes oppose the passage of injections.

(49) See § LXI.

(50) Fragment rf' une Lettre du docteiir Wag-
lev, siir le Trichiiris oil Ver a. queue y al conseigle
Wichmann de Hannover ; see Goeze, the loorlc
cited, p. 16, note.

(51) Opere fisico'inediche, torn. i. / c.

(52) Jlistoria physiologica Ascaridum ; Leo-
ivardiae, 176% p. 77.

(53) De la gen. des vers dans le corps de Vhom-
me, etc. troisieme edition, torn. i. ^j. 17*

(54) See note, no. 48.

(55) See § LXYIII.

(56) Hofinann, De foetuum in uteYo morhis,
Disquisitio patliolog. etc. p. 143. According to
HiiUer, Elem. physiolog. corporis humani, etc. torn.
viii; Lausan, 17/8, § VIII, 2?. 97? children resem-
ble their mother more than their father.

(57) Vesti, Dissert, de verme timhilicali ; Er-
fordiae, I7IO, 4°. Muller, De Verme umbilicali ;

Tithingae, 1605, 4*^. Baldinger, JYeves magasin sur
pratische Aerxte, vi. Band, p. 54.

(58) t2 Castro, Medicina morborum muliehrium;
Hamburgi, l6 28, 4°. lib. ii, sect. ii. cap. xxxiii. Mer-
curialis, de morbis mulieribus proelectiones ; Veil'
etiis, IGOI, 4°. cap. ii. Zacuti Lusitani, praxis
historiarum ; Amstelodami, 1641, lib. iii, cap. xii,
observat. 1.

Schenclc, Observationes medicae rarae, novae^
etc. ; Francfort, I6OO. 8^. lib. iv, no. 313,

134 ^'OTES TO THE

(59) Stalpart, Vandericiel^ vol. ii, ohservaf.
28, speaks of a large lumbricoules fount! in the pla-
centa, and of another which had passed into thi
umbilical cord.

(6i)) Traite cles maladies des enfans etc: ji. 303.
He met with the taenia in two girls, whose moth-
er and grand-mother had been troubled with this
■worm. Similar observations have been made in
dogs by Werner., Vermium intest. jpraesertim hu-
manae, etc p. 10^, 103.

(01) Traite ds la gen., etc, ligula pisciunifp. 98,
the seventh proof.

(62) See ^ LXVII.

(63; Blscli, Traite de la gen. etc. ligula jpisci-
iiin, p. ^,ligula avium, p. 8.

(64) Goeze, the work cited , p. 129, 126.

(65) Goeze, ibid, p. 128.

(66) Goeze, ibid, p. 158, 16% 250.

(67) Goeze, ibid, p. 13/.

(6S) Goezp, ibid, p. 377, 409, 423.

(69) Goeze, ibid, p. 429.

(70) Werner, Vermium intestinal, etc. p. 104.

(71) Traite de maladies des enfans, etc. p. 294.

(72) The band fdoiivej of the intestines, (Fas-
ciola intestinalis. J the crinodes fGovdii,J though
not human worms, sometimes enter our bodies and
live in them, producing various severe symptoms ;
see Rosenstein, the ivork cited, p. 304.

(73) Sec ^ LVI.

(74) See the works of Bloch, already cited,
and of Goeze, honoured by the celebrated Koyal

SECOND LECTURE. 135

Academy of Sciences of Copenhagen. I am far
from adopting the opinion of these two authors,
because their arguments intended to suppport them
are in part hypothetical, and in part contrary to
observation. The reader is at liberty to examine
and compare the sentiment 1 have expressed in this
Lecture, and then pronounce judgment on it.

I have related facts only, and with these for
my guide, I have disregarded the opinion of others.

{75) Werner, Vermium intest., etc. p. 103,
i04.

(76) Werner, ihe ivorh cited, j). 101.

(77) See note of the iirst Lecture, no. 175, and
that of no. 80, of the second Lecture.

(78) Epistola ad Jo. Doniiiiic Bianciardi.

(79) Lettere medico-pratiche intorno aW indole
delle Febbri maligne deloro principali rimedi, col-
la storia d'e vermi deW corpo uiiiano et deW uso
del m er curio ; renezia, 1750, jJ- 70.

(80) ^^ Quaerenti an tern, cur in tarn larga, faci-
lique communicationes ratione non plura vermino-
sorum hominnm exerapla obveniant, responderera,
id ea propter fieri non posse, quoniam ea ipsa ovula
aliquam praedispositionem ad evolutiouem requi-
runt. Absque muco nimlrum intestinorum parieti-
bus non ita facile ad haerere, nutriri, et evolvi pos-
sent. Calor etiam, debilisque intestinorum scyba-
la tardo raotu expellentium habitus, procreaticnem
mirum in modum facililabit, quibus morbis viscido
nimirum atque intestinorum signitie eae etiam geu-
tes, in quibus plurimi verminosi reperiuntur, max-

136 NOTES TO THE

ime obnoxii sunt. Sic vix aliter fieri potest, quam
ut Helvetiae incolae, quorum maxima victus pars
ex iacti ciniis paraelur, viscitio Belgae et Rusi vero
ob victus atque aeris conditiones intestinorum de-
bilitate atquo. laxitate laborent ex quibus contitioiii-
bus facilime magna ea Taeuiarum atque vermium
in regionibus illis obvenientium copia explicabitur."
Werner f Verm, infest. ^ etc. p. 104.

(81) Et vere Taenia in amabili sexu frequen-
tius sese exserere raihi videtur, quippe qui collec-
tis circiter 161 observationibus, 90 ad laeminas, et
74^ ad mares pertiiiere compererim praetereaque in
piscibus, quorum esocera. perc.im, cyprinos, latum
rutiiumque et asellura nomino. et variis quadrupedi-
bus faernellas saepissirae ni semper Taeniis gravi-
das mares vero numquam verminosos observave-
rim." Pallas, Dissert, de infestis viventibus intra
viventia, j?. 61.

(82) IJe vi vitati sanguini neganila ; vita au-
tern propria solldis quihusdam corporis Jimnani
fartihiis adserenda. See Brera, Sylloge opuscu-
lorum selectoruiUy etc, vol. i. opusc. 1.

(83) See § LXVII.

(84) See §^ LXII, LXIII, LXIV, LXV,
LXVI.

(85) See the Appendix to tbe principal buraan
worms, ^ LIV, and following.

(86) Traite de la gen. des vers, etc. p. 96,
twelfth proof. If animals sometimes, as well as
man, do not perceive the presence of worms in t!ieir
body, this fortunately proves that they are not nu-

NOTES. isr

Bierous, and that they are not situated in irritable
and sensible parts. In these instances the worms
siuTly are no cause of disease. This accidental
circumstance cannot establish a general rule, and
the best practitioners have condemned a proposi-
tion so badly applied. They have also demon-
strated as extravagant the opiuion of those Ameri-
can physicians, who have pretended that a small
number of worms might be beneficial to the health
of children ; according to their opinion, these
worms may be intended by provident nature to
consume the superabundance of nutritious sub-
stances in the body of children. The want of
worms, according to these physicians, would be a
state of disease ; in truth, they have not omitted
to speak, in the nosology of that part of the world,
of this particular class of complaints,. What ex-
travagance of the human understanding ! exclaims
Weikard, Elementi di medicina, etc. Pavia^ 1800,
Tom. ii, Fac. ii. p. 71.

(87) In fact Brown^ Weikard and other mod-
ern observers have reduced the disorders, occasion-
ed by worms, to the class of asthenic diseases ; in
the classification of diseases they precede tabes,
or if you please, the general consumption of the
body. See Brown, Elem. di Medicina, Roma,
4797; 8°. vol. ii. p. 280, §§ DLXIX, DLXX.

F,.VD OF THE NOTFS OF THE SECOND tECTURE.

18

THIRD LECTURE.

VERMINOUS DISEASES.

§ LXXIII. When the seeds of worms arc once
developed in the human body, health is more or
less deranged,(l) and the morbid symptoms which
then appear, are in proportion to the number and
size of the worms, to the sensibility of the parts they
occupy, and the general morbid diathesis which
takes place at the same time, whether as the cause
or effect of the worms.

Hence it is that verminous affections are some-
times local, and sometimes sympathetic and gen-
eral.

1. LOCAL AFFECTIONS FROM WORMS.

§ LXXIV. These diseases are seated in those
parts of the body wherein the worm is developed
or to which it is transported.

The physician observes the symptoms in the
part affected, and in distant parts of the body with
which an immediate relation subsists by means of
the communication of nerves, and is able to distin-
guish the symptoms peculiar to each species of the
worms already named.

VERMINOUS DISEASES. 16»

For this reason we may eall the symptoms, pro-
duced by the presence of worms, either partial or

common.

§ LXXV. Children and persons of a feeble
constitution and lax fibre are most predisposed to
worms.

Children are most frequently tormented by as-
carides vermiculares and lumbricoides ; adults, on
the contrary, are subject to taeniae and vesicular

worms.

In nervous fevers and other asthenic diseases,
both acute and chronic, the complication of worms is
very frequent, especially the tricocephili, as we see
in the history of verminous epidemics.

[^Verminous epidemic is incorrect language, be^
cause it implies the existence of a morbific cause
which is inadequate to produce the effect ascribed
to its agency : at least there is no evidence that in-
testinal worms ever have produced an epedemie
malady. ^

In the first place, we cannot imagine that most
of the inhabitants of a populous city, or of an ex-
tensive territory, ever had, at any one time, a suf-
ficient number of worms to occasion a sickness of
any sort ; and secondly, if we could suppose these
worms so to exist, they would not produce an epe-
demie disease, but a considerable number of differ-
ent diseases, all occurring simultaneously. That
certain causes may sometimes arise lending both to
generate disease and to increase intestinal worms,
cannot indeed be doubted ; some of these are the

140 VERMINOUS DISEASES.

exhalations from unhealthy grounds, unfavourable
seasons of the year, deficient and unsound diet, &c.
It is also true that during the continuance of fe-
vers and some other diseases, worms may be un-
pleasantly affected, and even expelled from the
body. These effects may happen either from the
influence of the disease on these animals, from a
failure of their usual nourishment, oV from the
operation of remedies used to restore the sick. Un-
der these circumstances worms may, and do, ren-
der any prevalent disease more complicate and se-
vere, but that they alone ever produce an epidem-
ic disorder, is a doctrine which it would be equal-
ly unphilosophical and unsafe for a physician to
admit. A. T.] .

THE COMMON AND GENERAL SYMPTOMS OF WORMS.

§1 LXXVI. The signs of the presence of worms
in different parts of the body are certainly very ob-
scure and equivocal. L

Aaiong the symptoms common to them, there
are some which may arise from a cause very differ-
ent from a verminous affection.

In the year 1797? a man came to the clinical
hospital of Pavia, who was several times examined
and always exhibited the symptoms peculiar to tae-
nia ; they produced the effect however of flatulent
colic, which disappeared after the use of a stimu-
lant regimen. Similar examples are reported by
To(lef[)l) and confirmed by daily practice. It also
happens, not unfrequently,'' that the sick evacuate

VERMINOCS DISEASES 141

worms without any previous sign of their existence.*
The most sure sign in the local or sympathetic af-
fections arising from worms, is their expulsion by
the mouth or per anum.

The human body, however, when deranged by
worms, presents some phenomena which may at
least admonish the practitioner of the probability of
their existence.

§ LXXVII. In persons attack^'d by worms,
the colour of the countenance is changed ; it is
sometimes red, then pale, or leaden-coloured ; a halt
circle of azure appears under the eyes, they lose
their vivacity, and are fixed and motionless with
regard to surrounding objects ; they are sad and
dejected ; the lower eyelids swell and the pupils
are evidently dilated. At other times the eyelids
are yellowish, and the same tint extends over the
white of the eye. There are also insupportable
itchings in the nostrils, with occasional hemorrhage
from the same parts ;(S) headache is frequent, expe-
cially after taking food ; this is sometimes so vio-
lent as to produce delirium and phrenitis.

The mouth is full of saliva, and exhales a fetid
and verminous odour; there is grinding of the

* We saw in ISOl, at the clinical hospital of Prof. Finely a
woman, 50 years old, who had all the symptoms of a gastric
fever ; three grains of tartrite of antimoniated potass were pre-
scribed ; the patient vomited much porraceous matter; the day
after she voided with the feces, apiece of flat taenia, about four
metres long. The woman never after experienced any symp-
toms of the presence of worms. F. Trs.

142 VEinirNOUS DISEASES.

teeth ; uneasy and agitated sleep, and great thirst.
Sometimes somnambulism renders the patient tim-
id. Fainting, vertigo, and tingling of the ears, aug-
ment the morbid state of the sufferer. The cough
is dry and convulsive, sometimes stertorous and
even suffocating, respiration is difficult, and some-
times attended with hiccough ; speech is interrupt-
ed, and in some instances entirely suppressed.
Tbe mouth is frothy, and there is palpitation of
the heart ; the pulse is hard, frequent, rapid and
intermittent.

The belly is tumid aud troubled with borboryg-
mi ; there are eructations, naqsea, reaching to vom-
it, and vomiting. At one time there is no appetite,
at another it is so great that the patient is compel-
led to take more food than ordiuary.(4) The belly
swells and is the seat of severe pains, there is a
sense of pricking and tearing which is not fixed but
wanders over the whole adominal cavity ; these suf-
ferings are aggravated when the stomach is empty,
and immediately cease on taking food. The bow-
els are sometimes relaxed, sometimes costive.

The urine is crude and turbid; the excrements
fetid ; cardialgia afflicts the patient and sometimes
destroys him ;(5) the body is emaciated, though
the patient eats much : and violent itching of the
arms sometimes occasions fainting.

At other times tenesmus aggravates the pains
of these parts. Languor, anxiety, listnessness and
extravagance in conduct, discourse and the intel-

VERMINOUS DISEASES. 145

jeetual functions, are observed in persons harrass-
ed with worms.

§ LXXVIII. We are not to suppose that the
union of all these symptoms is requisite to enable
lis to judge of the presence of worms ; the principal
of them are sufficient, and they are, according to
Mouro,{6) unusual dilatation of the pupil, saliva-
tion, extraordinary appetite, wasting of the body,
a pricking sensation at the stomach, tumefaction of
the abdomen, anxiety and loathing of food. Ros-
enstein{7) affirms that the surest sign is the comfort-
able state of the patient after drinking a glass of
cold water, and voiding some worms or fragments
of worms. I have witnessed pains of the joints
similar to those of arthritic rheumatism, accompa-
nied by dilatation of the pupil, an abundance of sa-
liva in the mouth, and an intolerable itching at the
end of the nose.

All these are so many almost certain signs, in
children and feeble women, of worms in the intes-
tines.(8)

§ LXXIX. AVe have already proved, (9) that
worms of all species and sizes, may live concealed
in every part of the human fabric. The symp-
toms derived from worms have relation to the part
affected and injured.

The functions assigned to each part, and the
mode of their performance in health and in sick-
ness, are soon made apparent by the morbid phe-
nomena, whether they arise from the affection of
a particular part, or from the lesion of some other

144 VERMINOUS DISEASES.

viscera which are immediately or sympathetically
connected with it ; 10) thus when worms have pass-
ed into other parts of the b -dy from the stomach
and intestines, the patient will present signs result-
ing from a local affeciion, even some which arise
from the sympathy of the parts connected with the
seat of the disease.

A woman who had fallen into the w^ater, was
seized with a violent pain in her head, a vspasmo-
dic contraction of tlie eyes, particularly the right,
and vertigo, so that she could not stand ; often af-
ter dinner, or in the evening, she was surprised by
a giddiness and sort of apoplexy, which deprived
her of sense ; she became blind for a few moments,
her eyes rolled about, and the whole surface of her
body became red. Believing the disorder to orig-
inate from nervous weakness, the remedies recom-
mended in vertigo, were ordered, but without suc-
cess. One day feeling something in her nose, she
introduced a lon-^ needle, in form of a hook, and
extracted first a living lurabricoides, then two more,
then a third, and afterwards a fourth ; the disease
abated but did not entirely disappear. The neces-
sary remedies were directed, seven more worms
were brought away, and this woman was perfectly
cured of this terrible disease. (11)

A man, about thirty eight years old, of a pale coun-
tenance and feeble constitution, had complained
for three years of a fixed obtuse pain in the right
hypochondriac region. Except a putrid fever ten

VERMINOUS DISEASES. 145

years before^ no complaint had led him to take any
medicine.

Afterward attacked with a slow fever, he died
very much emaciated. On opening the body, the
right lobe of the liver was found hard and large,
introducing the scalpel, a great quantity of yellow-
ish serum passed out, with several hundred hyda-
tids of different bigness. There was every reason
to believe they were social vesicular worms. (IS)

Even apoplexy may be induced by worms in
the brain, and by other local diseases of that vis-
cus. The vesicular worms attached all along the
plexus choroides, which I discovered in the brain
of an apoplectic(13) doubtless confirm this opinion.
A lumbricoides in the urinary bladder produced
nephritis and a severe and mortal disease of the
bladder. (*)

* Dr. Levacher of Feuterie, secretary general of the medic-
al society of Paris, was consulted by a country patient, who had
a complaint, for which the physicians of the country had not
found a remedy. It was a constant erection in a man forty
years old ; he was married and had children. During several
months this man had been much incommoded witli this state
of erection, which neither yielded to cooling nor antispasmodic
remedies, nor was it lessened by the venereal act. Tlie pains
were sharp and nothing could calm them, still there was no fever,
nor any other appearance of disease. Dr. Levacher gave it as
his opinion, that worms were the cause of this disorder.

The consultation was ridiculed and neglected ; but after
some time the patient having spontaneously voided several lum-
bricoides, the advice of Levacher was brought to mind, and some
anthelmintic medicines were taken. The poor man discharged
more worms, and was cured, JP*". Trs.
10

146 VERMINOUS DISEASES.

The most experienced surgeons for several
years believed that the pains which the patient suf-
fered were occasioned by large calculi(i4) in the
bladder.

I would relate several other similar cases, to
prove that the symptoms produced by worms are
connected with the parts which they occupy, if I
did not fear to dwell too long on a subject which
every practitioner sees daily confirmed at the bed
side of the sick.

§ LXXX. Assured by the above symptoms,
of the presence of worms, it remains for the phy-
sician to decide what sort of worms occasion or
aggravate the disease to be treated, since every
particular species of worms is attended by signs
in a great measure peculiar, in addition to those
that are common and general.

SYMPTOMS OF TAENIA.

§. LXXXI. Persons affected with taeniae com-
plain of a sense of pain in the belly, produced by
something alive, with a turning motion and weight
in the side.

Occasional prickings, or rather bitings, are felt
in the region of the stomach, the abdomen swells at
intervals, and then subsides almost by undulation ;
a sense of cold, from time to time, pervades the ab-
dominal viscera. The appetite is uncommonly
great, w hile the more the patient eats the leaner he
is. He is sensible of increasing weakness in all
his limbs ; his complexion is livid, and he is fre-

1

VERMINOUS DISEASES. 147

quently faint ; the pupil is unusually dilated^ his
eyes are suffused with tears ; vertigo confuses the
head of the patient and excites vomiting ; the legs
vacillate, and sometimes the whole body seems to be
affected with convulsive trembling. In other cases,
according to Hippocrates, speech fails ; often small
substances, resembling tha seeds of the lemon or
gourd,*^ are evacuated with the feces of the patient,
which are portions of the marginal papillae of these
worms. (15)

§ LXXXII. Dr. Wagler mentions a young
man, troubled with taenia cucurbitina, who became
uneasy and impatient whenever he heard music, and
was obliged to retire. (16) Goeze also speaks of
several persons having taenia, on whom music pro-
duced disagreeable sensations. (17)

In fine, these patients generally find themselves
ill at ease in church, so soon as the organ is touch-
ed.

§ LXXXIII. The head of the armed human
taenia is furnished with two appendages in form of
pointed fangs ;( 18) sometimes it attaches itself with

* Two years ago (1812) a woman who had long been trou-
bled with taenia, on taking the spirit of turpentine, voided a
large quantity of these bodies resembling orange seeds, togeth-
er with numberless small pieces of a thin skin or membrane.
These were supposed to be fragments of the worm, and were
the only signs of it that were found in the intestinal evacuations.
No symptoms of the worm have since appeared ; and her Iiealth,
which had long suffered from this worm, has, since its expul-
sion, been good. %S. T.

148 \TRMINOUS DISEASES.

such force to the mucous membrane of the intestines^
as to produce the most severe, and even deadly
8ymptoms,(i9) since the internal surface of the in-
testines is mangled ; inflammation soon follows, and
suppuration or even gangrene may be the conse-
quence.fSO) At other times fastening themselves
on the intestines, like leeches, they cause violent
pains of the abdomen, and terrible spasmodic con-
vulsions destroying the sufferer. (21) A singular
symptom of this taenia, is a frequent sense of ten-
sion or tightness in the nose. I once saw^ a pa-
tient who, every instant, complained of this extra-
ordinary inconvenience. (S3) Practitioners have
believed that these symptoms continue till the head
of these taeniae is evacuated.

sympto:ms of the vesicular worms.

^ LXXXIV. The symptoms of these worms
have not yet been precisely ascertained, because
we have hardly yet begun to make observations on
their existence in tlic different parts of the body.
These worms arc common, especially in persons of
a weak lymphatic system ; they adhere to the lym-
phatics and suck in their contents. (33)

"Whether these vessels, being weak, favour the
development of these worms, or whetherthese small
animals, by consuming the lymph, procure a more
abundant nourishment at the expense of these parts,
it is certain that asthenia prevails in this system of
vessels, so soon as any disease appears which is
believed to be connected with it. Agreeably to the

VERMINOUS DISEASES. 14$

beautiful experiments of Masca^ni, CruickshanJc,
and of Assalinif as well as since the pathological
observations collected by Soemmering (S4) and by
Wolffy{25) physicians are more than ever convinc-
ed of the influence of the system of lymphatic ves-
sels over the functions of the animal economy.(S6)

^ LXXXV. The vesicular worms scattered
through the substance of the brain of sheep, render
these animals vertiginous, meager and stupid ;(S7)
living in the ventricles of the human brain, we have
observed that they are the cause of apoplexy. (28)
In these cases we should also consider the mechani-
cal effects they produce on this viscus as depending
on the presence of foreign bodies, since they must
also contribute to excite all the phenomena which
result from the irritation of this organ. Vesicular
worms have also been found along the plexus cho-
roides of the brain, in a man, who, during his life,
was subject to very frequent vertigo, and to tingling
of the ears. (^9) In the hydrocephalus internus of
children, vesicular worms are ordinarily in the sub-
stance or ventricles of the brain. (30) In encysted
dropsy we also observe an infinite number of these
worms, at least if some practitioners of merit are
not deceived. (31) With Pallas^ we regard them
as causing this and similar diseases.

§. LXXXVI. Hydatids have been found in the

matter of expectoration,^- in urine, and in fecal
discharges. (32)

* Dr. Bonafox, in his TraiU sur la nature et le iraitement
(h la Phthisie Pnhaonzdre^ aflmits. from obsorvation. a species

ast

150 VERMINOUS DISEASES.

Authors speak of liydatids seen iu the cavity
of tlie thorax, in the substance of the heart, in
the superficies of the pericardium, (33) in the sto-
mach, in the intestines, ^34) in the mesentery, (35) in
the iiver,(3G) in the epiploon, 37) in the vesicula
fellis,(38) in the kidneys,(39) in the uterus, (40) in
the the placenta,(41) in the umbilical cord, (43) in
the testicles,(43) in the ovP4ries,(44) in the intersti-
ces of the muscles,(46) in fine, in almost every part
of the human body.(46) xlre all these hydatids,
truly vesicular? This question is not yet fully
elucidated or decided. If ICoelpin and Walther
liave concluded that for the most part hydatids
are a mass of vesicular worms, (47) Werner, an
accurate observer, has also made it appear,(48) that
small bladders of hydatids are formed of inorganic
substances, and consequently they cannot constitute
a separate auimal. In this view of the subject
Soemmering'^ s idea would be well founded, (49) in
regarding hydatids as real varices of the lymphatic
Tessels. It remains to be proved that the hydatids

of hydatigeuous phthisis. He relates p. 24, that on opening the
body of a child of 5 years old, who died of this disease, he
found three hydatids in the lobes of the lungs : these hydatids
were of the solitary species ; two were on the left division at
some distance from each other ; they did not exceed the dinien-
sions of a hemp seed ; the third was in the right lobe, and was
as big as a large hazel-nut.

We cannot admit with Dr. Bonafox, a sort of hydatige-
nous Phthisis, because hydatids are not produced by consump-
tion, but from general and local asthenia. F, Trs.

VERMINOUS DISEASES. 151

found in the human body can justly be called vesi-
cular worms, and that these vesicular worms be-
long to the class of the hermit vesicular worms of
Bloch,{^0) or to the social vesicular worm, as others
have pretended,(51) against the observations re-
peated even by Block. Before we can confidently
decide what morbid symptoms they produce, and
which may announce, if not certainly at least with
probability, the existence of these worms in any
particular part of the body, the researches of phy-
sicians must be directed by those of naturalists.

SYMPTOMS OF THE TRICOCEPnALUS.

§. LXXXVII. Tliis worm according to authors,
having no biting organ, all the inconveniences it
produces must arise from its irritating the intes-
tines, chiefly the large, exciting those diseases which
depend on a morbid irritation of the intestinal tube.
Collected in great numbers they deprive the system
of its requisite nourishment, and contribute to lessen
its strength. Inflammation and dilatation of the
intestines, occasioned by these worms, though rare,
have been noticed by several practitioners. (52)

§ LXXXYIII. They have been found in the
bodies of soldiers who have died of a contagious
epidemic ;(5i) among miserable people, poorly fed,
who have fallen victims to some slow nervous fe-
ver ;( 4) among infants nursed and detained in or-
phan houses, who have been attacked with typhus
accompanied with petechiae.(.')5) This worm com-

15;2 VERMINOUS DISEASES.

monly passes from the large(56) to the small intes-

tines.(57)

§. LXXXIX. In mucous diseases which are
manifestly asthenic, arising from a defect of nutri-
ment, and which I think might properly be called,
general consumption, when symptoms of worms are
subjoined, — they are most frequently produced by
the tricocephali and lumbricoides which live to-
getlier.

SYMPTOMS OF THE ASCARIS VERMICULARIS.

§ XC. Commonly this worm resides in parts
abounding with mucosity,(58) such as the large in-
testines, the vagina, etc. ; they generally inhabit
the lower portion of the rectum. (59) By contract-
ing and extending themselves they excite in the
large intestines, particularly in the rectum, a dull
feeling of irritation, or a tedious and unsupporta-
ble itching, and sometimes very acute and cutting
pains. (60) It is probable this worm insinuates its
mouth into the folds of the intestines, and thus re-
sists the peristaltic motion of these organs.

They are united into conglobate masses with
other worms of the same family ; the inner surface
of the intestines is entirely altered by the irritation
produced by thousands of these worms, and the
want of mucus, which their eating this fluid oc-
casions, renders these parts more sensible and
irritable.

^ XCI. In children and weak persons, the mu-
cous substance is ordinarily more abundant tlian in

VERMINOUS DISEASES. 153

adults and robust constitutions ; hence these worms
prevail more in the former than in the latter, be-
cause in the first, circumstances favour their growth
and reproduction. Infants and enfeebled persons
being already irritable, it follows that the ascarides
verraiculares must produce in these individuals
more serious inconveniences than in adults and firm
subjects.

§ XCII. The symptoms darived from these
worms are extremely violent in the inflammation of
the intestines, principally in the colon and rectum.
Though these worms exist here in small quantity,
the effects of their presence are very severe. The
dificiency of the mucous secretion, and the increase
of heat are so many predominant causes of the
phlogistic diathesis, which renders tliese inflamed
parts more susceptible of morbid irritation.

§ XCIII. Frequently these worms, situated in
the wrinkles of the end of the rectum, are the cause
of tenesmus, hemorrhoides, and of swelling and in-
flammation of the anus.

Those portions of the intestinal canal which
are supplied with nerves from the branches of the
intercostal nerve being irritated by worms, the ef-
fects which hence result and which have often been
observed, are convulsive cough, grinding of the
teeth, itching of the nose, and various other vermi-
nous affections, from sympathy.
20

154 VERMINOUS DISEASES.

SYMPTOMS OF LUMBRICOIDES.

§ XCIV. The head of this worm terminates in
a cutting sharp poiut;(6l) it insinuates itself into
the raucous membrane of the intestines, causing
pungent and rending pains, of which those complain
who have these worms, particularly in the umbilical

region.

Colic, and a rumbling in the belly, are signs
peculiar to this kind of worms. Sometimes the
patients experience the same phenomena as those
occasioned by the application of leeches.

^ XCV. This worm, according to observa-
tions already collected, makes itself a passage
through the walls of tlie intestines,(6^) and alone
produces the complaints above mentioned wherever
they are ;(63) these symptoms are more or less se-
vere, according to the greater or less irritability of
the aiFected part.

§. XCVI. This worm possesses great sensi-
bility, which is very fortunate for the human ma-
chine ; air, and cold water, throw them into a state
of asphyxia, and the peristalic motion of the intes-
tines when quickened, or the use of a drastic purge,
is often sufficient to expel them from the body. For
this reason, when these worms have once descended
into the large intestines, they are easily evacuated.

VERMINOUS DISEASES. ^ 155

ir. SYMPATHETIC AFFECTIONS FROM WORMS.

§> XCVII. Ill all anomalous and rare diseases,
every intelligent physician begins his investigation
of the causes, by inquiring whether the patient has
ever noticed any sign of worms.

Experience has often demonstrated that a great
number of severe and obstinate diseases may arise
from worms, especially when tliey are lodged in
the stomach and bowels.

§ XCVIII. The doctrine of the sympathy be-
tween the abdomen tand other parts of the body,
was known to Hippocrates ;(64) it has been eluci-
dated since by the most esteemed practitioners, (05)
and they assign sufficient reason for the manner in
which the irritation, produced by worms in the sto-
mach and intestines, may derange the whole animal
economy, and prove the cause of the most violent
spasmodic affections, even in parts of the body
most remote from the abdomen, and particularly in
the skin.

When the skin contracts, says i?osensfei?i,(66)
shivering succeeds, and if this is communicated to
the throat, deglutition is impeded ;. 67) from this
spasmodic contraction arise all the other symptoms
which have been observed by pliysicians in persons
troubled with worms, as the intermission of the
pulse, palpitation of the heart, syncope, vertigo,
loss of speech, blindness, buzzing in the ears, de-
jection of the mind, stupidity, delirium, contractions
in sleep, disturbed thoughts, inquietude, anxiety.

156 VERMINOUS DISEASES.

hiccough, convulsions, epilepsy, apoplexy, and au
iniiuite number of other diseases, which we have
mentioned only in part.(68)*

* The Journal general de Medicine, edited by the learned
Sediltot, for tlie month of floreal year 12, contains observa-
tions communicated by M. Iloiizelot, surgeon in chief of the ci-
vil and military hospitals of Meaux, among which is a case too
interesting to be omitted in this place.

Pierre M. , . . . , born of sound parents twelve years old,
ten of which he had passed in perfect health, which was not at
all impaired by the eruption of the small-pox or measles, when
in June, 1799, the following symptoms appeared ; a continual
spitting, whiteness of the tongue, countenance alternately pale
antl flushed, mouth often full of water, a moving of the alae
nasi, contraction of the muscles of the face and eyes, stricture
of the chest; constant agitation of the arms and head, and slight
convulsions.

November 1, a sudden loss of sense; limbs flexible^
nu)uth somewhat frothy ; in tlie evening at supper, a momentary
blir.dness, though he was perfectly sensible. A physician who
was consulted, did not perceive any thing more than a simple
nervous disease which he called epilepsy, the consequence of
a slight fright which tlte patient experienced six months be-
fore. He prescribed antispasmodics, which produced no effect.
A violent anthelmintic purge removed all the symptoms, which
returned the following June ; then he had a momentary loss
of si.i,ht, of hearing, and of speech ; a sense of oppression of the
chest ; and at last the strongest nervous symptoms. Some pur-
gatives being administered, tliey produced the discharge of an
enormous quantity of black and very fetid fecal substances.
The sjMnptoms subsided in part till the first of ventose year 9.
At this period, J/. Ilouzelot was called in ; he made the following
notes on the state of the patient; a changing colour of the face,
a dark semicircle under the eyes, itching of the nose, pains
about the epigastrium, general emaciation, an undulating motion
of the stomach, mobility of the wings of the nose, of the mus-

VERMINOUS DESEASES. 157.

§ XCIX. In the year 1.^43, an epidemic ce-
phalalgia made its appearance in some provinces of

cles of the face and eyes ; white tongue, painful stools. The
same evening he lost his speech, respiration short and very pain-
ful ; the patient intimated by signs that a great weight impeded
his speaking and breathing. The symptoms disappeared for a
moment to be followed by violent convulsions in the muscles of
the arm. After the fit, the lad said that before the attack he felt
something move in his stomach, and that a second after he lost
his speech. Some calming medicine procured a pretty good
night; there was no other crisis.

February 21, in the evening, M. . . . , though perfectly
tranquil, lost his sight, which soon returned, and then he be-
came deaf. This deafness declined, and was succeeded by aphonia
and difficulty of breathing. The patient was successively for an
instant blind, deaf, and dumb, and terrible convulsions followed
all these singular symptoms. The muscles of the spine were so
contracted as to bend the body backward. These muscles re-
laxed to obev the contractile force of their antagonists, which
in their turn bent the trunk forward. The tongue passed out of
the mouth, the eyes were turned up and the arms were stiff, the
nates touched the feet ; the pulse was small and frequent ; and
respiration very short ; the severity of these symptoms put his
life in danger. As this lad threw up every thing he took, M.
Hoiizelot caused him to inhale ammonia, — all the symptoms
immediately ceased as if by enchantment. A strong opiate
procured repose during the next night. The remission of these
complaints after the use of anthelmintics, led M. H. to believe
that they arose from worms ; this opinion however was not well
received. In the morning of Feb. 22, the symptoms returned
with extreme violence, the head being most affected.

His eyes were rolled up, he understood nothing, his ideas
disconnected, and his obstinacy in speaking of nothing but re-
ligion, all resembled a fit of mania.

The cerebral affection often abated to be transferred to the
muscles of the tongue, which was thrust out of the mouth. This

158 VERMINOUS DISEASES.

France which was found to have heen occasioned
by worms. (69) They are sometimes the cause of ma-

jtaroxysra had lasfcd three hours, ^\ hen lie was made to respire
ammonia, which aflbrded relief : the patient said that before this
attack, he felt a pricking and something move in his stomach.
Notwithstanding the entreaties of M. Houzelot, he could not
induce the family of the patient to follow the use of antispas-
modics, on which the first physicians insisted, with anthelmin-
tics. February 23, the boy's life was in imminent danger; the
symptoms were so much aggravated, the blindness, deafness,
aphonia, temporary mania, protrusion of the tongue, and the
geTieral convulsions, were nut the most alarming of them. The
contraction of the muscles of the spine continued three hours :
the mouth was closely shut, and the masticating muscles were
so contracted that it was necessary to use a tube to get down a
few spoonfuls of a composing draught. The volatile alkali was
now used without success ; the sufferer had taken nothing for four
days, and was ready to expire.

On the 24th, a consultation was agreed on; that the disease
arose from worms, appeared so evidently that a strong decoc-
tion of artemisia semen contra, of the fuciis helminthocorton,
Linn, and of uhsiinthium, with the addition of orange flower
■water, an infusion of the flowers of tiliaor linden tree, and pills
made of suhmuriate of mercurj' and semen-contra, were imme-
diately prescribed. No remission of symptoms on the 25th;
26th, symptoms less violent; two stools, with two lumbrici—
general and partial convulsions.

On the 27th, liiteen very large living lumbrici were discharg-
ed. There is a marked diminution of the symptoms, and an ob-
vious improvement; in seven days, fifty -five living and twenty-
eight dead worms Avere voided. On the Tth of March, a new
order of symptoms took place. The belly became the seat of the
disease, the musclesof the abdomen were so violently convulsed
that they rose and fell alternately at least six inches. This
state continued t!)rce hours. On feeling the abdomen, a pretty
large tumour, hard and moveable, was discovered in the left iliac

VERMINOUS DISEASES. 139

ma,*(70) of dysentery,(71)of St. Vitus's dance,(7S)
of catalepsy,(73) of tetanus,(7'i) of epilepsy,(75)

region. A cataplasm of garlic, wormwood and tansy wms applied
over all the abdomen. Tliese symptoms rcajjpe»red for three
hours in the night of the 8th and 9th.

The patient evacuated with his feces fifteen lumbrici, and a
considerable quantity of blackish matters. A brisk cathartic,
procured the next day, copious dark, fetid evacuations, loaded
with an enormous quantity of putrid v/orms, among which forty
lumbrici were counted.! From this epoch to April 11th, the
anthelmintics were continued ; the patient was six times purged,
and again discharged fifteen worms, and a quantity of matter
containing the fragments of many more.

From the last date M. seemed radically well, till the begin-
ning of August, when he experienced some slight indications
of worms. On the 13th and 14th, convulsions, itching of the
nose, and spasmodic twitchings of the abdominal muscles, took
place. The 23d and £4tli, he had loss of sight, hearing, and
speech; a ptisan and anthelmintic pills were administered.
The presence of taenia was suspected, and M. de JVo/(^er's rem-
edy was prescribed. Pronounced better from the first dose ;
the symptoms abated almost instantly. This remedy taken
three times more, produced the discharge of thirty lumbrici.
The patient has been six times purged ; he continued the anthel-
mintics, and the treatment w as terminated by the use of cincho-
na and preparations of iron, with so much success that on the
22d of October, 1804, the patient had complained no more
after the month of August, 1803. Vermifuges however, com-
bined with purgatives, were still occasionally administered.

* Our colleague Esquirol, piiysician of the Lunatic Hospi-
tal opposite la Salpetriere, has just published in the Jiecueil

•j- Of this number, one was found ten inches long-, as large as tlie ring-
finger of an adult person, covered with very short hairs, vi<ibli\^'iththe
glass, and appearing black.

160 VERMINOUS DISEASES.

convulsive asthma,(76) amaurosis, f^y) pleurisy,(78)
as well as oth(r convulsive affections, 79) and in
women the suppression of the menses. (80)

pereodique de la Sociite de Medicine de Paris, edited by Dr.
Sedillot, a case which deserves a place in this work. A young
man of 18 years, of middle size, frizzled hair, large and black
eyes, devoted to tlie study of surgery, led a very retired life.
During the heats of last summer this young man went often to
bathe in the Seine, in the warmth of mid-day. In the begin-
ning of June, he gave signs of alienation, to which phrenzy
was soon added. Two copious bleedings restored him to tran-
quillity ; some days after the delirium reappeared with the same
fury ; two new bleedings gave no relief; purgatives did no good j
at length the patient was conveyed to the hospital August
10, 1803.

His face was pale, his eyes fixed, the features of his coun-
tenance were sunk, and his memory weakened. He was calm
at the moment, and dined with a good appetite ; immediately
he tears and breaks every thing in his way, he sings, dances,
hollows, and threatens with a strong and hoarse voice ; he ut-
ters the most obscene language. With the most dissimilar ideas
and disconnected phrases, he blends tlie names of his relations,
his friends, his professors, and the officers of government He
speaks of love, infidelity, courtship, etc. His countenance is by
turns red or yellow ; his tongue thick, dry, and covered with a
yellow coat; his breath is fetid, and his skin burning; in the
evening he ate and drank voraciously. During the night he con-
verses quietly, or flies into a passion with those he believes to be
near him ; he swears and ruLS about his chamber to extract the
nails, ivith ivhich he imagines the pavement of his chamber is
studded. His cries are horribly painful ; if one approaches him,
he loads him with abuse, he spits in his face ; if any one re-
proves him, he threatens, or remains motionless, his eyes shut,
leaving his head and limbs to their own weight, or as they are
placed, provided the position is that of easy flexion; copious,
fetid, brown urine, belly constituted.

VERMINOUS DISEASES. 161

These disease did not cease till the worms were
evacuated, or the physicians were deceived in the
indication of cure, when the patient became the vic-
tim of the mistake.

August 12. Beside the symptoms of the preceding even-
ing, a SN'ncope came on and Listed two hours. He refers
his pains to the larynx and epigastric region. Frontal cephalal-
gia, voracious appetite. Frightful shrieks at intervals; he seems
suddenly to fall into syncope ; he dreams in the night, dreams
of snakes and of contending with them.

1?. He sleeps six hours in the day ; an hour alter he is fu-
rious.

14. An enema procures a copious discharge, at first hard,
then liquid and yellow. Abundant brown urine.

15. A return of reason, he is however dejected, has some
sleep; he always has acidulated, nitrated drink.

16. Delirium returns in the night; he breaks every thing ;
the strait jacket is put on him, which occasions much sweating,
but has no moral influence over him, nor has entreaty any
effect.

17. A tepid bath for an hour, followed by the shower bath ;
the patient at first braves the shower bath, but soon falls into a
!*yncope, tliough he had taken no food.

18. Tepid bath during two hours, laxative drink. Fre-
(juent nasal hemorrhagy ; more calm, but incoherent in his ideas.

20. Bath ; another shower bath suspended after two
minutes, for fear of syncope, though the diameter of the
column of water was but five millimetres.* Bleeding from the
nose. No delirium in the evening; but his eyes were wild, his
speech short, and his motions quick and rough.

21. Bath, lotion of oxycrate over the head, less agitation, sleep.

22. After coming from the bath, a profound sleep of some

hours. In tiie evening a clyster, followed by liquid yellow dcr

jections.

* The French initUmetre\s tlie thousandth part of a metre, or '03937
part of an English inch, .'?, T.

SI

162 VERMINOUS AFFECTIONS.

III. VERMINOUS AFFECTIONS OF THE WHOLE SYSTEM.

§ C. We find in the writings of physicians,
various asthenic diseases, both acute and chronic,

23. Agitated in the ^Jay? sleep at night ; bath, acidulated,
nitrated drinks.

£4. Delirium and raving return j Makefulness, abundant liquid
stools,

26. Face much flushed ; abdominal pains, particularly ot the
epigastrium; frequent stools; syncope with a sense of tigli/.ness
in the throat.

The patient rubs his nose much, and desires his servant to
rub it.

28. A bolus of jalap and submuriate of mei-cury. Infusion
of male fern (Pol_y podium filix mas, Linn. ;) several liquid dis-
charges mixed witli mucus, and a large quantity of lumbricoides
and ascarides.

29. The same medicines the same effects ; calm in the even-
ing.

30. Idem. In the evening a return of reason. Since, sev-
eral discliarges every day, mixed with yellow mucous substan-
ces and sometimes worms.

31. Infusion of Roman chamomile; a progressive return to
reason ; sleeps more, sometimes interrupted by dreams, but of-
tener by outcries, appetite without voracity ; the eyes more
closed, complexion less yellow.

September 22. Siomentary explosions of fury, slight de-
lirium ; tears, followed by immoderate laughter. He recognis-
es every person in the house, speaks of his family, and promises
to follow my advice for the complete reestablishment of his health.
A'isage pale, pulse weak, eyes dejected, slow answers, and en-
feebled recollection; boluses of cinchona and canella; infu-
sion of orange tree, more wine with his meals.

Oct. 1 . In the niglt he sends forth frightful shrieks and leaps ia
liis clianiber to avoid points in the floor ; he dares not rest against

VERMINOUS AFFECTIONS. 1^

occasioned by worms, and which have thence heeu
called gastric verminous fevers, muscous diseases,
and glandular diseases.

the wall for fear of being pressed; he jumps on his bed and
then off' again, ahvavs because he thinks some one is driving
points into every part of his body, especially into the soles of
the feet and palms of the hands.

For an instant he feels as if strangling, with pains of the
epigastrium.

2. Idem. The next day he took boluses of jalap and sub-
muriate of mercury. Several liquid stools, the following days,
infusion of rhubarb. It was not ascertained tliat worms had re-
cently passed the bowels.

From this time his countenance was less dejected, there
was no incoherence of ideas, nor raging ; his memory revived
and his strength improved. The patient inquired for some
books, attended to his dress, and desired to see his parents.
He was rather sad, and walked by himself. There was no
vestige of his malady, excepting great debility ; a heaviness and
confusion of his head : he was restored to his family,

22. In the night he screamed out and had a syncope for two
hours; he took a purgative draught which procured a very black
discharge; no sign of delirium, some dejection of his spirits re-
mained, with an obscure pain of the liver. A blister was ap-
plied to the pained part. The healthy complexion of youth,
plumpness, habitual gaiety, the free exercise of all the intellec-
tual faculties, all announce a perfect convalescence, and this
young man has since enjoyed very good health. Our colleague
Giraudij, who is also successfully occupied in treating mental
alienation, informs us he has observed several cases of sympa-
thetic mania, caused by worms. We cannot too strongly in-
vite him to enrich the medical art by his observations on the
treatment of the diseases of the mind. Dr. liosqnUlon also
speaks of annnstance of lunacy produced by an insect lodged
in the frontal sinuses. /''. Trs.

1(54 VERMINOUS AFFECTIONS.

§ CI. Persons inhabiting cold, wet, and un-
healthrul climates, whose food consists of viscous
rather than nutricious substances, who drink im-
pure water, who are daily fatigued by their labour,
who have little rest, and are a prey to those pas-
sions of the soul which break down the mind, and
weaken the body, these persons are found to be sub-
ject to those general affections which arise from
worms. '? o the assemblage of these causes more
or loss active and more or less permanent;, are to
be attributed the origin of the most famous vermin-
ous epidemics described by authors, and particu-
larly those of Bailou,{Si) Van Suiietenf[82) Hux-
ham,{SS) and Van-den Boschj[8'i) as well as the
fevrrs reputed to be of this kind by a number of
celebrated practitioners.

We must ascribe to these causes the intermit-
tent 'uid remittent fevers, named verminous by
l)ehaenf{S5) and by other writers of merit. But
how can we consider w orms alone as the primitive
cause of those diseases which have been so mortal?
I do not deny that the morbid irritation they pro-
duce, since we see it to be the cause of a number
of sympathetic verminous affections, may also con-
tribute to increase these asthenic disorders of the
whole system. Still however no one can convince
me that the mere irritation from worms can be suf-
ficient to produce a fever of the typhous character.

We often see in smallpox and measles symp-
toms of worms ; it would nevertheless be errone-

VERMINOUS AFFECTIONS 163

ous to derive these liighly asthenic diseases trora
worms.

§ CII. We have already shown(86) that the
astlienic state of the human body is favourable to
the development of the germs of worms, provided
there exists in some part a decomposiiiou in the
continuity of the ors;ans.

Worms, escaped from the egg, find in the de-
composed matter, an aliment which serves to nour-
ish them.

In severe diseases, mucus abounds more* in the
degestive organs than in other parts ; it thence fol-
lows that the development of worms must be more
frequent in the intestinal tube than in other parts
of the body.

§) cm. From all that has been hitherto said,
we clearly comprehend that verminous fevers, like
gastric fevers, so called, (87) are really nervous fe-
vers, during which worms multiply and grow in
those parts of the body that are most enfeebled.
Tlie same m\y be said of mucous(88) and of grandu-
lar(89) diseases ; they are all the effects of a slow
and universal consumption of the body. In these
diseases worms are evacuated, and no more are de-
veloped ; and under the influence of a stimulating
and appropriate regimen, the body begins to re-
gain its lost strength, and to miintain the contin-
uity of the organs, particularly iu those destined
for the natural functions. I do not therefore speak
of the symptoms of these maladies, because those
of nervous fever are slow or acute, and accompa-

166 VERMINOUS AFFECTIONS.

nied by partial weakness of the stomach and intes-
tines. We have spoken particularly of those dis-
eases,(90) and of the association of symptoms pro-
per to the worms already mentioned. (91) The
physician may infer from them the existence of
worms, since those that live at the expense of the
human body render its diseases more severe and
complicated, as they always tend to increase the
debility and the solution of the parts of the body.

END OF THE THIKD LECTURE.

XOTES

TO THE THIRD LECTUR^.

(1) As Block has affirmed that worms are not
always the cause of diseases in the animal machine,
Traite de la gen. des vers, p. 69, douzieme preuve,
he must have said it to prove, as a naturalist, that
worms are natural to every animal.

But that a physician of great repute, like the
American Rush, should maintain that worms are
necessary to preserve the health of children, is what
every practitioner will oppose : see Weikard,
Maladies locales, classe premiere, etc. Natural-
ists have not omitted to notice the complaints,
sometimes even fatal, occasioned by worms in ani-
mals. Goeze, an exact narrater of every thing he
had occasion to observe, Versucheiner, J^aturg.
etc. p. 98, says he once took a temporary living frog
•which could not move, and seemed to be almost dead :
this frog, put in a basin of water, immediately sunk
to the bottom, and in a few minutes died. In its
viscera two Cucullani were found and several as-
carides vermiciilares which were swarming in the

J 68 NOTES TO THE

whole substance of the lungs. Several observa-
tions* similar to these, and vi^orthy of attention have
been collected and published by Vallisnerif Op, ii.
p. i»

(2) Collectio Societatis medicae hauniensiae,
p. SI.

(3) Baglivi, Praxis medica, lib. i.

(4) We read in the Ephemerides des Curieiice
de la J\^atiirc, dec. ii, an vi. obs. xxxiii, the history
of a case of insatiable hunger occasioned by lumbri-
coides. The patient, who was incessantly ill, found
no relief except in taking food.

(5) Sauvages speaks, Nosologia method cl. vii.
gen. XX, spec, x, obs. cxviii, of a cardialgia, which
in a certain part of the country occasioned the
death of several persons. On opening the dead
bodies, lumbricoides were found so closely attach-
ed to the coats of the stomach, that they were even
perforated.

From the same cause arose the volvulus of the
young woman who vomited up every thing ; see
Sauvages.

(6) Set; Van Swieten, De Morhis infantum, etc,

(7) Traite des maladies des enfans, etc, p. 313.

(8) A young woman feeble and emaciated came
to the Clinical Hospital of Pavia, in the winter of
17^7 j she had been tormented for more than twen-
ty days with pains of the joints, which rendered
her stiff and immoveable.

There was not any swelling of the articulations ;
both pupils were largely dilated, the mouth inun-

THIRD LECTURE. 169

dated with a very viscid mucus ; these symptoms
made me suspect that the disease might originate
from worms, and be kept up by them.

On administering suitable remedies, she evac-
uated nine large lumbricoides, and immediately the
appearance of arthritis disappeared. We meet
also in Rosenstein with two cases very similar to
the observation I have just given. Dr. Lindestolpte
was called to a girl of ten years, who complained
of a pain in her left side, with a dry cough, slight
heat, strong pulse, great thirst, and sometimes a
titing or pricking in the stomach ; she often lost
her speech, and had spasmodic contractions.

He thouglit these symptoms arose from worms,
and prescribed some anthelmintic powders.

After taking them twice, she was attacked about
midday with so violent contractions, that her feet
were turned toward her back. The convulsions
ceased ; she had ^o more pain, and fell asleep.

Her mother, w ishing to raise her from the bed,
saw a round living worm fall on the floor, half a
metre and three decimetres* long, which turned it-
self about like a serpent. This worm passed from
the body during the convulsive struggles.

After evacuating several pieces of worms, the
girl was cured.

The other case is one of Br. Varelius, of a

young man who suffered a very sharp pain of the

* The decimetre is the tenth part of a metre, or 5,93710 in-
ches. The close of the note p. 161, on the word miUhnetre,
should he thus — or ,03937 of an English inch, uluchthe readei-
19 desired to correct, ^i. T.

irj» NOTES TO THE

thigh; and in the right lumhar region, which ohlig-
ed him to carry the right foot benk forward. Uis
father feared a luxation ; but the physician observ-
ing that the son had a tension in the epigastric re-
gion and frequent pains of the stomach, and also
that his mouth .was full of saliva, and that he had
an itching of the nose, and serous or watery urine,
imagined that worms were the sole cause of these
symptoms. In fine, he procured their evacuation,
and the patient was very soon restored to health.

(9) See § and note II, of the first Lecture.

(10) The organs of the animal body are so con-
nected together, that they cannot continue to act
without the concurrence of each other, and the pres-
ervation of one depends on the reciprocal influence
of others. We cannot however conclude that the
proximate cause of the action of an organ exists
without itself; in truth, we see its dependence
on others, by virtue of the common tie, and of mu-
tual relations. The parts of the human fabrick
are thus reciprucally united, and severally concur
to the support of the body. For this reason when
one part is hurt, others, the most intimately related
to it, must consequently partake of the injury.

(11) The observation is from Weikard^ in his
Traite des maladies locales^ where he speaks of
worms.

(12) Ekardtf Dissertatio sistens observaiionum
hydatidum in liejpate inventarum una cum prae-
missis ad hanc materiam spectantilms. See Bre-
ra, Si/lloge opusculoriim selectorum ad praxim me-

THIRD LECTURE. 17!

dicam spectantium, vol. ix, p. 137. That these
hydatids were social vesicular worms, is suspected
with reason from the author's recital. Take his
own words :

" Hydatidum majoribus ilia ovi gallinacei, mi-
noribus vero ilia pisi magaitudo inerat. Fluido
in iisdem coinprehenso, non prorsus fuerunt diduc-
tae, atque dilatatae. Majores ovali, minores autem
magis circulari forma erant instructae, tam vesicae
earundem, quam fluidum, valde clara erant et pel-
lucida. Hydatides sectae et fluidura in poculum
vitreura receptum, innumerabilera punctorum minu-
tissimorum i4i eo circumnatantium, fuscorum speci-
em referentium copiam osteuderunt, qui humore
aeri exposito dein evaporato, et parietibus et pocu-
li vitrei fuudo adhaeserunt.

^^Quodfluidum neque omnino serosae, neque
omnino lymphaticae, fuit iudolis, et colore distinato
carens."

(13) See^XXTII.

( 14) The observation is reported by Dr. Pere-
loom, in his little work entitled, Descriptio et iconica
delineatio novi generis vermium stomachidae dictiy
etc. p, !34, I shall transcribe it in his own words,
because I deem it worthy of the greatest attention
of practitioners.

^^ Olitor, quinquaginta fere aetatis, ante aliquot
tempus nephritide laborabat, ita ut periti judicarcnt
calculo vesicam occupatam esse, turn ex miclu do-
loroso, difficili, impcdito, et quocunque modo tur-
bato ; turn ex sensatione oneris in abdomine, titilla-

tm NOTES TO THE

tione vergae et caeteris hoc symptoma comitantibus ;
turn ex grcssu varicato et dolore spatico cruris sinis-
tri ; tuui ex iirina crueiita, purulenta, aeque gru-
mosa, turbida, mucosa, foetida, vel et crassissima ;
sed praecipue cathcterismo repetito. Ideo variis
remediis usus fuit, ut aqua calcis, millefolio, bal-
satno sulphuris, atque elexirio vitrioli JVJIynsichti,
pro parte proprio motu, pro parte et consiiio peri-
tiorum. Tandem et horum usus pertaesus, post lon-
gum satintervallum^iterum meae turae sese commit-
tebat. Debilis erat, vehementibus doloribus afflic-
tus noctu dieque, sed praecipue dum mejcbat. Uri-
na jam adeo erat purulenta, ut plus puris ac urinae
emitteret ; vitra euim, lotio caute recipiendo usitata,
dimidium, et quod excedit sedimenti purulenti ple-
na erant, intermixtis frustulis quasi carnis recens
mactati. Praeter emollentia precedeutur adhuc lau-
danum in usum vocabam cum levamine adjuncto re-
gimine. Urina vcro post aliquot dies, loco sedi-
menti purulenti, brunncum deponebat, insimul cras-
sior et stercoreum foetorem prodens dum laboriosius
faciebatur.

*' Accedebat emissio flatuum sat fortium, ex ure-
thra. Sedimentum dictum accuratius examinatum,
inter caetera in eo oryzae graiiulum intermixtum
erat ex reliquiis ciborum besterna die ingestorum ;
et passim varia talia quotidie detegebara, praecipue
panis secalinae non bene commanducata. Per
quinque fere dies insolita haec secretio miserrime
continuabat, alvo peuitus obstructa, licet earn man-
natis et pranis debita in quantitatc reserare coiia-

THIRD LECTURE. 1T$

bar, donee tandem diarrhaea insequabatur. Faeces
sensim sensimque liquidiores, tandem cum foetore
urinoso, ipsius stercoris praedominante, prodibant,
ac tandem sinceram uiinam alvus dcponebat, per
decem fere dies hacc diarrhaea dundecies quando-
que vicesies de die, patiens conflictabatur, ut tu-
bus intestinalis inde penitus quidera exoneraretur.
Interea dum absolute nihil urinae j)er urethram emit-
teret, aliquatenus inde sensit levaminis ; et reno-
vatione quasi virium gaudebat, cibi avidus, bene
quoque digerens. Licet nee adstringentibus, ne
ipso quidem laudano, diarrhaeam compeseere po-
tuerim, sensim tamen sponte cessabat, ut in laxita-
tem alvi degeneraret, faecibus nihilominus adhuc
urina faeientibus. Tamen ut prius vehemtissimo
cum cruciatu ibat lotium, cujus sedimentum stereo-
reum duas partes totius exeedebat, continens quae-
cumque alvus indigesta ex hestcrnis rejecerat, ut
ficuum semina, pomorum volvas, cieerum siliquas,
olerum frustulas, et singula ne referam, poni chi-
nensis granura compressum medulla jam semidiges-
ta continebat. Quis hujus scenae non misertus es-
set, exitum acerbum minitantis? Praedictis solum
modo remediis adhibitis, cum animadvert! febrem
fere abesse, et animo forti dolores subire patient-
em, ita admonui;, ut talia aliraeota caperet, quae in
faeces pulposas coneoqui possent, ut farinacea, lae-
tem, ova, jus carnium, etc., turn et ut ipsi bis de die
clysma injeceretur ex terebintbina median'e vitello
ovorura aquae immixta. Prirai enematis portion -
em una cum urina patiens mejabat, post secundum

174 ^^OTES TO THE

non tantam, post tertium quartumvc clysma, solum
niodo odore terebinthinae urina erat praegnans.
Ita injectis plus minus decern clystetibus, urinam
iterum cum sedimento purulento albo minirae vero
stercoreo, vel tale peregrinum olente, secernebat.
Nee minus dejectio regularis erat absque urinae
putore. Quidquid agerem, clysteres amplius re-
cipere recusabat, ilerelictus ab omni spe, et cogita-
tioncm suscipiens, praeter terrae japonicae solution-
em, ab aliorum remediorum usu desistere, observa-
tioui solummodo animum submittens. Ita proce-
deiis interea sensim ut cumque vires recuperavit,
domum egressus, publicos agens conventus, olitoris
fuiictiones exercens, licet raagno cum dolore urinam
mittens, adeo ut languidam duceret vitam.

" Post novem mensis ad me retulit, se liucus-
que cum praedictis remediis continuasse : addebat
vero mictionem lancinantem minime sopitam esse,
utpote cum urina purulenta passim magnas frustu-
las quasi sanguinis grumosi ejicieus, sinceri san-
guinis, particulam moustrans mane mictam, cujus
longitudo fere sesqui pollicis erat, crassities vero
semi pollicis, adhuc renunciabat similia quotidie
accidere. Die tertio Novembris, 1771? mane, per
urethram lurabricum teretem expulit, quem mihi
vivum videre contigit, prout ex viiga egressum,
patiens ipsum extrahebat et vitro injiciebat. Hie
colore gaudet albo etin naturali magnitudine, repre-
sentatur fignra quinta, spiritu juuiperi conservatus.

" Posthae membris labefaetis, vermem equidem
socium nequaquam, sed ingentia frustula, gelatinae

THIRD LECTURE. 175

instar sanguinolentae, urinae sedimento intermixta
largiter exonerare miser continuavit, febre, praete-
rea hectica et hujus cohorte vexatus et ad ultimura
vitae halitum usque dolore exquisito mactatus,quani
aliquantulum quidem compescere laudaiio potui,
ipseaiet vero strenue religiosa patientia et pia de-
ditlone sui voluutati divinae sustentare valuit, men-
te adhuc dum constante ischuria tandem vitae filum
abrupit, die ©3 Augusti^ 1772.

^' Aperto cadaveris abdomine, prout mihi liu-
manissime ante aliquot tempus tentamento aegrotus
legaverat, invenimus una cum Candida peritia CI.
chirurgo Jauo Ruurhof, aliisque amicis anatomicis ;

"1°. Intestinum colon cum peritonaeo arete
concretum.

^^ 3°. Laborasse defunctura hernia epiplocele,
omnino in tunica vaginali procidente cum processu
valde attenuate, filiforrai, intestina vero baud sub-
secuta fuisse, quoniam inter se validissime et ubivis
fere erant concreta.

" 3°. Fundum vesicae externe totum cartilagine-
ura, contrahi ineptum, induratum et cum intestino co-
lo, caeco et recto, ligamentis cartilagineis, nee minus
latissime cum osse pubis, concretum quae ligamen-
ta incisa vel disrupta, pus fundebat, quare et tuni-
ca vaginalis dextra puris plena erat.

*'4t°. Catherem vesica recipere renwebat.

*^5^. Glandulae mesenterii, quotquot offendi-
mus, substantiae ex albo cartilaginae erant, magni-
tudine fere ju gland urn.

<<6°, Plurima ulcera fistulosa ex vesica in an-

176 NOTES TO THE

ncxa monstrosa intestina, vel et in peritonaei ca-
Yuni cxibant.

^* 7 . A^esica interne oranino infarcta erat ma-
terie gelatinosa ejus parieti affixa, pus mentiente
ingrassatuni, dura, tenaci, glutinosa, parum olente,
in aqua valde su!»sidente, nullum vacuum pro nrina
recipienda relinquente, nisi quod rivulus serpen-
tinus crassities uretcris urinae transcursum formabat
per substantiam dictam, tandem quoque adeo op-
pletum et deletum, ut sensim sensimque ischuria
inde nata vitae filum abruperit. Calculus in ve-
sica baud detectus fuit. Intestinum rectum vix
distingui posset, ita cum vesica erat coalitum, quare
nee locus suppurationis praecedentis quae commu-
nicatioui vesicae cum intestine recto ansam praebu-
erat, ad voium iudicari licuit. Erant interea ure-
theres naturales, nee minus renes, papillis solito
mlnoribus ut cunque donati. Hepar satis sanum
apparebat, et quod notabile, cadaver minime adipe
destitutum erat."

(In) See ^VI.

(16) Goeze, VersucheinerfJVaturges.derEin-
geiceid,, etc. p. 27S.

(17) Goeze, the work cited.

(18) See § XV.

(19) See ^ XITT, p. SO.

(SO) Syllogenf Observationiun varii argiimenti :
Uauniae, 1783, 8°. p. 45.
{U) See § XL
(3^) The patient was attended by the learned

THIRD LECTURE. 177

professor Borda, of Pavia, who was pleased to
communicate to me the accident mentioned.

(23) See § XXVII.

(S4) De morbis vasorum absorhentium corporis
humani pars pathologica ; Trajecti ad Moenunif
1795, 8°.

{2 ) Arzney kundige abkandlung ueber den
^iitzen der Wasserj oder lijmphen Gesasse ; Lin-
gen, 1795, 8°.

(26) See Soemmering, the icorJc cited.

(37) Leake, Mhandlung vom drehen, etc. ;
Leipzig, 17»0,8°.

(28) See ^ XXIII.

(29 ' Weikard, Vermischte medizinische Schrif-
ten, 'if. stuck, p. lOS.

(30) Ludivig, De hydrope cerebri puerorum ^
Lipsiae, 177'*. Ved. Baldinger, Sylloge select.
Opusc. argumenti medico-practici, etc,

(31) J\*ordische Beytrage, 1 Band, p. S-t.
(3^) Medical Transactions, vol. ii. p. 486, P^z-

losopJiical Transactions, etc. vol. xxii, p. 497? t-'ol.
XXV, p. 3B4. Memoirs of the London Medical
Society, vol. ii, art. ii.

(33) Holler, De corporis humani fabrica, vol.
yi, p. 480, not. 6.

(34) Soemmering, Baillie anatomie des Krank
haften baues von einigen der wichtigsten Theile im
menschlichen Korper, ucbersetx, Und mit Zusat-
zen von Soemmering ; Berlin, 1794, p. 134.

(35) Baillie, the work cited, p. 116.

(36) Eckardt, Dissert, si-stens obs. hydatidum in

23

17« NOTES TO THE

hepate invent, etc. Soemmering, Baillie, the work
cited.

(37) Jlcta JSTatur. curiosor. Berolini. v. i. p.
348.

(38) IValtheVj Annotationes Academ., etc. p. 84,
no. 6.

(39) Medical Communications, etc. v. i. p. 10.

(40) Smdifort, Ohs, anatomico-patholog. lib. ii.

(41) Soemmering, the work cited, p. 2:32.
(4?2) Ruijschius, ohserv. xiv, p. 15.

(43) Morgagni, De Sed. et causis morh. etc.
mpist. iv, art. xxx.

(44) Eckardt, Dissert, cit.

(45 j Werner, Vermium intest. brevis expos,
continuatio secunda,p. 7-

(46) Morgagni, De Sedibus et causis morb. etc.
JEpist. xxxviii.

(47) See ^ XXVI.

(48) Verm intestinalium, Taeniae praesertim
humanae, etc. p. 68.

(49) De Morbis Vas, absorb, corporis hum. etc.
^ XXII.

(50) See §^ XXIV, XXVIIT.

(5i) See §1 XLIll, and the annexed note,
no. 27.

(52) Margrnff, De morbis a vermibus intestina-
libus oriundis ; Vittebergae, 1799, p. 8.

(53) Wagler, Dissert, de morbo mucosa, Prae-
side, 1. G. lioederero, etc. See ^ XXIX.

(54) Blumenbach, Handbuch der J^aturges,
etc, p. 4t0.

THIRD LECTURE. 17»

(55) Stollf Pars septima ratio, medendi ;] View
tiae, 1790,;?. 116.

(56) See § XXIX.

(57) Werner, Verm, infest, etc. p. 84, Stoll,
Op. et loco cit.

(58) See §^ XXXVII, XXXVIII, XXXIX.

(59) See ^ XXXVI.

(60) Van Phelsum, Hist. Ascarid. pathologica,
etc. cap. iv, v, vi, vii.

(61) See ^ XLV.

(6^) See the end of ^ XLV.

(63) See the end of % LXXIX.

(64) '^ In corpore humano confluxus unus, con-
gpiratio, una, et omnia consentientia.^' Hippo-
crates, de alimentis, etc.

(65) See my JSTotes mcdico-practiques, sur les
differentes Maladies traitees dans la Clinique med-
icale de Pavia pendant les annees 1797? 1798, pre-
miere partie, § XL II.

(68) Traite des Maladies des enfans etc. p. 310.

(67) I have lately seen a young man, otherwise
very robust, who was suddenly attacked with a
violent convulsion of the throat and chest, which
threatened suffocation, and obliged him to cry out
with a loud voice. This convulsion lasted three
or four hours ; it subsided and afterward returned,
in such a manner that in twenty four hours three
paroxysms had taken place.

In the intervals the patient complained of a
sense of cold in the xiphoid cartilage, and was de-
jected. After minute examination no assurance

180 NOTES TO THE

of worms could be found, though he had several
symptoms of them, such as dilitatiou of the pupil,
salivation, itching of the nose, pains of the joints,
as well as the anamalous character of the disease,
which strengthened the suspicion of them. The
convulsion commenced, according to the patient, at
the region of the stomach, like a flame rising and
fixing with violence in the larynx.

The stomach being strengthened by an electu-
ary of cinchona, valerian and opium, and continu-
ing for some days, the convulsive access gradual-
ly lessened in force and frequency, and finally dis-
appeared.

(6^) See § LXXVI and the following.

(69) Saiiuages ; JSTosol, metJiod^ etc. cl. iii, gen,
xxiii, sp. vii.

(70) Ephemerides naturae curios, dec, iii, ob-
serv. cxxxv.

A few days since I was called to visit a girl of
nine years, who after surmounting a scarlet fever,
exhibited all the signs of an effusion of water in
the ventricles of the brain, as they are pointed out
by Ludwig, in his excellent Dissertation de hydrope
cerebri puer or um. The disease which had pre-
ceded, the certainty that the child had never been
affected by worms, the deficiency of urine, the swell-
ing of the abdomen, as well as the oedema of the infe-
rior extremities, all contributed to the belief that this
disease was hydrocephalus internus. The wretch-
ed sufferer, reduced almost to the grave, presented
no hope of recovery, yet being unwilling to leave

THIRD LECTURE. 181

her without any resourse, I prescribed some diuret-
ic and tonic raediciue, which possessed anthelmin-
tic properties, as the sudden appearance of the dis-
ease made me suspect it might arise from worms.
Submuriate of mercury in powder, and a saturated
infusion of valerian, made stronger by the addition
of a good dose of camphor, were the remedies I
chose to produce these effects.

I obtained no success during the two first days
of this treatment; the disease on the contrary was
worse, but on the third day she vomited a living
lumbricoides, and some mucous and bilious matter.

The next day she voided four lumbricoides;
and in a short time she was fully restored to health.

(7 1) Sauvages, JStosol. Method., class, xi, gen.
ix, spec. XV, speaks of a verminous dysentery,
which, from iVugustto November, attacked a fourth
part of the inhabitants of the country, and destroy-
ed a number of tliera.

The pains of the abdomen were sudden and
severe ; a sense of heat became violent in the vis-
cera, and a vomiting of mucous matter, resembling
the spawn of a frog, aggravated this complaint.
It gave way to the use of anthelmintic remedies,
after the worms were expelled from the body.

(73) In the Ejihemerides nat. ciiriosor. ann.
iv. ohserv. clxxxvii, we meet with a case of St.
Vitus's dance, occasioned by worms. A sim-
ilar case is reported by Sihlot in the Journal de
Medicine de juillct ann. 1783, torn, ii, p. 22* A

18£ NOTES TO THE

taenia and several lumbricoides were the cause of
this malady.

While practisin;^ medicine in the hospital of
Berlin, in the autumn of 179 "»> under the direction
of the illustrious Selle, I saw a child about twelve
years old, affected with St. Vitus's dance, which
had been produced by worms, though the patient
did not exhibit the leist sign of any verminous af-
fection.

(7-3) Sauva^eSf J\rosoL Method, etc. cl. ix, gen.
xxiv, species ii.

(7^) Commercium litterarium JSTorimbera^ensey
torn, if p. 385; torn, xv, 7?. 124. Sauvages^ JVo-
solog. method, torn, ii, tit. tetanus. Heister, Medi-
clnische chirurg., und anatom. warnehmurgenf
1. Band, p. I70. Brera, Sylloge^ opuscid. selector ,
vol. iv. p. 18.

(7.'^) Jicta naturae ciiriosor. vol, vii. ohserv.
cxxvii, vol. vii, ohserv. xix. Van den Bosch, Histo-
via constitittionis epidemica verminosae,etc,p.i'^2.

Ackerman, Dissert, de epilepsiae motuumque
convalsivorufu infantum causis praecepuis ; Gry-
phiae, 176j. Medical Observations and Enqui-
ries by a Society of physicians in London, vol. vi.
ohserv. of Fothergill. Gordak geschichte derfrau-
en Zimmers ; Konigsburg. 1770, 8°. Journal de
Medecine, torn, xxx, p. 5i.

(76) Ephemerides JSTaturae curiosorum, dec. iii,
an. iv, ohserv. xix, an. vii, viii, obs. clxxxxiii^
Acta Helvetica, vol. vi; p. 216.

THIRD LFCTURfi. fSS

(77) Ephem. JSTat. curiosor. dec* ii, an. v. ohs.
clxx. Journal de Medicine^ tome xxxiv, p, 13j.
mchteVf Elementi di Chiriirglaftom. iii, cap. amau-
rosi.

(78) Bonnet, Sepulcretum, lib. ii, sect. 4, oh-
serv. xxxviii. Riverius, Observat. cent, i, no. 7^-
Ephemerid. nat. curiosor. dec. ii, an. 5, Append,
p. SO.

(79) Selecta Medica Francofurtensia, Franc
ad Viadr. 1739, torn. i. p. 110. Henneherg, Dis-
sert sistens historiam morbi convulsivi infantis,
ejusdemque sanandi methodum ; Erford, 1791.
Abrege des Transactions philosophiques de la socie-
te royale de Londres, tome xiv, Venise, 1796,
p. SI 9, 273.

(80) Spigel mentions a young woman, of a dis-
tinguished family, who bad an aversion to food,
like a pregnant woman ; there was tumefaction of
the abdomen, with a total suppression of menstru-
ation. The parents consulted a number of physi-
cians, who said she was with child, and all medi-
cines were abandoned. In the mean time the dis-
ease increased, and she died a victim to ignorance
and inattention. On opening the body, her inno-
cence was apparent, there was no embrio in the
uterus, but a mass of water and mucus was found
in the intestines, and a taenia as long as the bow-
els. See Rosenstein, Traite des maladies des en-
fans , etc, p. 311.

(81) Opera omnia genera, 1563,4'^. opp. i, j;.25.
(83) Commentaria in Hermanni Boerhaave

14a NOTES TO THE

aphorismos de cognoscendis et ciirandis morhiSf etc.
torn. iv. p. 7^0.

(83) Opere fisico-mediclie, tome i, p. 284.

(8!) Constitutiones epidemiae verminosae, quae,
anil. 17^0 — 63 grassata fuitf etc. JSTorimhevgae,
i779, 8'.

(85) B^atio medendi in JSTosocomio practico*
Vindohonensis, torn, xiv, p. 142.

(83) See §^ LV, LYI.

(87) See my J^otes de Medecine pratique sur
hs diverses maladies traitees a la Clmique medi-
cale de Pavie dans les annees 1793 a7id 1798, pre-
miere partiey § 44. If worms in the stomach and
intestinesj sometimes become the cause of diseasej
as of fever for instance, it cannot on this account
be called a general disorder, since tlie cause of it
is entirely local. The bilious, gastric, pituitous, and
verminous fevers so mucli in vogue during the last
century, ought to be considered as simple local af-
fections, or as complaints wholly chimerical ; as
accurate and observing physicians have agreed.*

If we arc to understand by verminous disease,
the verminous affection general in appearence,
which is occasioned by the accidental presence of
worms in the stomach, disturbing the functions of
the system, because tliey derange the functions of
the stomach which is in other respects liealtliy ; we
cannot deny this, provided we view it as depend-
ing on a local injury, and differing from a general

* riofessor Fi.iel dises not oven mention any febrile ver-
minous disorders in hh JSTosographic philusophique. F. Trs.

THIRD LECTURE. 185

disease. In fact, a disease of this kind is never
preceded by predisposition ; it does not originate
from increased or diminished general excitement,
but from a body which may be regarded as alto-
getlier foreign, and which may be either in the sto-
mach or intestinal tube. Bvoiviiy in his medical
writings, says nothing of the gastric affections, nor
does he name verminous fevers, though several
physicians of the first rank have written of them.

If, however, what we have said of fevers called
verminous, be compared with the principles of
Brown's doctrine, it will be seen that this philo-
sophical pljysician, when speaking of diseases aris-
ing from poisons, f Elements of Medicme, vol. i.
§. LXXVII,^ he informs us that these diseases
should often be regarded as local, because the poi-
son (and we will say a worm,) by mechanically at-
tacking the stomach and intestines, organs endow-
ed with great excitability, may produce from sym-
pathy, an irritation through the whole system ; but
as neither the sthenic nor asthenic diathesis is there-
by produced, it cannot be considered any thing else
than a local malady ; this view of the case is con-
firmed by the treatment, which consists merely in
expelling the poison, or the worm, from the body.

If, on the contrary, worms in the first passages
are preceded or accompanied by febrile commo-
tion, originating in reality from the irregular ex-
citement of the system, and is evidently occasioned
by a power directly or indirectly debilitating, no

physician can deny that the development of worm*?
Si

186 > NOTES.

would be favoured by these circumstances, which,
as we have repeatedly observed, appear precisely
in this state of the body, and rather from the effect
than as the cause of the febrile disease. All the
accompanying symptoms indicate a general ner-
vous affection predominating in the organs destin-
ed to perform the animal functions.

An inclination then, to found on this basis the
chimerical existence of a worm fever, is, in my
opinion, a dangerous error in practice.

(88) Waaler, Diss, de morbo mucosa / Gottin-
gae, 1765,4°.

{Sd) Werner, Verm, intest, brevis exposit. con-
tin, secunda, etc. p. 4.

(90; See my JSTotes medico -pratiques f etc. sec,
partie, cap. i, class, ii and iii.

(91) See §^ LXXVI, LXXVII, LXXVIII,
LXXIX, LXXX.

END OF THE NOTES TO THE THIRD LECTURE.

FOURTH LECTURE.

THE TREATMENT OF VERMINOUS DISEASES.

§ CIV. The asthenic diathesis of the human
body, especially when it prevailsin the gastric sys-
tem, is one of the chief circumstances which favours
the development of the verminous germs,(l) which
circulate in the mass of fluids in the form of very
small molecules, (^) or remain at rest in diflferent
parts, where accident may deposite them. (3)

The effects produced by the use of emetics and
cathartics, which many physicians still prescribe
and administer to dissolve and expel the raucous
substance which we have already considered as
the aliment of worms, and which in the opinion of
some persons, favours also their adhesion to differ-
ent parts of the body, must not only be useless,
but even dangerous.

If Monro and Rosen stei^'it) have sometimes
used emetics with some success^ it is to be attribut-
ed rather to the general efforts and concussion of
the frame, particularly of the stomach and intes-
tines, produced by the sudden and violent actioin

188 TREATiMENT OF

of this remedvj which detaches and expels them
from the stomach/i)) Purgatives act in the same
manner, by increasing the peristaltic motion of the
intestinal tube ; worms are by this means often se-
parated from the intestines and evacuated vi^ith the
feces. It may soon be seen however that both
these remedies must debilitate the system, and con-
sequently predispose it to verminous affections.

§ C V. Worms are common and familiar in those
constitutions, in which the lymphatic system pre-
dominates.(5) We further know that sheep are
subject to tiie social vesicular worms, when they
feed on wet low pastures, especially during autumn
and in rainy years. All the debilitating causes
which arc favourable to the development of the
seeds of worms, examined with care, will persuade
the philosophical observer, that the multiplication
of worms can be easily prevented by means of a
tonic and nourishing regimen, such as we shall
point out in speaking of the prophylactic method.
No one can be said to be completely cured of worms,
if after their expulsion, the predisposition to ver-
minous complaints be not also removed.

§. C3VI. Guided by these principles, we may
with ease and certainty perceive the trae indica-
tion by which the physician should regulate bis
plan of treatment in curing the disease occasioned
by worms, whether local or sympathetic,(7) slight
or severe.

'J his mode of proceeding is more or less con-
stantly crowned with success, and contributes to

VERMINOUS DISEASES. 189

render observations philosophical, as it evinces
the extravagance of those remedies which have
been invented by superstitious men for the cure of
worms, and which have been adopted even by phy-
sicians of raeril,(8) who have too blindly subscrib-
ed to the opinion of the former.

§ CYll. Jn the treatment of worms anil the
effects they produce, the physicians ought, in the
first place, to be assured of their existence, of their
seat, of their quantity and quality, because nature
has organized them differently, and experience
proves that they do not all yield equally to the
same remedies. (9) The medicines which destroy
ascarides are sometimes inert with regard to the
lumbricoides and taenia.

On the contrary, the remedies which are high-
ly recommended against the taenia, administered to
patients not having this worm, may occasion very
severe derangements of the animal economy.

For this cause, before we commence the treat-
ment of worms, it is incumbent on us to ascertain
their species, in order to direct the method of cure.

§. CVIII. In the treatment of verminous com-
plaints in general, seich remedies as strengthen the
body, at the same time that they diminish the mor-
bid secretion of mucus, and resist the decay and con-
sumption of all the parts, give action to the organs
destined to the natural functions, annoy the worms,
destroy them, and excite throughout the system
that energy which is so necessary to expel them, and
to prevent their further increase ; the remedies that

190 IRKATMENr OF

produce all these effects, accomplish the necessary
indications.

We are chiefly to regard as such the articles
taken from the class of stimulants, which, possessing
a bitter and an astringent principle, are well suit-
ed to invigorate the nervous power, and augment
the cohesion of the solids.(lO)

Besides, experience every day proves that these
worms are expelled from our bodies by the use of
these medicines when administered in quantities
adapted to the degree and character of the asthenic
diathesis, whether this action takes place in con-
sequence of the subtle and penetrating odour of
these substances, or their mechanical agency on
these vermin ; the former is more probable, by ex-
citing the system, and particularly the parts affect-
ed. The verminous nidus is formed by the mu-
cous substance constantly enclosing the worms,' li)
which remaining like any foreign matter, are set in
motion and expelled by the increased action of
the organ s.(lli)

§) CIX. By reasoning accurately, we easily
perceive that the speciiic property of destroying
and expelling worms from the body has been false-
ly attributed to a certain class of remedies. Be-
fore this can be true, anthelmintics must be endow-
ed with the power ascribed to them, and they should
constantly produce the desired effect. This can-
not be alBrmed except by persons who are influ-
enced rather by superstition, than exact and phi-
losophical observation.

VERMINOUS DISEASES, 191

The mere catalogue of remedies vaunted against
worms would fill whole pages, but it could only
serve to open the way to pyrrhonism.

I am not disposed to say much of them, because
an analytical exposition of their history would be
foreign from my subject. I shall therefore gener-
ally confine myself to an enumeration of all those
remedies only, which in the opinion of every prac-
titioner, are acknowledged to be the most active and
efficient in fulfilling the above indications. I shall
then describe those remedies, which experiment
and observation have recognized, as well suited to
expel from the human body the different species of
worms. It is necessary to observe that several
medicines are endowed with a drastic power, though
stimulant, and that others possess a corroborant
power.

The physician should convince himself of the
species of verminous affection, whether it is local,
sympathetic, or general, before he decides on the
remedy which is to be employed.

Drastic purgatives may be proper for robust
persons, in whom worms produce local symptoms,
though they would occasion serious mischief if giv-
en to feeble subjects, especially when the asthenic
diathesis greatly prevails in the stomach and bow-
els. In these cases we should effect the desired
end by employing remedies which excite and
strengthen the animal frame, without altering the
natural secretion of the fluids.

1^2 TREATMENT OF

§ ex. Pbysicians have been in the habit of
prescribing their remedies for verminous complaints,
both externally and internally.

The internal administration is preferable to the
external, because the former is more eifectual than
the latter ; it is followed by more prompt and
sure success.

A number of patients however, and particular -
ly children, dislike to swallow the necessary medi-
cines, because they are ordinarily very disagree-
able.

Other patients, harrassed by sympathetic ver-
minous affections, can swallow nothing. Others,
with great weakness of the stomach, throw up eve-
ry thing given them. Lastly others, tormented by
the hemorrhoids, or some other local disease of the
anus, cannot receive enemas, by means of which
might be introduced into the body whatever could
not be swallowed, or retained on the stomach.

In all these cases, the mere application of the
remedies appropriated to the exterior, particularly
over the surface corresponding to the part affected,
as the region of the stomach, of the small intes-
tines, and all the abdomen, is the only means of
conquering or diminishing the disease.

Epithems compounded of the remedies which
are directed to be taken internally in similar cases,
applied to the region of the stomach, have been re-
garded as excellent to drive worms from the ij>tes-
tinal tube by Boify Frank and Weikard. These
remedies dissolved in the gastric juice of ani-

VERMINOUS DISEASES. 19.5

mals,* and then applied over the skin, are capa-
ble of producing effects scarcely inferior to those
obtained, when they are administered internal-
ly (14)

For this reason, when I have wished to apply
medicines to the surface of the body for the expul-
sion of all the worms which torment the inner parts
of the body, and at the same time to strengthen the
solids, I have advised them to be prepared accord-
ing to the rules laid down in the anatripsologia.(15)

§ CXI. I ought to remark, that in the sympa-
thetic affections from worms, the nervous system
being strongly excited, the most suitable remedies
and such as should be preferred in these cases, are
those endowed with a diffusively stimulant proper-
ty, that is, calculated to sooth and calm the de-
rangement and disturbance of the living solids.
The class of medicines called antispasmodic, ex-
hibits a long series of them. Valerian, opium, and
assafoetida are the most frequently used. But let
us pass to the examination of the principal reme-
dies which have been extolled, either against worms
in general, or some particular species of them.

* Dr. Alibert is convinced by a multitude of experiments,^
of the nullity of the gastric juice, and the medicines he has ap-
plied by friction, without having recourse to this vehicle,
have been attended with the same success. See Memoires de
la Societe Medicale rf' emulation, 1st year, second edition ; Bul-
letin des sciences de la Society PJdlomatiqiie de Paris, nivose
jear6, F. Trs.

20

194 TREATMENT OF

FIRST SERIES OF VERMIFUGE MEDICINES.

§ CXII. The vegetable and mineral kingdoms
furnisli most of the remedies which have been pre-
scribed in verminous affections, and vvbicli physi-
cians have called vermifuge or anthelmintic.

1 shall point out the vegetables under the Lin-
naean name, and the minerals by the new nomen-
clature introduced by the jb^reuch chemists.

YEGETABLE VERMIFUGES.

^ CXIII. Mlium cepa.{iQ) Onion. The fresh
roots, or the expressed juice which has a peculiar ve-
ry volatile odour and an acrid taste, are frequently
used ; this is however less efficacious than the com-
mon garlick.

§ CXIV. Allium sativiim.{i'Y) Garlick. It?
recent bulb contains an oily volatile principle,
which is suited, like assafoetida, camphor, and sub-
limed sulphur, to strengthen the stomach and bow-
els, and thence to expel worms. The observations
0^ Jlosenstein,[i8) and of Tissof,( 19) leave no doubt
of its possessing this property, since these two phy-
sicians, having continued its use a long time, suc-
ceeded in discharging entire taeniae. We also
have examples of sympathetic convulsions, occasion-
ed by worms, and cured by garlick.(20) These arc
prescribed under different forms, and they are com-
bined with other remedies in their exhibition.*(21)

* Our colleague M. Cadet, authoi' of the excellent Diction-
noire de Chimie, has extracted an essential oil from garlick,

VERAtTNOUS DISEASES. 195

^ CXV. Artemisia santonica.{22) Santoni-
eum. The seeds of this vegetahle, which is well
known to apothecaries by tlie name of wormsecd, of
semen-coutra, and of zedoary, f Kaempheria rotuw
dtifLinn.J are very eflScacious in expelling worms,
particularly the lumbricoides. They have a bit-
ter and subacrid taste and smell ; all their activity
depends on a volatile oil that is easily extracted.

They are ordered in substance, in infusion, in
decoction, and in form of electuary, combined with
other remedies., S3) The confections and pastils
made of them 34) answer best for those who are
nauseated by the odour of medicines. The dose for
children is two grains, and for adults a drachm, in
powder or electuary. The infusion is made with
milk, and for this, two or three drachms of the pul-
verized spAYien-contra is requisite.

§ CXVI. Chenopodium antheltninticum.{25)
Jerusalem oak. The seeds of this vegetable, vrhich
grows in Pennsylvania, have an agreeable, pretty
strong odour, and an aromatic taste ; it is said to
be much used in America against worms, especially
against the lumbricoides. Chalmers^ who gives the
des'cription of it,(^6; affirms that with tlie powder
of these seeds only is composed that anthelmintic
electuary, so famous in North America.

which, applied to the skin, excites an almost insupportable pain
and irritation. He thinks it may be used as a vesicatory, and
perhaps with the advantage of not affecting the bladder like
cantharides. F. Trs.

196^ TREATMENT OF

§ OXVII. Convolvulus Jalappa.[^y) Jalap.
The resinous acrid princijile of tliis root, which has
a disagreeble smell and nauseous taste, is proba-
bly the cause of its anthelmintic virtue. Wep-
ffr,{2S} after having employed without success the
remedies most celebrated against the taenia, suc-
cessfully prescribed to one of his patients half a
drachm of this root in powder. It is commonly di-
rected in combination with other remedies. ('^9)

§ CXVllI. Jlngelicae cortex.{SO^ Angelica,
the bark. Dr. Grieve{-ii) was the first who gave
this article as an anthelmintic, particularly against
the lumbricoides. An ounce of this bark is boiled
in three pounds of water, to one pound ; of which
decoction the patient takes every morning, one or
two ounces.

This remedy has sometimes occasioned griping
pains ; it has however occasionally expelled an ex-
traordinary quantity of w^orms.

^ CXIX. Ferula AssafoetidaJ 22) Thegum-
mi-resinous juice, obtained from incisions of the
root of this plant, is what is used in medicine for
the cure of several diseases, and particularly for
the purpose of relieving the human body from
Worms, and those spasmodic affections from sym-
pathy, which result from them. The virtues of
this substance reside in the volatile oil and resi-
nous principle which it contains.

Its taste is somewhat sharp, aromatic, andnau'
scous ; it diffuses a smell of gariick.

VERMINOUS DESEASES. 19:

It is given in pills, or in some other manner,
in doses from two to ten grains, several times a
day; it is sometimes combined with other medi.
cines, as myrrh, the Mack oxide of iron, submu-
riate of mercury, etc.(83 Enemas of as»at'oetida,
and cataplasms, in which this article enters, (34)
seem to me better, on account of the lepugnaiice of
many sick people to swallow this medicine, whose
odour is so disgusting. Frictions of assafoetida dis-
solved in the gastric juice,(3r>) are preferable.

§) CXX. Geoffi'oija snnnamensis.(S6) Cab-
bage-bark tree, or wormhark tree. The bark
of this plant has latterly been recommended against
worms. I have many times used, and witnessed
its efficacy against lumbricoides and the ascarides
vermiculares. I have given it in powder and in
extract ; 1 think the decoction however prefera-
ble.( >7)

§ CXXT. Jugla7is regia.{SS) The walnut tree.
AVith the green bark of the nut I have made a de-
coction, an infusion, an extract, and a rob,(39)
which all possess a corroborant, astringent, and a
vermifuge property, as the observations of An-
dry,[4*0) and of Fisher{'H) evince. It has lung
been observed that oil was injurious to insects;
those even, which heat revives after submersion in
water, die if immerged in oil, or covered with it.
Redi and Malpighi have made many experiments
on this subject ; the result is that the oil closes all
the air vessels, which in these small animals are
very numerous, and distributed almost over every

198 TREATMENT OF

part of the body. Agreeably to these views, oily
substances have been recomineirtled as vermifuges,
antl the oil of walnuts h;is been particularly extol-
led by Aadrij,[\^2>) and by other French physi-
cians ;(43) tliey mix it with wiiie,f4i) and believe
the compound to be the more active and efficacious.

§1 CXXII. Lauras campliora..^^) Camphor.
The volatile principle of tliis substance is a diffu-
sive stimulus proper to strengthen the nerves and
calm spasms, which renders it very efficacious in ver-
minous afflictions, as Pringle has demonstrated. (46)

The celebrated Mascati generally prefers cam-
phor to othvir vermifuges, for the expulsion of lura-
bricoides. Half a drachm is dissolved in a pound
of water, to which a drachm of gum arabic is add-
ed, and this mixture is given in small spoonfuls.
Sometimes a larger quantity of camphor is dissolv-
ed in an equal quantity of water, and with some
ounces of this solution, and a quantity of tepid
milk, injections are prepared, which are equally
efficacious with children. As it is to be apprehend-
ed, says the illustrious P«//efa,(4<7) when campho-
rated enemas are used alone, that the lumbricoides
may retire to the upper portions of the small intes-
tines, or the siomach, these clysters should only
be administered where children have great reluc-
tance to take medicines by the mouth, because the
camphor, being highly v<datile, soon penetrates to
the stomach, and all the viscera are impregnated
with its subtle odour, it is also communicated to

VERMINOUS DISEASES. m

the month and respiiation, so that the lambrkoules
are nearly aspliyxied and intoxicated with it.

The employment of camphor is also attended
with this precious advantage, that it counteracts the
predisposition to the further development of ver-
minous seeds.

1 have always used it with the greatest success ;
and I cannot too strongly recommend its use to phy-
sicians in worm complaints, 48) whether given m
the mode already mentioned, or some other, or com-
bined with other remedies. '49)

^ CXXIII. PohjpodiumFilixmasJJrQ) Male
polypody, or fern. The anthelmintic virtue of this
plant has at all times been celebrated ; its taste is
disagreeable, mucilaginous, soft, styptic and bitter.

It is recommended against worms, particular-
ly a-ainsfc taeniae and lumbricoides. Theoijhrastus,
Eresius,{5i) Galen,{^z) P^m//,(53) have prescrib-
ed Us use in doses of a drachm, and even to two
or three drachms, in powder, or dissolved in wa-
ter, as Windt[>A) advises.

The powder of the root of the filix mas being
the principal remedy of the specific of .Yoiiffev,
proposed as infallible against the taenia; 55) it is
necessary to know that this root, kept for a long
time, loses its virtue.

^ CXXIV. Spigelia anthelmla,^) V^ orm.
grass, or Indian pink. The herb and root of this-
plant indigenous in the West Indies, of which Lin^
naeus has left us a very exact description, :57) pos-
sess, like opium, a narcotic quality.

SOO TREATMENT OF

Among the Indians it is celebrated as a vermi-
fuge, and Brown was the first to make known its
utility in Europe ;(?8) afterward Rosenstein, Ber-
giiis^ and Dahlberg brought it into fashion in Rus-
sia and Sweden. 1 have also frequently ordered
it with the greatest success. From ten to twelve
grains, in powder, are given to children, morning
and evening, and from half a drachm to a drachm,
to adults. An infusion or decoction is made of tlie
herb ;(o9) the extract has not yet been made use of.

Lining, a celebrated physician of Charleston,
S. C in place of the above, substituted the spigilia
marilandicay{60) or Carolina pink, another plant
which grows in South Carolina,(6l) which, ac-
cording to BergiiiSj is more efficacious than the
preceding species. Arnemann attributes the vermi-
fuge property solely to the root ;(63) and this re-
duced to powder is prescribed in milk, beginning,
for children, with a dose of half a scruple. The
use of all these powders generally renders the body-
costive ; practitioners therefore advise to keep the
bowels open, by administering, every third day, one
or two grains of submuriate of mercury, mixed with
a suitable quantity of rhubarb.

§ CXXV. TanacetiimvulgareJ(iS) Common
tansy. Hoffman employed the seeds of tansy
against worms with go<.d effect. Several other
physicians have said much in their favourj and par-
ticularly Rosenstein,(J^-^) who was in the habit of
combining them with other anthelmintics. (65) One.

VERMINOUS DISEASES. 201

two, or three drachms as a dose, are prescribed ia
a pound of water, in infusion.

§ CXXVI. Valeriana officinalis{Q6). The
volatile oil, contained in the root of this plant, has
a smell of the goat, and a bitter aromatic taste ; this
article is one of the best stimulants, of which medi-
cine can boast. In all nervous asthenic affections,
it produces unequivocal effects, and most generally
it acts more powerfully than a number of medicines,
which are highly commended in these complaints.
Practitioners have esteemed it as equally beneficial
in worm complaints, and particularly in sympa-
thetic affections depending on them, such as epilep-
sy, St. Vitus's dance, etc. In the famous electu-
ary of Storcky(C}Y) the powdered root of the offici-
nal valerian, called Valeriana sylvestris^ or wild va-
lerian in books of pharmacy, is the most active in-
gredient ;(68) the dose should be proportioned to
the age temperament, and degree of weakness of
the patient. It is prescribed under different forms,
and ordinarily combined with other remedies.

^ CXXVII. Veratrum Sahadilla.{69) Ceva-
dilla. Indian caustic barley. This plant grows in
Mexico. The seeds and capsules, pulverised to-
gether, have been used, time immemorial, among
the poor, for the destruction of those insects, which
want of cleanliness has permitted to multiply on
different exterior parts of their bodies. Loeser(70)
first admitted this plant into the class of anthel-
mintics ; it was employed with success by Schmuc-

ker,{7i) in epidemic verminous dysenteries, and in
a6

20:2 TREATMENT OF ^

cases of taenia, where JYovffer^s remedy had failed.
These trials, variously multiplied, lead us to con-
clude, that the seeds of the cevadilla produce the
desired effects, and that their use is not followed
by any bad consequence.

Schrniicker prescribed them in powder, in the
dose of half a scruple, blended with a little sugar
and a few drops of oil of fennel, taken for four days,
directing the patient to drink some decoction of
chamomile flowers after it ; on the fifteenth day he
augmented the dose to fifteen grains, forming it in-
to pills with honey : every five days he subjoined
the use of a purgative.

TIjus he administered the remedy to adults.
He followed tiie same method with children, ex-
cepting that the dose of the powdered seeds was
but two, four, or at most six grains, mixed with
syrup of rhubard.

In cases of vermicular ascarides, he rendered this
treatment more active by means of enemas of the
decoction of the cevadilla seeds, adding to it an
equal portion of milk.

Uer%{7^) lias repeated the experiments of
Sclimucker, with equal success.

It however appears from the observations of
Odhelius,{7S) that the virtue of Schmucker^s ver-
mifuges is rather to be attributed to the combined
use of jalap and submuriate of mercury, given to-
jretber as a cathartic.

In whatever mode this remedy may act, it is
well to know that the seeds of the cevadilla con-

VERMINOUS DISEASES. 203

taining a poisonous caustic principle, and having
an excessively acrid and burning taste, ought to be
exhibited internally with great circumspection, be-
cause it may readiljf produce deleterious effects, and
even death. (7-i)

§ CXXVIJl. Aloes, rhubarb, tlie gratiola offi-
cinalis, gamboge, chamomile, and particularly sul-
phureted scammony, {"diagrede sidphure.J and oth-
er similar articles, are also remedies commonly us-
ed for the expulsion of worms. I liave not spoken
of these substances singly, because these drastics
being usually combined with vermifuge remedies,
vegetable or mineral, cannot in strict reasoning be
directly classed with those medicines, which we
use to expel worms from the body, and to prevent
the development of verminous seeds.*

* We are indebted to M. Charpentier Ccssigni, member of
the Academical Society'of Sciences of Paris, for sonie very inter-
esting details on the juice of the papaya, ( Carica pqiaya,) em-
ployed b}' him with the greatest success in the verminous dis-
eases of the isle of France and Reunion.

This tree is very common in most hot countries. It springs
up without care or cultivation, and grows spontaneously ; it is
unisexual. Certain male trees are however occasionally seen to
bear hermaphrodite flowers and fruit not so large, and less round-
ed or filled up, and shorter than that of the female tree, equal-
ly good however, and affording prolific seeds.

In order to extract the milk from tlie fruit, this must be green
and fresh gathered ; they are pricked with a pin or cut longitu-
dinally ; it yields a milk which is collected and given while new
to the patient fasting. This is tlic most powerful of all the an-
tlielinintics. It is said even to kill the taenia cucurbitina, whicli
is common in the island. It is thought by some to be corrosive,

204 TREATMENT OF

MINERAL VERMIFUGES.

§ CXXIX, Sal Ammoniac. Muriate of ammo-
nia. Among the most efficacious rfiraedies for the ex-

because when first taken it occasions colic, followed bj erysi-
pelas ; but in these cases it was acknowledged tliat the dose was
too large. Its activity and danger have been diminished bj
mixing with it boiling water, three or four times as much water
as of the juice, and giving this to the patient after stirring it with
a spoon; administered in this way I have not heard of its pro-
ducing any accident. Some of the planters say this remedy
may be given, without addition or inconvenience, to persons of
every age; they have however remarked, tiiat when taken in
great quantities, it may excite a slight inflammation of the
anus ; but they add that this is removed in one or two days by
means of lotions of emollient herbs.

Some have attempted to mix it with sugar or honey ; it is
pretended however that this addition very much lessens its effi-
cacy.

M. Cossigni adds, that the proofs of tlie powerful property
of this remedy are already very numerous, without reference to
any unpleasant consequence from its abundant or excessive ex-
hibition. What renders this medicine very important is, that
a single dose of it is commonly sufficient to kill all the worms
of the patient, however numerous they may be.

To an infant of from six to eight montlis, and even a year,
is given a tea spoonful of the milk of papaya, mixed and bea-
ten with three spoonfuls of boiling water or of boiling milk :
this has the property of moderating the action of the remedy.
A table spoonful of the milk of the papaya is given to children
of five, six, or seven years of age, with three times as much boil-
ing water ; and to those ol twelve or fourteen years, two ta-
ble spoonfuls of tliis milk, mixed with six of boiling water.
Three hours after tliis medicine is swallowed, the patient is to
fake a quantity of pure oil of Palma Christi, suited to the age,

VERMINOUS DISEASES. 205

pulsion of intestinal worms, BZoc^(75) admits the mu-
riate of ammonia, combined with rhubarb or jalap.*

sex, and strength of the patient, in order to discharge the dead
worms, whose continuance in the intestines might prove injuri-
ous, etc. The seeds of the papaya dried and pulverized, and
given in suhstance, are anthelmintic ; the decoction of these*^
Avith the roots neitiier occasions nausea, sickness of the stomach,
nor colic ; they are rather insipid, hut not purgative.

Our colleague Cossigni has further remarked, that the milk
of papaya, grown on dry ground, and in a warm situation, is
more active than that of the papaya, produced in opposite
circumstances, and that the milk of the former dries more readi-
ly and perfectly, than that from wet and cooler lands. For more
ample details, see the work of M. Cossigni, entitled, Moyens (V
Amelioration et de Restauration proposes au Gouvernement et
muv hahitans des colonies, chez Delaplace, libraire, etc.

We ought however further to inform our readers that the
trials made in France of the juice of the papaya by professors
Corvisart and Lerou.v, conjointly with Dr. Graperon, had no
success. These experiments have been repeated by Dr. Mlhert
and M. Calvet, the nephew, at the hospital of Saint Lewis. Five
children, from five to six years old, troubled with worms, took,
for four succesteive days, the concrete juice of the papaya in
two drachm doses, and in the manner directed above, with mt
producing the expected effect. Dr. Alibert gave, on the fifth
day, three grains of the oxide of tin, combined with a sufficient
quantity of extract of juniper berries, and three of the young-
patients voided a number of lumbricoides.

To render the history of the papaya complete, we want an
exact analysis of these different preparations. M. Cadet Gassi-
coiirt, an eminent chemist, has done us this interesting service.

* Our fellow member Duval, equally commendable for hif-
learning and morality, has employed this remedy, against lum-
brrcoidcs, in his practice, with complete success. F. Trs.

206 TREATMENT OF

He advises a scruple of the former with half a scru-
ple of either of the roots every half hour. A like

"M. Vauqiielin, who has already made this analysis, has found,
between the concrete juice and certain animal substances, some
very curious analogies. He has not only observed a pretty
large quantity of phosphate of lime, but he has separated
from it a white substance, quite similar to animal oil, or fat.
Mr. Rot'h, a surgeon in the isle of France, has sent me several
samples of the evaporated juice, and a bottle of liquid papaya.

<' As M. Vauquelin has operated only on the concrite juice,
T thought it would be interesting to examine this material in its
liquid state.

" The bottle containing it was well closed and sealed, but on
opening it, it was not full ; the stopple was forcibly withdrawn,
I examined the gas, wbicli was disengaged from it, which was
carbonic acid. The liquid, white and opaque like milk, exhaled
an insupportable odour, resembling assafoetida, but more active
and nauseous. This smell became gradually weaker. This milk
strongly reddened the tincture of turnsole, which the aqueous
solution of the concrete juice did not. Its flavour was sickish
and acrid, leaving in the mouth a taste of sugar. The concrete
juice had not the same sharpness, or acrimony."

"The milk of the papaya filtrated, passes transparent and
o-reenish like clarified whey ; it leaves on the filtre a white mat-
ter, curdled, of a siiety insipidness, insoluble in cold or hot wa«
ter, swelling in the air, and puffing up on the coals like case-
ous matter."

" The concrete juice, distilled over an open fn-e in a glassves-
sel, has given a great quantity of carbonate of crystalized am-
monia, a fetid oil, and disengaged much carbonic acid gas and
carboneted hydrogen. There remained in the vessel a volu-
minous mass of coal, shining like that of some animal substance."

" This coal, reduced to ashes, gave a quantity of lime and
phosphate of lime."

" I have distilled in a sand bath, and over a gentle fire some
liquid juice of the papaya; the liquoy coagulated ; it passed in-

- VERMINOUS DISEASES. £07

dose should be suited to the age, strength, and
state of the stomach of the patient.

to an insipid phlegm, having no acid property. I have stopped
the distillation, and filtrated the liquor from the matrass to sep-
arate the concrete matter.

" The liquor was much more acid than before. I saturated
one portion with potass ; I evaporated it ; and poured on alko-
iiol, which dissolved a small part of the extractive and saccha-
rine matter, without touching the salt whicli had formed. The
salt exhibited all the characters of malate of potass. Exposed
to the air, it readily absorbed moisture, and equally precipitat-
ed the nitrate of mercury, from lead and silver. Another
portion of the acid liquor from the same distillation, was treat-
ed with alkoliol, which separated a white substance, entirely so-
luble in water, precipitating by the acetite, and by the nitrates
of lead and of mercury, making a sort of dry and brilliant var-
nish, when applied to the surface of bodies, acquiring by de-
seccation, the transparence, aspect and taste of the gums.
Treated with the nitric acid, this material gives nothing of ox-
alic acid ; it is malate of lime perfectly similar to that obtained
from pouring alkohol on the clarified juice of houseleek. Final-
ly, I have precipitated a third portion of the acid liquor by the
acetite of lead ; I treated the precipitate with the sulphuric
acid, diluted with water, and from this I obtained malic acid.
Alkohol poured on the filtrated solution of the concrete juice ef-
fects the same precipitation of malate of lime. I confess that I
suspected at first that the malic acid, which existed in so great
quantity in the milk of papaya, might arise from the beginning
©f the fermentation which the juice had undergone ; but aftei fin -
ing in the concrete juice the same acid united to the lime, I have
considered it as one of the constituent principles of this vegeta-
ble matter. The white, concrete matter w hich gives to the
juice of the papaya the appearance of milk, has not, as has been
supposed, the characters of pure albumen, or fibrine, but thos*?
of curd ur cheese."

£08 TREATMENT OF

Hirscliel.VQ) affirms that he thus succeeded in
curing a sufferer who bad been for a very long time
incommoded with a taenia, and who, to obtain re-
lief, had taken, without advantage, several highly
extolled remedies. I have employed, with the
greatest success, in cases of lumbricoides, particu-
larly in children, the anthelmintic drops of Dr. Hart-
mcLYin/in which the liquid aniseted Ramsey' carbonate
of ammonia is combined with assafoetida and a bit-
ter essence. (77)

§, CXXX. Barytes. The muriate of barytes,
prepared with all the precautions of modern chem-
ists, is a remedy endowed with great exciting pow-
er, extending its effects chiefly over the system of
lymphatic vessels.

For this reason, this salt has been employed, witk
the best effects, by Crawford{7^) and Clark 79)
in scrophulous diseases, and in chronic elastic tu-
mors; by Altholf[8[)) in scirrhosities, and obstruc-

" It is affected like cheese, by the acids, alkalis, and distil-
lation ; the presence of caseous matter in a vegetable is not
surprising. Proust has already found it in the emulsion of
almonds. This concrete matter furnishes by analysis the
phosphate of lime and carbonate of ammonia, which brings them
very near to animal substances."

" In like manner the liquid juice of the papaya, or the concrete
juice when dissolved, presents also two remarkable substances."
" The first retained on the filtre is the caseous matter, mix-
ed without doubt with a small portion of albumen ; the second
is a solution of the malate of lime with excess of malic acid in
the natural liquid juice j without excess of acid in the concrete
juice." F. Trs.

VERMINOUS DISEASES. 209

tions of the menseiitenc glands, in tubercles of the
lungs, in pituitous asthma, and in dropsies ; in oth-
er kindred diseases, by the celebrated Hufe--
la7id,{Si) and by myself.

The illustrious Hiif eland, Westrumh,'S^) Ber-
ni^au,{Sd) and Kloths have used the muriate of ba-
rytes in verminous complaints with so great bene-
fit, that, according to them, there is no more pow-
erful remedy than this, to expel from the intestines
the vermicular ascarides. This medicine* however
does not suit in cases where the lymphatic system
is irritated, especially if disposed to inflame, as is
often noticed even in diseases of the asthenic dia-
theses, as may be seen in the judicious reflections
of Darwin. [85) The muriate of barytes is most
commonly given dissolved in water ; it is also di-
rected in pills and powder.

^ CXXXI. Ferritm. This metal, prepared
according to pharmaceutical processes, is one of the
best tonics for the stomach.

It is on account of this property, that physi-
cians have attributed to the filings of iron, an an-
thelmintic virtue, and not for the asperity of its par-
ticles, as some have pretended. In the works of
Wedel,{S7) of Welthoff, {S8) and of Van-Doeve-
rew,(89) wc read of many cases of worms expelled
from the stomach and intestines, by means of eight

* Di'. Elzccir Unux cured hvo soldiers of taenia, witli pills
t)f muriate of baijtes. We regret that we cannot subjoin t!ie
two cas^s wJiich tliis excellent physician has just c(#mmunlcat-
ed to ijs. K Trs.

S7

eiO TREATMENT OF

or ten grains of limatura ferri^p mixed with au equal
part of rhubarb, taken two or three times a day.
J)arhic(dO) succeeded even in expelling a taenia
with iron filings ; he recommends it still more for
cases of colic produced by worms. The filings of
iron, mixed with cinnamon and magnesia, prevents
those bclchings and flatulences, which sometimes
incommode particular persons, who have taken this
preparation of iron.

It seems probable that some of the particles of
iron, not yet dissolved in tlie first passages, pass
into the vascular system, which they strongly ex-
cite.* It is probably from this cause that the im-
proved complexion of those who take iron but a
short time, is derived.

This medicine therefore is equally well suited
to prevent the morbid diathesis which favours the
development of worms.

The siiljjhate of iron is ranked among the pre-
parations, which, according to llosenstein^^Qi) are
best suited to relieve verminous affections. It
possesses a greater astringent force than iron ; it is
also more useful in moderating excessive excre-
tions of mucus from the intestines, and to give tone
to parts relaxed. It is prescribed for children in
doses of two, four, or to ten grains, and to adults
from half a drachm to a drachm, and better still, if
combined with cinchona, valerian, jalap, male fern,

* Is it not owing to tlie great tendency of iron to unite
■with oxygon, that we are to attribute its tonic and exciting quali-
ties ? F. Trs.

VERMINOUS DESEASES 211

seinen-contra, assafoetida, or rob of walnuts, etc.(9S)
To a child seized with spasmodic convulsions oc-
casioned by worms, I prescribed a mass of pills, (9S)
in a manner analogous to that of Fuller : the worms
•were promptly expelled from the intestinal tube, the
convulsions subsided almost immediately, and the
patient was well.

Water acidulated with iron,(94) and what are
better the martial waters,(95) so much commended
by practitioners, as a means of curing verminous
complaints, possess this medicinal quality by rea-
son of the iron they hold in solution, and united
with other astringent substances which strengthen
and invigorate the stomach, the intestines, and tiie
whole animal machine.*

4 C XXXII. Mercury. A number of eminent
physicians(9 J) have ascribed to mercury the prop-
erty of dissolving and attenuating the mucus of the
intestines, and of destroying the worms which in-
habit them.

Conformably to this idea, they have recom-
mended, without limitation, the decoction of mer-
cury, as a very active remedy in verminous com-
plaints. A similar practice has given rise to. dis-
cussions, of which it is useless to speak here.
I shall merely remark that nonoxidized mercury
has no irritating power on our bodies, except what
comes from its weight and continual motion, and

* See. in tlie work of Dr. Marie de Saint- Ursin, entitled the
^mi des Femmes, page 238, the maner of using the artificial
mineral waters. F. Trs.

212 TREATMENT OF

the facility with which it is oxidized when intro-
duced into the stomach and bowels ; tliis last pro-
perty tends rather to weaken, than to strengen and
excite the humm frame. (97) This being admitted,
it clearly appears that the decoction of mercury,
and even mercury itself introduced into our body,
are of no importance against verminous complaints,
though their use has been highly celebrated ; 98)
stiU less can they be adopted in the treatment of
worms. The people who work in the mercury
mines of Almada, in Spain, are more subject to worms
and venerial complaints, ihan to any other; though
these individuals, and particularly those who melt
the mercury, absorb so enormous a quantity of it,
that small globules of this metal are evacuated with
the excrements. (ij9) The same thing happens to
persons employed in the mines of Lydria, and in
the laboratories of Chemnitz, in Hungary, and of
Frt'yburg, in Saxony, where the amalgamation
with mercury is practised, to purify gold and sil-
ver. In these places, I have seen, as it were, ver-
minous complaints to be epidemic.

The labourers are constantly enveloped in humid-
ity, badly fed and poorly clothed ; they live indeed
in a situation suited to produce asthenic diseases,
and consequently conducive to the development of
verminous germs. But let us proceed to positive
facts.

Monck has performed a series of experiments
to determine the quantity of the mercury which
was dissolved in the water in which it had been

VERMINOUS DISEASES. £13

boiled to make a decoction of it ; and in conformi-
ty to the results obtained, he asserts with certain-
ty that the water holds in solution only the small-
est possible portion of mercury : that the largest
portion of the solution is charged with particles of
lead and foreign substances usually found in union
with mercury.

In addition to this, Rosenstein has administered
mercury in several cases, even to salivation, with-
out being able to expel a single worm.* Instruct-
ed by these observations, and by some of my own,
I conclude that nonoxidized mercury is not to be
regarded as vermifuge, except when it has been
triturated with other appropriate medicines. It is
administered to patients tormented with worms un-
der the form of electuary or pills. (100)

Mercury, given in the state of oxide, acts on
the solids as a powerful stimulant, since by its use,
the pulse acquires great force, and the secretions
and excretions are augmented. In this way sever-
al of the oxides of mercury have been very efficient
in expelling worms, and in curing verminous affec-
tions. Among these the submuriate of mercury is
to be preferred, tlien the ammoniacal muriate of
mercury ; and the sulphate of mercury administer-
ed in powders, boluses, or pills(lOl) etc. Sul-

* Our school- fellow, Dr. Ciishet, has assured us that he em-
ployed the decoction of mercury uith two children, troubled
with lumbricoides, with the greatest success. Professor Foiir-
croy also recommends the use of it in his Cours de CItimie, at
the school of medicine of Paris. F. 7Vs.

£14 TREATMENT OF

phur blended with mercury, and triturated togetliei ,
has also been found useful in the cases abovemeu-
tioned : the black sulphureted mercury fie mercu-
re sulfure noirj has been given from a grain, to ten
grains, twice a day. (102) In the administration
of the mercurial preparations, it is necessary to take
care that they do not readily provoke salivation,
which by debilitating the stomach and bowels,
might produce eftects contrary to those intended.

The dose should be insensibly augmented, and
the mercurial preparation suspended so soon as the
patient feels a heat in his gums, as I am accustom-
ed to do in the treatment of general venereal dis»
€ases.(!03)

^ CXXXIII. Petroleum, At Montpellier,
petroleum is famous against worms ; it is common-
ly called rock oil, red petroleum, and naphto-pe-
troleum. Dr. Hasselquist affirms also that in E-
gypt* the taenia being common, the inhabitants re-
lieve themselves by means of petroleum taken in
water in the dose of twenty or thirty drops each
time.(104H) A physician liaving for a long time
prescribed various medicines without success, to a
man suffering with taenia, at length ordered him
half a drachm of petroleum mixed with an equal
quantity of oil of turpentine, to be divided into three
doses ; the patient, already fatigued with remedies,

* Dr. Larrey, who has so well described the diseases of E-
gypt, assures us tliat the taenia is rarely seen there; and that
the ijihabitants aiid physicians do not know the petroleum.

F. Trs.

VERMINOUS DISEASES. 213

did not take them without the greatest reluctance,
aud to sret rid of the business at once, swallowed
the whole quantity as a single dose. He was im-
mediately delivered of the entire taenia.

Some time after the same physician prescribed
for a woman, thirty drops of this oil to be taken in
the morning, and forty more of them in the after-
noon ; she was soon delivered of a worm twelve
metres long.(103)

The petroleum is a very stimulating and heat-
ing remedy : it is given in combination with some
syrup, or with other remedies possessing a stimu-
lant antispasmodic power,(106) in the dose of ten,
twenty, or thirty drops. Vicat has advanced by
little and little to the dose of one hundred drops ;
many practitioners advise the external use of it in
cases of pains of the abdomen occasioned by worms.
For this purpose the whole region of the abdomen
is rubbed with the petroleum alone or mixed with
ox^s gall, as Mellin advises : in this way it is more
penetrating and at the same time more active.

^ CXXXIV. Muriate of Soda. The stimu-
lating effect of this salt facilitates the digestion of
food, dissolves and attenuates the mucus of the
stomach and intestines, excites the bowels to dis-
charge their contents, opposes the putrefaction of
the animal parts, and gives tone to the cohesion of
the fibres.

These properties have not only rendered this
salt necessary for the seasoning of our daily food,
but also very useful in many asthenic diseases, and

216 TREATMENT OF

especially iu those which attack the system of
lymphatic vessels, such as scurvy,(108) costive-
ness,(109) ohstructions of the viscera and glands
of the ahdomen.(llO) scrophula,(lH) etc. The
muriate of soda must also he injurious to worms,
as in fact it has been observed to be by Heber-
den,{ii2) and by Rush^( iiS) who have administered
it on these occasions with success, both by adding it
in larger quantity to our daily meals, and by taking
it alone, in large doses, fajsting.

§ (3XXXV. Stanmim, Ever since the days
of Paracelsus^ the power of expelling worms from
the intestines, has been attributed to tin. In the
last century, Alston{li-if) of Scotland, began to
make use of tin with the greatest success, not only
against lumbrico'ides, but also against taeniae. Oth-
er physicians of great name(115) recommended it
also as one of the strongest and most powerful an-
thelmintics, as we shall notice in the sequel. *(l!6)
§ CXXX\ I. Zincum. In convulsive, epileptic,
and hysteric complaints, the sublimed oxide of zinc,
lias been diretted to advantage, as may be seen in
the cases and observations of physicians, particu-
larly in the work of IIaH.{ii7) This remedy has

* Dr. J. L. Jllheii, in his excellent conrs da MatiereMedi-
ctde, sajs that tlie oxide of tin is one of tlie most potent reme-
dies against the taenia. He gives it to children in doses of
three grains, in a convenient quantity of extract of juniper.
For adults, he malies use of the muriate of tin in clysters : the
latter should not he given without great caution, as it is a vio-
lent poison. F. Trs.

VERMINOUS DISEASES. sir

also been used in convulsive affections arising from
worms, and vvitli some success, according to the
experiments of Dr. JIartini^[ii8) of Monckf[ii9)
and of Storke.{i^O)

It is ordered for children in doses of half a
grain, to one or two grains, in a little sugar, two or
three times a day.

For adults the dose is increased in proportion
to the age and irritability of the individual. It is
very useful in the treatment of the ascarides ver-
micHlares.(lSl)

§. CXXXVII. Sulphur. The property of sul-
phur is to destroy the insects which infest different
parts of our body. It has been remarked that the
combination of sulphur and mercury, is an excel-
lent remedy against worms. (122)

We derive the same advantage from the use of
sublimed sulphur, administered in doses of ten,
twenty, or even thirty grains, etc. It is also united
with camphor, or assafoetida, to form pills. Tis-
sotf Van-Swieten, and Van-Doeveren employed
it against worms with the most perfect success.
Persons predisposed to worms find themselves
well after the use of the cold sulphureted wa-
ters,(i23) and by this means are secured against
the evils which worms produce.

II. TREATMENT OF TAENIAE.

§ CXXXVIII. The difficulty of expelling these

worms from tiie intestinal tube is often very great.

The enormous length of these worms,^^l-Ji4) and
S8

218 IREATMENT OF

particularly their various convolutions in the small
iutestines, render it impossible to expel them with-
out incommoding the patient.

A specific is still wanting to kill them without
disordering the stomach and bowels ; if such a rem-
edy should ever be found, they might be easily
dissolved and discharged w th the fecal matter, be-
cause once dead, they no longer adhere to the mu-
cous membrane which lines the alimentary canal.

The armed human taeniae, by insinuating them-
selves with greater force into the substance of the
intestines, are more difficult to expel, than the tae-
nia without arms.(lS5)

Thus the morbid symptoms they occasion, be-
ing consequently more intolerable,i^i26) demand
more prompt and efficient relief.

§ CXXXIX. The principal remedies used by
practitioners to expel the taenia are taken from the
class of the most powerful eyacuants, and from the
most active stimulants ; the number of these reme-
dies is great because several of them are inefficient.

On tbis point it is necessary to remark, that the
administration of these remedies should be adapt-
ed to the age, constitution and morbid predisposi-
tion to which the individual tends who is troubled
with the taenia; in a word, to the excitement of his
system. In an individual of middling strength,
att'ected with tbis worm, and who has a tendency to
asthenia, we can easily expel the worm that tor-
ments him by a simple evacuant, or a compound
drastic cathartic.

VERMINOUS DISEASES. 219

Oil the contrary, an individual attacked with
taenia, of a cachectic constitution, in whom the as-
thenic diathesis prevails, will be with certainty
cured, by means of a stimulant treatment propor-
tioned to his state of weakness. This being grant-
ed, we clearly comprehend how some persons liave
been cured by taking tartrite of antimony, (i27) sul-
phate of soda,( 128 nitrate of pi>tass,(t-'J9; gambo-
gia,(130) or jalap,(131) and other similar remedies ;
while these same medicinal substances administer-
ed to other patients, also affected with taenia, have
been unsuccessful, or even injurious.

This also explains why recourse must some-
times be had to opium, (132) to electricity,(133)
and to a stimulant regimen. Besides the variety
of constitutions, the different species of taeniae oc»
casion, as we have said, a noteable difference in the
success of the treatment undertaken with these med-
icines.

A gentle evacuant or a bracer, though light,
are ordinarily sufficient to drive out the unarm-
ed taenia ; the armed taeniae, on the contrary, are
not "commonly detached from the walls of the in-
testines, till after the exhibition of a drastic pur>
gative, which, by irritating the intestinal tube, oc-
casions a violent and rapid peristaltic motion, whicli
obliges it to give up its hold, or by another remedy
which acts on the worm with a force altogether me-
chanical, for example, like the oxide of tin. (134)

It is from a profound examination of these prac-
tical results, that we arrive at the knowledge of

220 TREATMENT OF

the true cause which frequently renders inert the
treatment of taeniae, by those compounds and meth-
ods wliich are so highly commended in the publica-
tions of authors, i!lustrioui9 however, and which
have been spread through all the courts of Europe,
sometimes as infallible specifics, sometimes as mar-
vellous secrets. From this philosophical source,
we can comprehend how it is, that in many cases
of taenia, which have been almost without hope,
the desired success has been obtained by medicines
quite simple and common, such as garlic, ( I >5) the
seeds of cevadilla,(!»i6) muriate of amraonia,^137)
filings of iron,(t«i8) the oxides of mercury,f 139)
petroleum, (140) etc. It is, in fine, in this manner,
that we shall be able to determine the true value
of the different methods which have at various pe-
riods been adopted for the expulsion of taeniae from
the human body.

1 shall mention such of these methods as have
been deemed most successful, in order to give a
general representation of the means that medicine
can employ in triumphing over an enemy so injuri-
ous to health, and sometimes so difficult to be driv-
en from his strong holds.

§ CXL. But before we enter on the details of
the remedies, employed at different times, by dif-
ferent physicians, and with various success, I should
offer some practical precepts, with the view of reg-
ulating and favouring the discharge of the worm
from the patient under treatment. So soon as
a part of the taenia appears from the anus, it seems,

VERMINOUS DISEASES. ^n

at first, very easy to extract the entire worm. Ob-
servers however agree that this is impossible, and
I have been several times convinced, when desirous
of doing it, that by pulling, even \\ith caution, the
portion evacuated, that the patient begins to feel
in his belly a twisting and drawing, such as would
throw him into convulsions, if the pulling were
continued, or the worm not cut oif. When, in place
of cutting off the worm, a thread of silk is tied round
the portion passed out of the anus, it retires into
the body about three metres eighteen centimetres ;
but soon after it is again detached from the intes -
tines, and passes out of the anus.

So soon as the patient begins to find the worm
to be passing out, he should immediately repair to
the close- stoool and remain patiently seated till
the whole worm is voided.

The taenia, rolled into a knot, is ordinarily ex-
pelled with the feces ; but it is discharaged with
difficulty, either because its head is buried in the
mucous membrane or valves of the intestines, or
because a mass of mucous matter impedes its ex-
it ; then the patient, tranquil on his pierced chair,
should drink, in repeated and frequent doses, an
infusion of chamomile flowers, or what is better, he
should take an ounce of sulpliate of magnesia to
quicken the peristaltic movement of the intestinal
tube.

If after taking proper medicines, the worm is
not evacuated, or but partially, it is obvious that
suitable remedies must be repeated next day, or

222 TREATMENT OF

even more active remedies, if the first have beca
insufficient.

It sometimes happens that the patient, ready to
expel the worm, after an abundant alvine evacua-
tion, experiences a strong sensation of lieat and anx-
iety at the praecordia, which ends in vomiting. In
this case we need not be uneasy, because this ac-
cident soon passes away ; the patient has only to
snuff up some radical vinegar (acetic acid), to be
almost instantly restored.

METHOD OF ROSENSTEIN.
fCold water, and, mineral waters, j

§. CXLI. We have elsewhere noticed, (141) that
taeniae, plunged into hot water, move with vivac-
ity, and plunged into cold water, that they are al-
most asphixied. Rosenstein, supported by this
observation, judged that these worms could be ea-
sily detached, by causing the patient to drink a
large quantity of cold water, after taking a purga-
tive, because the cold water depriving them of the
power of moving the neck and fixing the head into
the folds of the intestines, they would be thurst
from the body by the violence of tlie peristaltic
motion, increased by the action of the purga-
tive.(14S) He communicated his thoughts on this
subject to Dr. Darelius, who some weeks after,
sent him a taenia expelled in this way; this
worm was seventeen metres ninety nine centime-

VERMINOUS DISEASES. 22S

tres* long, the neck entire, at the end of which was
the head with its tube and four lateral holes.

The same Dr. Darelius cured several other pa-
tients in this manner.

Lindhult and Sidren have, in like manner,
had the same success.

Rosenstein then remarks, that if water could
remain cold half an hour, or an hour in the stomach
and intestines, or if taken every moment, it could
pass without delay into the stomach and into the
bowels, this means would never fail to succeed.
But as we cannot always find these circumstances,
we should frequently repeat the potions of cold
water so as to obtain its effect with certainty. (143)

§ CXLIl. We have noticed from tlie results
communicated by Dr. Soa, that the muriate of soda
kills taeniae with promptitude ;( 144) besides the
vermifuge property of this salt which is confirmed by
practitioners,(145) I would advise a strong solu-
tion of it in cold water, instead of water simply,
to give more eflRciency to Rosenstein^s method ;
sea water cooled might answer this purpose very
well : the same may be said of mineral waters,
which hold muriate or sulphate of soda in solu-
tion.(146)

* The centimetre is the hundredth part of a metre, or near-
ly four tenths of an inch. t^. T.

224 TREATMENT OF

METHOD OF MEIER.
{^Carbonic acid gas. J

§ CXLIII. A young girl, seized first with
epileptic attacks, and by fits of violent colic, ex-
hibited unequivocal signs of the existence of a tae-
nia in the intestinal tube.

Some slight remedies were prescribed, without
effect; but after eating freely of strawberries just
gathered, and drinking a cup of warm milk, she
bad four copious alvine evacuation^ accompanied
with pain, and in the last of which she passed a
fragment of tape worm three metres eighteen cen-
timetres in length. (14'7)

Dr Meier of Erfurt, after being informed of the
treatment, attributed this effect to the considerable
quantity of carbonic acid gas, which is disengaged
from fresh strawberries so soon as they are taken
into the stomach, since this fruit contains no oth-
er material capable of expelling a taenia. To ver-
ify his hypothesis, he ordered a patient, having
taenia, to take every hour a teaspoonful of carbon-
ate of magnesia, and immediately after, audtlier
spoonful of the acidulous tartrite of potass. Tha
patient having continued this treatment two days,
evacuated the third day several pieces of taenia.
It was observed on this occasion, that by abandon-
ing the remedies mentioned, he voided no more of
the taenia, and that so soon as he took them anew

VERMINOUS DISEASES. S&S

he discharged several more pieces of the worm
witb the feces.

§ CXLIV. The vermifuge property of carbon-
ic acid gas has already been announced by Tar-
^«owi,(148) by Hulmej^i-IQ) by Hartmann^{ioO)
by SuensckCf {15 i) and lastly determined by a beau-
tiful series of experiments made by the celebrated
Inge7ihouz.{i52) The credit however of reduc-
ing to practice the trials of physicians, cannot be
refused to Dr. Meier, to whom we are under great
obligations. This method is mild and agreeable,
and at the same time seems calculated somewhat
to strengthen the system.

This method ought not to be abandoned, and
I should prefer tlie use of the carbonate of magne-
sia and the acidulous tartrite of potass, as directed
by Meier.

The cold mineral waters charged with carbon-
ic acid gas,(153; and in want of these, the aerofo-
rous powder of Wagler(id4*) or the water of Selt-
zer artificially imitated,(155) may render this meth-
od more eflficacious than that of Rosenstein.

METHOD OF CHABERT.

Essential oil of turpentine and liquid carbonate
of ammonia.

§ CXLV. The essential oil of turpentine, com-
bined with petroleum, has already been noticed,
as well suited to expel taeniae. (156) The remedy

of Chabcrt consists in the distilled oil of turpeu-
2J)

226 TREATMENT OF

tine with the liquid carhonate of ammonia ; this
mixture he assures us 157) is a very powerful and
infallible means of expelling the taenia from do-
mestic animals. (158) Repeated ohservations prove,
that though this remedy acts with activity and
energy against taeniae, it produces not the least dis-
order in the system. It is also to be desired that
it should be adopted by ph^^sicians to expel taeniae
from the human body, since we have sern that the
essential oil of turpentine, muriate of ammonia, and
carbonate of liquid ammonia, are also remedies,
which have been advantageously employed both
against taeniae and lumbricoides.

METHOD OF NOUFFER.

The root of folypodmm filix mas,

§ CXLYI. Toward the middle of the last cen-
tury a great number of persons, troubled with tae-
niae, went to Morat in Switzerland, where madam
JS'ouffeVf ifter the death of her husband, continu-
ed to cure them with promptitude and success, by
means of a secret which she held from her husband.
The king of France gave a considerable sum to ob-
tain the formula of this celebrated remedy, and
charged the physicians Lassone, Macqiier, Lamothey
de Jiissieu and Carhuri, to examine it, nnd make
such trials with it as they might think proper.
This committee made their report, July 13, 1765,
whence it appeared that the remedy of JSTouffer
answered very well in practice, and that it merited

VERMINOUS DISEASES. 227

the celebrity it had acquired. The king ordered
the publication of it for the benefit of suffering; hu-
niduity, in the following tenns.(159)

Preparation of the patients,

^^This treatment requires no preparation, unless
it be to take for supper, seven hours after a com-
mon dinner, a soup-panada, made in the following
manner: take a pound and a half of water, from
two to tliree ounces of fresh butter, and two ounces
of bread cut into small pieces; add a sufficient
quantity of salt to season it, boil the whole over a
good fire, stirring it frequently till it is well mixed
and reduced to a panada. Fifteen minutes after,
give the patient two middling sized biscuits^ and a
glass of white wine, or pure water, if he does not
commonly drink wine.

" If the patient be costive, give him the follow-
ing clyster fifteen or thirty minutes after supper:
take a good pinch of mallows and of marshmallows,
boil them a little in half a pint of water, add to it
a little muriate of soda, strain it. and mix. with it
two ounces of olive oil.

Treatment of the patients.

" The next morning, eight or nine hours after
supper, the following specific is administered : take
three drachms of the root of the filix mas,(l60) re-
duced to a very fine power, mixed with four or six
ounces of the distilled water of tlie male fern or
of the flowers of the tildcn or lime tree (t'dleulyj

328 TREATMENT OF

the whole to be swallowed by the patient, rins-
ing the tumbler two or three times with the same
water, that none of the powder may remain in the
glass or mouth.

^' For children, the dose of this powder is lessen-
ed to one drachm. If the patient, after taking the
powder, sliould be incommoded with nausea, he
must inhale the odour of strong vinegar ; if, not-
withstanding this, the po'Mier rises and seems rea-
dy to be discharged from the mouth, he must swal-
low and do every thing in his power to keep it
down ; but if obliged to reject it in whole or in
part, he must continue to take it till the nausea
ceases, and till what equals the first dose is retained,

'^ Two hours after the powder is taken, the pa-
tient is to swallow the following bolus : take sub-
muris.'ie of mercury, and dry resin of scammony of
Aleppo, of each twelve grains, of gamboge five
grains ; reduce these three articles to a very fine
powder, and with a suflBcient quantity of hyacinth
confection form the whole into a bolus of middling
consistence ; this is the purgative dose usually giv-
en ; that of the confection' 1 61) is from two scruples
to two scruples and a half for persons of robust con-
stitution, or difficult to purge, or who have previous-
ly taken strong purgatives. A bolus compounded of
eight and a half grains of submuriate of mercury, and
the same quantity of the resin of scammony, is
given to weak persons who are sensible to the ac-
tion of purgfilivcs, and for children the dose should
be diminished agreebly to the prudence of the phy-

VERMINOUS 0E8EASE 229

sician. In a case where all circumstances unite,
seven grains of submuriate of mercury and as mucli
of the resin of scammony with a sufficient quanti-
ty of h^vacinth confection, are sufficient, without the
gamboge.

^' This bolus has also been given at two times,
that is, one half of it two hours after the powder,
and the other part three hours after the first, be-
cause the first had operated but slightly. Immedi-
ately after the bolus, one or two small cups of green
tea ; and from the beginning of the evacuations, a
cup should be given from time to time till the worm
is discharged. After the bowels are opened, but
not before, the patient is to take some good broth,
and some time after, a second broth or light soup,

"^ The patient may afterward dine temperately,
but throujrh the dav he is to be cautious and rather
abstemious ; if however the bolus has been partly
ejected from the stomach, or if retained, it has not
purged sufficiently in four hours, he must then take
from two to eight grains of sulphate of magnesia,
dissolved in a convenient quantity of boiling wa-
ter."

% CXLVII. The powder of the male fern has
been employed with* success, as we have elsewhere
remarked, (162) for the expulsion of worms from
the intestines, and particularly taeniae and lum-
bricoides. Even before madam J\%uffer had un-
veiled her secret. Dr. Herrenschwand had used
this remedy in cases of taeniae, pursuing nearly the
same treatraent.(l63)

230 TUKATMENT OF

The French commissioners however, who were
chosen to examine the remedy of .Confer, and oth-
er physicians who liave often tried the method ot
Harrenschwand and tliat of JVovffer, certify, that
ihis remedy is fatal to the human unarmed taenia,
but that it produces no effect against the armed
human taenia.(l6L) The Russians, the French,
and the Swiss have chiefly contrihuted to the ce-
lebrity of these two methods ;(165) in fact, the in-
habitants of these countries are more subject to the
unarmed taenia than to the other species.(l()6)

It follows that in Russia, in Switzerland, and
in France, one of these methods must be more effi-
cient, than in Lower Saxony,(l67) and in Italy,
where the inhabitants are tormented by the armed
human taenia,(l68) more than by the unarmed

species.

^ CXLVIH' In spite of the fine observations of
some celebrated individuals, who testify to the sue-
eess of jXo'uffer's method in the treatment of tae-
niae, I must however say, that the maxim of be-
lievina; it efficacious only against unarmed taeniae
is suijject to some restrictions. The celebrated
Palletta relates, that the'Milanese physician, Gal-
laroli, drove both species of this worm from the
human body with Mufers remedy.(l69)

I have also had several patients attacked by
the armed taenia, who were happily cured by the
same rc5imen.(i70) Though these observations
seem to contradict the maxim announced by the
French physicians and other practitioners, I ought

VERMINOUS DISEASES. 123

uevertheless to notice the exception to which it is
subject; 1 am led to this by a practical case truly
singular. 1 report it because it seems well calcu-
lated to reconcile the two opinions given on the
method o^ JS^ouffer, and to settle with precision the
cases in which it may be crowned with success.

Case.

Jlntliony Arcova, of Pavia, of a tolerably robust
constitution, had no particular disease before the
age of 2'i years, if we except some attacks of an
autumnal intermittent fever, epidemic in this city,
and from which his health was soon reestablished ;
he was badly nourished, labouring more than usu-
al, preserving no proportion between his fatigue
and re[>ose. On the 9th of February, 1797, be-
ing occupied about his domestic affairs, before
breakfast, he was suddenly attacked with violent
pains in the abdomen, which soon subsided, but
afterAvard returned, accompanied with extraordina-
ry appetite, and an undulation of the belly.

Small pieces of the armed taenia w ere observ-
ed in his excrements. At length, on the 17th of
February, toward night, such violent cutting pains
took place, that he was obliged to keep his bed,
and to have recourse to some bitter spirit of "wine
and good rura to repair his strength. The pains
abated, and the patient had a tranquil night. The
following day, he rose with an unusual appetite ;
during the day he had three discharges, and with
each voided a piece of taenia three metres eighteen

U7 2 1.1

TREA IMENT OF

centimetres long. Thi-ee clays after, having again
suffered pain, he decided to repair to the Clinical
Hospital of Pavia, then under my care. Besides
the symptoms already mentioned, I found his pulse
very small and feeble. February 32(1, I direct-
ed him the soup-panada, prescribed by JSToiifferf
and the day folh.wing, gave him in Uie evening a
drachm of the pulverized root of the filix raas, and
then his purgative agreeably to the precepts of
.A'oiifer. The patient followed this regimen ex-
actly, and was again seized with griping pains, dur-
ing which he discharged, in several pieces, the
armed taenia, represented Plate I, fig. i, ii. The
same evening he took again the soup-panada, and
on the S3d he took, early in the morning, the fern
powder, and soon after the usual purgative. The
patient had no pain ; the remedy produced reach-
ing to vomit, which gave way on sucking a lemon.
He voided, without having pain, in his fecal dis-
charges, a lumbricoides, and two pieces more of tae-
nia, which, with the preceding, measured ten me-
tres sixty decimetres. Tlie head (PI. 1, fig. i,) and
the tail were among these pieces. The same treat-
ment was continued three days longer, but dis-
charging no more taeniae, and the patient being in
other respects restored, he returned to his house.
Near the end of August of the same year, he came
to consult me, because he again felt the pains of
the abdomen, and again discharged pieces of tae-
nia, which according to him were larger, broader,
and longer than the other pieces. I advised him

VERMI\OUS DISEASES. o$3

to enter the hospital where he arrived August 29th.
I treated him for seven days agreeably to tue plan
of JVoufer, as had been done in the month of Feb-
ruary ; but no effect was produced, as he discharg-
ed merely some small fragments of taenia, as hap-
pened before he entered on this course of treat-
ment, and the symptoms increasing for two days,
I subjected him to the trial of the root of the male
fern, according to the mode orHerrenschicand,(i7i)
in lieu of tliat of JTouffer ; but all was useless.
The griping pains returned with augmented vio-
lence ; the alvine evacuations were more frequent,
the patient very weak ; frequent fainting fits ren-
dered the disease more severe, and the taenia seem-
ed more and more diflicult to be expelled.

In a case to me so singular, I determined to try
Alston's i^Un; and accordingly, September 8th,
I prescribed for him, to be taken in the morning;, a
bolus, compounded often grains of filings of tin, with
a sufficient quantity of conserve of roses, to be re-
peated every two hours. After the third dose
he voided, in several pieces, a very large armed
taenia, in length twenty five metres one hundred
and fifty decimetres ;(17S) he recovered his health
perfectly, and was no more troubled with taeniae.

§ CXLIX. If we attentively consider this case,
it will teach us that the method of J\^iiffer may
be successfully adopted even in cases of armed
taeniae, if they are small or young, because this
worm, before his size and strength are completed,
is not yet firmly attached by the faugs of his head,
80 ^

234 TREATMENT OF

to the mucous membrane of the intestines. Tliis
case also instructs us, that the same method will
certainly fail when the armed taenia, at full growth,
is strongly fixed to the membranes of the intestines;i
and consequently occasions more severe symptoms.
I have had occasion to prescribe for these tae-
niae, when the age of the armed taenia was differ-
ent from that just mentioned.

This difl'crence has however required an oppo-
site mode of treatment ; if the instance is not rare,
it is certainly instructive.

§ CL. Further, the root of the polypodium filix
mas, even before the method of Herrenschwand
was'known, and before the secret of J>^ouffer was
revealed, had been employed by different physi-
cians in cases of taeniae and other worms, as we
have already announced. (174) Re7iard,{i7&) m
these cases, used to prescribe, in the evening, an
enema of soap dissolved in water, and during the
five following days administered, fasting, a drachm
of the pulvis radicis iilicis maris, dissolved in some
purslain, and soon after a bolus, compounded of
submuriate of mercury, of jalap, rhubarb and honey ;
and for common drink a decoction of the male fern
root. Vogel affirms,(17«) that nothing is more ef-
fectual ia expelling taeniae than half a scruple of
this root, and three grains of gamboge, taken morn-
i„p- and evening, for several days : the same thing
Ub been observed by Alix,{i77) by Duncan,{i7S)
etc.

VERMINOUS DISEASllS. 255

METHOD OF ODIER.
Oleum Ricini,

§ CLI. The celebrated physician Odier, of
Geneva, first administered this oil for the purpose
of expelling worms from the human body, and par-
ticularly taeniae. (I79) The experiments of Rpdi,
of Malpighi, already mentioned, (180) as well as the
practice of Andry and other French physicians,
have confirmed the vermifuge property of oily sub-
stances ; and among these the fresh oil of the com-
mon ricinus(l81) has been found the most proper,
because from its mildness, the sick take it with
ease and without dislike.

This oil both kills the worms and purges the
patient. Adults take three ounces for a dose, and
children a teaspoonful several times a day. It pro-
duces no pain ia the abdomen, as is the case with
most other purgatives ; this oil may also be given
without fear, even to ruptured persons. Goexe re-
lates (183) the case of a feeble and very irritable
old man, who had a double hernia, who soon re-
lieved himself of a taenia, by means of this salu-
tary oil.(183)

§ CLII. The use of the oleum ricini has been
confined to cases of the unarmed taenia, because
Odier and his colleague Dunantf have never de-
stroyed the other species, with this remedy. I can
however say, that it sometimes serves wonderfully
well to expel also the armed taenia.

£36 TREATMENT OF

la my journal, I have two cases of avmed tae-
Tiiae expelled by three ounces of this oil, takea by
a patient during three successive days, and by an-
other taken twice a day for a week.

^ CLTU. Some practitioners have calculated
to render the root of the polypodium iilix mas more
active, when administered in doses of two or three
dnichms, by prescribing, two hours after, an ounce
and a half of oleum ricir/i, instead of the purgative
commonly given by .Yoaffer, which is attended
with some inconveniences, as vomiting, colicy pains,
abundant evacuation'-, prostration of strength, and
other siuiilar sympcoms. After this oil has heea
taken, the patient drinks some broth, and the dose
is repeated the second or third time, if the suffer-
er can bear it, in order to drive the taenia from the
intestinal tube.

Sclle advises,(184) on the contrary, to take the
oleum ricini in the evening, and the next morning
ten grains of si;amboge, and to repeat it twice more,
drinking afterward some broth, provided no un-
pleasant irritation exists.

METHOD OF DESAULT.

Mercurials.

§ CLIV. T)r. Besault, an eminent physician of
Bordeaux, having observed that taeniae (principal-
ly the armed) sometimes attach themselves to the
intestines in such a mmner, that it is difficult to
separate and expel them, proposed for this purpose

VERMINOUS DISEASES. jgj

au ingenious and boM expedient, that of adminis-
tering alternately a mercurial friction and a purga-
tive of calomel in a large dose ;(183) it cannot be
denied that worms have often been expelled by
the oxides of mercury (186)

The method proposed however may readily oc-
casion diseases more intolerable and dangerous
thanthat of the worms.

Besides, very few persons would willingly sub-
mit to a treatment altogether mercurial. In usino-
mercurials therefore, and especially the oxides!
which are useful only in certain cases, the practice
of Rather,, iS7) who assures us he prescribed the
following remedy with the best success, is prefer-
able: ta^.e twenty grains of savine rsaiiuej in
powder, fifteen grains of the seeds of rue, ten grains
of submuriate of mercury, twelve drops of the oil
of tansy, and of syrup of peach flowers sufficient (o
form he whole into a bolus. The patient should

taUe half of It in the morning and the remainder
after dinner, drinking each time a glass of good

Tated '" "''"'"' """' ^'""''' ''"''"'' ''*''= ^"'^" °"'^'^-

METHOD OF ALSTON.

Tin.

i CLV. Tin was regarded, even anciently, as
a very efficient remedy for the expulsion of intestinal
worms ;; 1S8) it was afterward proposed by Dr Al
«ton to expel taeniae. Several physicians have(i80)

^,« TREATMENT OF

obtained from it great success, especially igainst

the armed taenia.

I have already remarked that in cases of old,
lar-e armed taeniae, the method of JVott/er was
insufficieut, and that on the contrary, with the
filings of tin, regularly administered, the desired
effect is promptly and certainly obtained.(190)

% CLVI. To comprehend clearly the manner
in which tin produces these salutary effects, we
must reflect on an observation of Block, relative
to the lanciolate taeniae, which are found in great
numbers in the intestines of lean geese ; in small
numbers in fat seese.(191) In the latter, he sev-
eral times found some of these taeniae included in
the rectum and enveloped in the excrements, with
which they are commonly expelled.

The reason why the lanciolate taeniae leave the
small intestines in fat geese, (the common abode ol
^vorms,) is certainly not to be attributed to their
fat, but to the change of their nourishment. In
villages, geese commonly feed on the simple pas nre
of barren places, and consequently the lanciolate
taeniae accumulate in the small intestines, to be
nourished by the juice of the grass they eat
Whereas geese sold in the city are commo.ily ted
on barley and oats to fatten them. The goose di-
^sts meal v*ry well, but the capsules of the gram,
:eparated only by the stomach, pass into the in es-
Uues. Hence it follows, that these small irreguUi
substances prick the worms and oblige them to de-
scend to the lower portion of the intestines, where,

VERMINOUS DISEASES. 259

not being able to support themselves long, they arc
soon expelled with the feces. From this observa-
tion Dr. Block concludes that it is certainly proba-
ble that the filings of tin act on worms by reason of
the sharpness and asperity of their particles : and
it has been remarked, in fact, that the coarsely
filed tin is more efficacious than that which is very
fine, because the particles of the former are better
suited to irritate the taeniae, and consequently to
expel them from the intestines.

§ C LVII. The tin of Malacca, or very pure tin,
called in England grain-tinf{i9il) is preferable to
any other, because it is more free from heteroge-
neous poisonous particles, which are usually com-
bined with this metal.(193) Margraff however
prudently admonishes us, that sometimes even in
the tin of Malacca and England, we meet with a
small quantity of arsenic, which may produce fatal
accidents. (194)

Unfortunately, the tin sold with us, is more or
less blended with lead, and the latter is very fre-
quently combined with arsenical pyrites ; physi-
cians should be very careful of its quality, when
they employ tin internally, for I can assert from my
own experience, that if the tin be not pure, the sa-
turnine or lead colic, and palsy of the inferior ex-
tremeties, will be the deplorable consequences of
its exhibition. (195).

§ CLVIII. Tin, coarsely rasped, is, as we have
said,(196) to be preferred to tin in fine grains, as
used by the English, according to the observations

240 TREATMENT OF

of Bloch,{i97) of Goeze,{i9S) and of Fother-
gill,{i99) to which I can suhjoin my own.(SOO)

It is administered in doses from half a scruple
to an ounce, according to the constitution of the pa-
tient, and the certainty of the purity of the tin. It
is ordinarily given in form of bolus, or electuary,
using theriaca, the conserve of roses, of absinthium,
honey, etc.

By adding some vermifuge, it has been thought
that its operation would be more effectual, and
with this view, the union of jalap has been recom-
mended,(201) the root of the male fern,(5i0^j the sul-
phate of iron,(S03) seraen-contra and sugar,(304') etc.
I have constantly used, with the greatest advan-
tage, when well prepared, Guy^s powder of Ethio-
pia.^205) In general, the use of tin should be con-
tinued for several days in succession, if one would
realize the desired effect ; it should be suspended
every fourth, fifth, or sixth day, to interpose a pur-
gative for the expulsion of the worms. (S06)

aiETKOD OF MATHIEU.

Thiffern, semen santonicae, and drastic
purgatives.

§1 CLIX. We now come to the last of the va-
rious methods, which have been vaunted for the
expulsion of taeniae.

M. Matliivii, an apothecary of Berlin, for some
years employed, with astonishing success, a raed-

VERMINOUS DISEASES. 241

icine, wliicb was remarkable for curing tbose per-
sons who had either species of the taenia.

His method, which begins to prevail, consists
in the administration of two electuaries, compound-
ed of the filings of English tin, the powdered root
of male fern, seraen-contra, scammonia of Aleppo^
gamboge and sulphate of potass.

The simultaneous exhibition of so many reme-
dies, which we have noticed as suited to expel both
species of taenia, must certainly produce effects,
if not constant, at least superiour to what may be
hoped from other methods. Aliz had already com-
bined, with great advantage, the use of tin filings
and the pulverized root of male fern.(S07) The
remedy proposed by Mathieu will, of consequence,
he still more active ; and physicians may try it
with confidence of success. (S08)*

* Dr. Bourdier, professor of the Special School of Medi-
cine of Paris, used the following remedy with the greatest suc-
cess, against both species of taenia : Pour a drachm of sul-
phuric ether into a glass of the decoction of male fern, which
the patient is to take fasting; four or five minutes after, an in-
jection of this same decoction, with two drachms of etlier, is to
be thrown up. One hour after, give two ounces of oleum ricini,
and one ounce of the syrup of peach blossoms. This treatment
is to be continued tor three days. The worm is commonly dis-
charged but half organized.

When the worm is in the stomach, success is certain ; when
in the intestines, the treatment, after some time, is repeated;
then Dr. Bourdier prescribes an enema of decoction of fern and
two drachms of sulphuric ether, immediately after the patient
has swallowed the etherated potion. F. Trs,
31

««3 TREATMENT OF

[Since the French edition of Brera, several ar-
ticles have been used as remedies against the tae-
nia, and with so much success, that they are like-
ly to supersede the further employment of sora«
substances, which formerly acquired, for a time,
a reputation, which they have not been able to sus-
tain. The most valuable of the new remedies is
spirit of turpentine, whose origin, as a vermifuge
in England, is given in the following paper from
the second volume of the Medico- Chirurgical
Transactions for 18 il.

r

^^ On the use of oil of turpentine in taeniae, com-
municated in a letter from John Ralph Fen-
wick, J\J. D. of Durham, to Matthew Bailie^
M, B. F. R. S, Read January ti, 1810.

« Sir, Durham, Dec. 19, 1809.

"Having been informed that you are desirous
of a fuller account of the efficacy of oleum terebin-
thini in expelling the tape-worm, and knowing no
one, who, by his influence in the medical world, and
his zeal for the improvement of medicine, is more
likely to diffuse a knowledge of that remedy, I
shall now lay before you a detail of all the infor-
mation I have received, and of all that my own
experience has taught me on the subject.

" You will make what use you please of the
communication, as my only wish is to make the
i'emedy generally known.

" In tiie month of August last, T was told that
Mr. John Hall, of this city, had been cured of the

VERMINOUS DISEASES. 2iS

tape-worm by the use of oleum terebinthini, and
had since administered it with success, in several
other cases ; and lost no time to procure a confer-
ence with him, when 1 received the following in-
formation.

*"• He stated that about five years ago, when suf-
fering severely from the tape-worm, he had met
with a seafaring man, who said he had cured him-
self of the complaint by taking oleum terebinthini.
He was induced, as he informed Mr. Hall, to try it,
by observing that whenever he drank rather free-
ly of gin, he always passed portions of the worm,
and experienced relief; w. ich led him to hope,
that if he could find some substance of the same na-
ture as gin, but stronger, it might effectually cure
him.

^' Under this impression, he took, (his ship be-
ing at that time in the Baltick,) a wine glass full
of oleum terebinthini. The consequence was, that
about two hours afterwards he passed, with a pur-
gative stool, an entire tape- worm ; from which time
the complaint had not returned.

" Disappointed in all the remedies employed
in regular practices, and encouraged by this state-
ment, Mr. Hall took two or three ounces (for he
was not at the trouble to measure it) of undiluted
oil of turpentine in the m<!rning, fasting ; and as it
did not operate in two hours, he had recourse to a
second dose, amounting, as near as he could guess,
to three fourths of the first. In about an hour af-
ter, he had a purgative stool, and witli it passed a

£44 TREATMENT OF

tape-worm, apparently not quite dead. The med-
icine produced giddiness, like that which follows
tlie use of ardent spirits, a slight headache, and
a tendency to sickness, but he felt no other incon-
vtMiience, and he has since continued well. Though
I had no reason, from Mr. HalPs character, to
douht the truth of his account, yet the extraordina-
ry dose, in wliich the medicine was said to have
been taken, determined me, before I ventured to
employ it, to examine carefully, and apart, those
inhabitants of this city, to whom he told me it had
been successfully administered. As their account
entirely confirmed his, I shall now give the out-
line of their cases.

" 1. Grreathead, aged 70, bad been afflicteu
with the tape-worm above twenty years, during
which time he had taken many remedies ; and
among others Madam J\roujfer''Sf with temporary
relief, but with no permanent advantage. He took
olei terebinthini two ounces undiluted, fasting; ; and
in two hours after one ounce more. A tipe-worm
came away soon after in a dead state, and he has
since experienced no return.

<< This took place near three years ago. The
medicine acted as a brisk purgative, and produced
considerable sickness, but no other inconvenience.

^^ 3. Edward Dodd, Sergeant Major to the
Durham volunteers, also took the oleum terebinthi-
ni rather more than two years ago. He had had
the disease about fifteen years, and had tried
Madam JS'oiiffev^s and othei: remedies in vain.

VERMINOUS DISEASES. 245

Ib this case also, a second dose of one ounce
was given two iiours after the first, as that did not
affect tbe bowels.

This, iu less than an hour, was followed by
the expulsion of a dead tape- worm, fifteen feet long,
which he had preserved and showed rae. He has
had no return. Edward Dodd stated, that he had
given it to a young girl 10 years of age, in the
dose of one ounce with complete success.

^< 3. Robson, shoemaker, aged 45, took the ole-
um terebinthini two years ago, after breakfast,
with considerable relief; but his complaint return-
ing in about six weeks, he took it in the usual dose,
and fasting. He did not attend to the nature of
what passed, except so far as to observe that there
were numerous portions of worm ; but he has since
been free from all complaint.

" This patient having drunk some malt liquor
in the evening, before the action of the medicine
had ceased, was seized with such violent vomiting
and diarrhoea as greatly alarmed his family. He
did not remark that the liquor was hard, stale, or
otherwise bad in i'.j quality.

^* Besides these, five other cases were mention-
ed to me, by Mr. Hali ; but as I had not an oppor-
tunity to examine the patients, I do not notice them
here.

'^ Conceiving myself now fully justified in try-
ing the remedy, I recommended it to Francis How-
ard of this city, butcher. He had laboured under
the disease for several years, and was much eraa-

S46 TREATMENT OF

elated. The medicine was administered by Mr.
Clifton, surgeon, on the morning of August 8th.
The first dose of two ounces not affecting the bow-
els, in two hours one ounce more was given, and
in about half an hour after, an entire tape-worm,
measuring fourteen feet and a half, came away
dead. Soon after taking the first dose, when I
saw him, he complained of giddiness and tenden-
cy to sickness. Neither his pulse nor the heat of
his skin was affected by it. It operated briskly
after the second dose, and produced great sick-
ness in the evening ; but he had no strangury or
heat in passing urine, or other inconvenience, and
was cheerful and at work early the next day.
Dr. Southey saw tliis patient as well as Mr. Clifton
and myself. Within the last three weeks the dis-
ease has returned, and he will shortly again take
the remedy. The second patient, to whom I re-
commended the oleum terebinthini, was Anne
liunsden, aged twenty. She took two ounces un-
diluted on the 23d of August, and that dose not
operating in two hours, she had one ounce more.
Nearly an(»ther hour passed before she had a mo-
tion, and the first being scanty and nearly natural,
and without any portion of worm, she took a third
dose, of the same strength as the second. The
medicine then operated briskly, bringing away a
large quantity of worms, broken into small por-
tions, with what had the appearance of skius and
much mucus.

VERMINOtrS DISEASES. 247

"I saw her on the 13th instant, and she had
not since felt any symptom of the disease. The
patient was seen by Mr. Clifton also. The third
(fourth ?) case was that of Welford, shoemaker,
aged nineteen. He had before twice taken the
oleum terebinthini. After the first trial, he remain-
ed free from all complaint for nearly six months 5
after the second, not quite so long ; with both, a
great quantity of worm had been passed. He took
the medicine August S5th, and passed several por-
tions of worm, the operation of the turpentine be-
ing that of a severe purgative, producing consider-
able sickness ; but as he felt quite well the next
day, and the effect had not been quite satisfactory,
I advised Mr. Clifton again to give it to him on
the 27th of August. He accordingly did so ; with
this dose however no tape-worm passed, but only
a very large lumbricus. During the month of No-
vember, he again had evidence of the presence of
tape-worm, on which he once more had recourse
to the oleum terebinthini, which brought away an
entire tape-worm, which was dead when it passed.
I saw it in Mr. Clifton's possession. I shall now
offer a few observations.

^* From the general failure of purgative medi-
cines in this disease, and from the circumstance
of all the worms being dead, when passed (except
perhaps in Mr. Hall's case,) we may safely con-
clude, that besides its purgative quality, the oleum
terebinthini is really poisonous to the taenia.
But though destructive to the worms present, wft

248 TREATMENT OF

have evidence in the cases of Welford and Cow-
ard, that it does not remove the tendency to gene-
rate these animals. This is yet a desideratum.
From WeUord's case, there seems reason to hope,
that the oleum terehinthini will be found useful
a2;ainst the lumhrims, and t am disposed to try it
in tlie form of injection^ against ascarides also.

'^ x\.fter the evidence adduced, it is unnecessary
to dwell on the safety of these large doses of ole-
um tirebinthiui ; I will therefore only observe that^
when exhibited, its quick action on the bowels pre-
vents its being absorbed, and accordingly we find
in these cases, no camplaint of those affections of
the urinary passages which have arisen from much
smaller doses. As to the mode of exhibition, my
directions have been, to take either no supper, or
a very light one the night before ; to abstain from
all food or liquid till the medicine has operated
twice or thrice, or a worm has parsed ; then to di-
lute freely, and through the day to avoid spirituous
or fermented liquors.

^' I have the honour to be

'* Your obedient servant,

*^J. R. Fenwick.'*

"We have seen that the spirit of turpentine had
betn used, in combination with some other article,
on the continent of Europe, before it was employed
as an anthelmintic in England. From England a
knowledge of this valuable remedy has extended
to North America, where it is frequently and sue-

VERMINOUS DISEASES. 249

cesafully administered for the destruction and ex-
pulsion of taeniae. It will, we think, be found
equally effectual in killing all the species of this
worm, and the lumbricoides. Further experience
of its anthelmintic properties, either when taken in-
to the stomach, or thrown into the rectum, may
prove its sufficiency to destroy all the intestinal
worms.

In two cases, where it was given to expel tae-
nae, I have seen a large lumbricoides discharged,
dead and entire.

A year ago, a child six years old, having
most of the symptoms of lumbricoides, took six
drachms of the spirit of turpentine, without the least
inconvenience.

No worms were voided; the signs of them how-
ever soon completely disappeared, and the little pa-
tient has since enjoyed uninterrupted, and unusual-
ly good health.

Some years ago a woman took, by direction of
her physician, an insufficient dose of this remedy
for taenia. Becoming impatient, two days after^
she took, without advice, six or seven ounces of it ;
this proved an effectual remedy, but was attended
by a severe inflammation of the rectum; this was
soon relieved by a few injections of flax-seed tea, to
which a small quantity of tincture of opium was
added.

The best mode of giving it seems not yet to

hare been fully ascertained.
3)3

/J50 TREATMENT OF

From what I have witnessed of its effects, I
should deem it important, before its exhibition,
freely to evacuate the alimentary canal. This ena-
bles the remedy to act both with mort certainty and
expedition. Whatever ijuantity it may be thought
proper to give at one trial of the remedy, should
usually be given in one dose. Throe ounces of the
spirit of turpentine taken at once will be more like-
ly to destroy the worm or worms, than the same
quantity taken one third at once and repeated after
an interval of one, two, or three hours, and will be
much iess tedious to the patient. In some cases
where the stomach or intestines, or both, ai^e dis-
eased, and their sensibility and irritability are great-
ly increased, the requisite quantity of the remedy
may perhaps be better borne, if given in two or
three doses, one or two hours apart.

If this idea should be confirmed by a more per-
fect knovvledge of the effects of the turpentine,
when variously administered, we think these cases
will be found to be rare exceptions to the best
mode of giving it in a great majority of cases.

The greatest inconvenience 1 have noticed from
taking this medicine has arisen from the prohibition
of drinking — or in other words, the inconvenience
has been such as mild, mucilaginous drinks would
have relieved. Now if the stomach and bowels
be freely evacuated before the spirit of turpentine is
directed, and this be taken in sufficient quantity, it
will commonly pass through the body in an hour
and a half, or in less time than this ; and so soon

VERMINOUS DISEASES. 231

as this effect has been produced — so soon as any
portion of the turpentine has been discharged per
anuiD; whether the worm appear or not, the patient
should be permitted to drink freely of any bland,
suitable liquid. I have known the patient to be
restrained from drinking for six or nine hours,
and to suffer much in consequence of this useless
restriction.

The larger the dose is, the sooner it passes
through the body, and the less is the chance of its
being absorbed, and of thus incommoding the urina-
ry organs.

This last effect I have never seen but once ; that
was not severe, and I believe it very rarely occurs.

In one instance we are credibly informed that
the turpentine operated on the bowels, bringing por-
tions of a worm with it, in fifteen minutes ; in anoth-
er instance the remedy was discharged, with an en-
tire taenia, in twenty minutes.

When one dos^e, properly administered, does
not prove curative, it is better to suspend its further
use for one or two days, or till the patient has re-
covered from any inconvenience attending its exhi-
bition, than to give a second or third quantity in
the same day.*

Foicler^s mineral solution of arsenic*

This medicine I have known to destroy the
taenia in several cases.

* If the turpentine sliould not move the bowels in three
hours, it should then be followed by a liberal dose of castor oil*

252 TREATMENT OF

Dr. Fisher*- says of it, " The taenia may be des-
troyed by Fowler's mineral solution ; for this pur-
pose the patient should take it, two or three times
every day, in as large doses as the stomach will
bear ; and continue the use of it till the worms are
destroyed. Hitherto this remedy has not disap-
pointed me in a single instance." Medical com-
munications of the Mass, Med, Societyy vol. i,
Boston, 1808.

The following case is taken from the Edinburgh
Medical and Surgical Journal, vol. x, p. 419.

Jl case of taenia in an infant, cured hy decoction
of pomegranate By W. Pollock, M. J). Com.'
municated by Mam Biirt, M» 1), Superintend'
ing Surgeon f Bengal.

^^I would have done myself the pleasure of tran-
scribing for you the case of taenia in an infant, the
moment I received your kind letter, but my jour-
nal for 1811 had been mislaid, and I have only
this morning discovered it.

" I formerly communicated to you some cases of
taenia, cured by the pomegranate decoction, which
were inserted by Dr. Fleming in his catalogue of
Indian Medicinal Plants and Drugs, printed in
1810, and, since that period, 1 have found the rem-
edy invariably successful, in a very great number
of instances. In some of these the taenia had ac-
quired an enormous length, and in some of them

* Joshua Fisher, M. D. President of the Mass. Med. So-
ciety.

VERMINOUS DISEASES. 255

it was received in tepid water, and lived for sev-
eral hours after it was passed. Tlie following case
occuring in an infant, not two months weaned, ap-
peared to me to be very remarkable, in consequence
of which I reported it to you, and also sent a copy
of it to Dr. Fleming at the time it happened. That
it is a very uncommon occurrence, may be inferred
from an observation of Dr. Hamilton, in his most
valuable work on purgative medicines, where he
says, that the taenia is altogether unknown in in-
fancy and childhood. Peter Daly, aged 14 months,
S7th August, 1811, was weaned about two months
ago, and has since been gradually drooping, in
consequence, as was supposed, of dentition. He
is now excessively reduced, refuses all food, and
is harassed with a constant diarrhoea. His skin
is loose, dry, and shriveled, and he has the whin-
ing, fretful cry of a child who has been long sick.

" Different medicines have been prescribed for
this diarrhoea without relief, and for several days
his stools have contained small fleshy shreds, some
of which considerably resemble half dissolved por-
tions of the tape-worm. Two ounces of water
were added to six of a decoction of the pomegran-
ate root, (prepared by boiling two ounces of its
fresh bark in a pound of water to nine ounces,) and
a table spoonful was ordered to be given tlie child
every half hour, unless sickness and vomiting inter-
vened.

"28th. He took the whole of his medicine yes-
terday, without either sickness or vomiting, and in

S54 TREATMENT OF

the evo-niug he passed a portion of tape-worm Jvlive,
upwards of six feet long. The medicine purged
him briskly, and today he has Toraited almost ev-
ery thing he has taken. Appearing much exhaust-
ed, an anodyne carminative mixture was ordered
to be given at intervals, to relieve the sickness.

^<29th. Appear!;, jiore lively ; has had no vom-
iting since yesterday, and the diarrhoea has been
much restrained by the anodyne. Quiescat.

" September 1st. Is manifestly better in every
respect, but his stools still contain portions of the
tape-worm. Eight ounces of the above decoction,
"without dilution, were ordered to be given in the
same manner as before.

" 2d. He took the whole of his medicine yes-
terday, without either sickness or vomiting, and
with but Utile effect on his bowels, till this room-
ing, when it began to purge him briskly, and he
passed another portion of the worm, nearly eight
feet long. He has been very hungry and has eat-
en a hearty breakfast.

"a.>th. No portions of the tape-worm have been
observed since trie last report, and the diarrhoea
gradually left him, without the use of any other
medicine. His bowels have become regular, his
appetite keen, and he has filled up apace. He hasf
the appearance of a healthy, thriving child, and
his strength has improved so rapidly, that he has
now begun to walk. From the above period he
continued to thrive till August 1812, when he
again began to pass pieces of the tape-worm* Th^

VERMINOUS DISEASES. ii35

potnegranate decoction was repeated, and he pass-
ed an entire taenia alive, fifteen feet long, since
Which he has been in perfect health, and is at this
moment a very fine boy. He is a son of Edward Da-
ly, a private soldier in his majesty's 53d regiment.
Merat, 7th January^ I8I4.3

TREATMENT OF THE VESICULAR WORMS.

§. CLX. I doubt very much whether the mate-
ria medica can furnish any good remedy for the
expulsion of vesicular worms, especially those in
the substance of the brain.

Sheep recover from these worms when they
feed on elevated mountains, and in a pure and dry
atmosphere.

This rural observation teaches us that an invig^
orating regimen is the only means of destroying and
disorganizing these worms. All those remedies
which exercise and excite the solids, and at the
same time invigorate the lymphatic system, and di-
minish its mobility, should, in my opinion, be pre-
ferred, because by confirming the course of the
lymph, and the cohesion of the solids, and by ex-
citing the irritability of the lymphatic vessels, the
vesicular worms, which we have said are always
attached to this system of vessels,(S09) will be de-
prived of their necessary nourishment, and thus
•cease to live.

§ CLXI. It would be fortunate if we could set-
tle the diagnosis of those complaints which arise.

£56 OF HYDATIDS.

from vesicular worms ; but if this is not impossible,
it is doubtless very difficult to determine.! 310)

The best method of cure, in my opinion, is to
use stimulating diuretics, and diaphoretics, com-
bined with the most permanent and efficient stim-
ulants. Squills, digitalis, purpurea,(211) colchi-
cum aututiinale, black hellK^bore, gratiola officina-
lis, opium, toxicodcndrum,(iil2) muriate of barytes,
muriate of soda, the preparations of iron, canthari-
des, sul>limed sulphur, liquid carbonate of ammonia,
and other similar remedies, are those from which
we ra;iy hope, if not the annihilation of vesicular
worms, at least for some relief from the diseases
the^ produce.

As conducive to the success of these remedies,
a nourishing regimen of easy degestion should be
adopted, with good wine, cinchona, moderate ex-
ercise of body, an elevated, dry habitation, situated
in a temperate, mild and healthful climate. The
treatment, in fact, should be that which is practised
in dropsy.

[The following account of hydatids, or vesicular

worms, though long, is too valuable to be omitted

in a treatise on the entozoa, or intestinal worms.

It is from Monro's Morbid Anatomy^ Edinburghp

1811, 8vo.

« OF HYDATIDS.

"By the term hydatid, is to be understood, a
round or oval-shaped semi-opaque pulpy bag, pos-
sessing a contractile power, without an external

OF HYDATIDS. 257"

©pening, of a pearly or yellowish colour, contain-
ing a watery fluid, and often a number of smaller
hydatids, included within its proper capsule or
cyst.

" Hydatids are of very different sizes ; some are
not larger than a millet seed, others are equal in
bulk to an ox's bladder. The coats of hydatids
are generally thin and semi-transparent, though
sometimes so thick as to be perfectly opaque. The
habitat (to make use of the expression of modern
naturalists) of hydatids is also different.

^^They have been discharged by vomiting, and
by stool ;* frequently they are attached to the pe-
ritonaeum, and especially to that part of it which
covers the liver, or they are imbedded in that or-
gan, or attached to the kidneys or ovaria, or to
some part of the alimentary canal.

^^ Hydatids have also, though more rarely,
been found in the cellular membrane, likewise be-
tween the muscles, and sometimes; though still
more rarely, within the bones.

"There formerly existed a great variety of
opinion respecting the nature of hydatids. Natu-
ralists now seem to agree, that they belong to the
animal kingdom, and constitute a genus of animals,
of which there are several species ; but sufficient
observations on recent or living hydatids have not
yet been made, to enable us to draw up generic or

* See Philosophical Transactions, vol. wn,
33

I

258 i.V HYDATinS.

specific characters.* Hydatids, like intestinal
"worms, are incapable of independent existence, and
therefore exhibit a contractile power, only when
examined immediately on being discharged from a
living animal.

"The remaining for many hours within the
dead body generally deprives them of the princi-
ple of life ; and hence all specimens of hydatids
are not observed to contract; and such as retain the
power of contraction, for some time after being ex-
pelled, may be considered as unusually tenacious
of life.

" Purulent matter, which is sometimes lodged
within the same viscus, also proves fatal to hyda-
tids ; and in this case, of course, they show no
contractile power. The hydatids, found in human
bodies, are different from those of quadrupeds. Of
"the humun hydatids, there are the following kinds.

" 1. When there is only one large hydatid of
a globular form, contained within a cyst.f

"3. Where there are several hydatids with-
in the same cyst, of different sizes and colours,
some being of a pearly, and others of a straw or

* The generic name of hydria has been proposed, but no
character of tlie genus has been established. It seems not im-
probable thattlie hydatids of the human body must form a sepa-
rate genus, distinct from the hydatids of sheep.

t See Case, VII, in which eight English pir^ts of fluid were
contained within a large hydatid ; there were no small hyda-
tids within it, and t!ie whole of the inner surface of the hyda>
tid was perfectly smooth.

OF HYDATIDS. 259

amber colour ;* and some of the larger of these are
found to contain others.

« A third kind of hydatid has been also describ-
ed, but which I have never yet seen, where a num-
ber of hydatids have been enclosed one within an-
other, like a nest of chip boxes.

« The fourth kind may be called the cellular hy-
datid, as it is peculiar to the cellular substance of
the muscles ; the cyst of this kind is of considera-
ble thickness, and consists of several distinct lay-
ers, which sometimes acquire a cartilaginous hard-

ness.

« There is a fifth kind of hydatids, which, from
being compressed together, and forming a substance
about the size of a garden pea, has been mistaken
for indurated lymphatic glands. This kind has
not, so far as 1 know, been described.

a The hydatids are firmly united to each other
by a very adhesive mucus, and by a thin membrane,
besides which each of them is enveloped by its own
proper capsule. These hydatids are very small,
being about the size of the ovula in the ovaria of
fishes. This kind is often found in the choroid plex-
us of the lateral ventricles of the brain, i-n cases of

* See Case IV. The cyst of the hydatid contained four
pints of water, and a great many hydatids of different sizes;
some were about the size of a nutmeg ; others, as large as a bill-
iard ball, floated loose within the largest hydatid ; and within
several of the larger hydatids, there were clusters of small
sperical bodies, grouped together, which adhered to their inner
sides.

26e OF HYDATIDS.

apoplexy and hydrocephalus. There is a sixth,
though very rare sort of hydatid, which also, so far
as I know, has not been described.

^< In this, the hydatids are united laterally, to
each other. I have met with only two examples of
this variety of hydatids, and in both, they were con-
nected with the liver. There were, at the same
time, a great number of hydatids of different sizes
attached to the peritonaeum, and floating about ia
the general cavity of the abdomen.

^^ One of the patients, a boy, was supposed to
labour under ascites, his belly being enormously
swollen, his breathing much oppressed, and he was
not relieved by an erect posture.

*' The superficial veins of the abdomen w ere
greatly enlarged. For about nine months before his
death, he had severe pain in the right hypochondri-
um, and a considerable partial iumour was observ-
ed in his belly, wldch increased with great rapidity
for ten days before his death.

"On dissection, about four pounds of a fluid, like
tar, ran out of the abdomen.

" A large hydatid was found adhering to the con-
vex part of the liver ; and six others were found
adhering to this, 'rhe stomach was much displac-
ed, the pylorus being as low down as the brim of
the pelvis, and the greater share of the intestinal
canal lodged within its cavity. The watery fluid,*

* According to Dr. John Hunter, this fluid contains very
small liydatids ol ditieient sizes, tlie largest being -j^-^ part ol"

OF HYDATIDS. 9.61

contained in hydatids, is generally transparent and
colourless, is to the taste slightly salt, and, in some
instances, a part of it is coagulated by heat, or by
the addition of acids, or ardent spirits.

*^ In some cases, the contents of the cyst are
tinged with yellow, which is probably owing to an
admixture of bile, exuding after death ; for the
yellow colour is observed only in hydatids which
are connected with the liver and gall-bladder.
There are also tumours, the contents of which seem
to be coagulable lymph, and a number of hydatids
which have burst, and the coats of these are shrunk
and inverted. There is a seventh kind of hydatids,
with narrow necks, which is frequently attached to
the placenta. I have also seen hydatids of the sec-
ond species, connected with the placenta.

" Some of the bowels, as the ovaria and kidneys,
are said at times to have been converted into hyda-
tids, but it would be more accurate to speak of the
conversion of these bowels into watery vesicles ; (the
genuine hydatid being rarely found within these
bowels ;) and these vesicles have only one coat, they
are not inclosed within firm cysts, and do not pro-
duce their like, nor do they possess any degree of
contractile power, like the genuine hydatid."

ail inch in diameter, and the smallest being less than a red glo-
bule of the blood. See Trans, for the improvement of Med. and
Chiriirg. Knowledge, xoL i. p, 38,

m OF HYDAxros.

" Of the Sac of Hydatids.

'"^Tlie sac of the hydatid seems to be formed of
condensed cellular substance, and the thickness of
the sac generally bears a ratio to its size and situa-
tion. This sac is secured in its place by several
bands of cellular substance, which pass between it
and the bowels, within which it is lodged, and in
the abdomen it is covered by the peritonaeum.

^* The thickness of the sac of an hydatid is in
proportion to its size ; though there is considerable
difference in this particular, the sac being thickest
where it is most exposed : thus when the greater
part of the sac is surrounded by the substance of a
bowel, as of the liver for instance, that part only of
the sac, which is exposed, is of a considerable thick-
ness, and is sometimes cartilaginous, or covered by
layers of bone.

'' I have observed that the inner surface of the sac
is by no means uniform, but always somewhat ir-
regular, and lined by a very thin layer of fat. A
glairy gelatinous liquor is also interposed between
the sac and the hydatid, which prevents the hyda-
tids from being injured by friction. The sac of a
large hydatid is sometimes divided into compart-
ments, which serve to prevent the smaller hydatids,
contained within the opposite ends of the sac, from
pressing on each other."

OF HYDATIDS. 26S

*^ Of the Coats of Hydatids.

" The coats of the hydatid are not of a uniform
density, being much thicker in some than in oth-
ers ; and even in the same hydatid, we generally
observe some portions of these coats of greater den-
sity than others ; so that in the same hydatid, there
is a difference as to transparency or opacity in the
different parts of its coats.

^^ Hydatids have two coats, an outer and inner,
and the outer coat is considerably thicker than the
inner. There are no filires in the outer coat of an
hydatid visible to the naked eye ; yet the outer coat
possesses the distinguishing character of a muscle,
the power of contraction on the application of a
stimulus. The inner coat is very thin, semi-trans-
parent, soft, pulpy, and very tender, and in very
large hydatids possesses a small share of elasticity.
The interior surface is lubricated by a fluid, which
renders it slippery to the touch. From the inner
side of some of the larger hydatids, there are several
excrescences, which are made up of a congeries of
very sm ill hydatids, and the size of these bears a
ratio to the size of the hydatid.

'^ These excrescences are retained in their situa-
tion by a very thin transparent membrane, which
covers them. There is still another appearance,
which I have remarked, namely — a number of small
cells, formed by folds of the inner membrane of the
large pregnant hydatid, containing the smnll ones.

264 OP HYDATIDS.

It has not yet been determined, what is the propor-
tion of hydatids, which may be called pregnant.

^rln some cases, the greater part of the inner coat
is studded over with these small excrescences, but
in other instances, there are only two or three such
excrescences, from the parent hydatid. On exam-
ining the coats of very large hydatids, even Avithout
the aid of a magnifying glass, very small hydatids
may be seen adhering to the coats of the hydatid,
Avhich would seem to show that hydatids are multi-
plied in the same manner as some of the fungi of the
vegetable kingdom."

^^ Blood Vessels of Hydatids.

^^The coats of hydatids are provided with very
small blood vessels, absorbents, and nerves.

*^The blood vessels proper to the coats of the hy-
datid, have no immediate connexion with those of
the organ, within which it is lodged ; the hydatid,
in this respect, resembles a worm lodged within the
human body.

^^ I have, in several instances, filled, with great
success, the blood vessels of the organ within which
hydatids were lodged ; also those on the sac of the
hydatid ; whicli, where the hydatid is of considera-
ble bulk, are of a large size, and which, like those
in the neighbourhood of other preternatural tu-
mours, acquire an unusual size; but none of the in-
jection got into the vessels of the coats of the hyda-
tid.

OF HYDATIDS* 265

But other authors have affirmed, that they had
injected the vessels proper to the hydatid. Dr.
WALTHERUS,of Berlin, supposed, that he had filled
the blood vessels on the outer coat of an hydatid,
which was contained within the liver ; but it is not
improbable, that he had mistaken the vessels on the
peritonaeum of the liver for those of the hydatid.
Watery vesicles, or dropsical cysts, as they have
been named by some authors, are very different from
hydatids ; for in these we observe only a single thin
coat, firmly attached to the neighbouring parts, on
which several blood vessels, filled by red blood,
may be observed. Such cysts frequently adhere to
the extremities of the fallopian tubes, to tlie liga-
ments of the uterus, to the choroid plexus, to the pla-
centa, kidneys, or are sometimes lodged within the
glandular viscera, and are also sometimes imbed-
ded in the mammae and testicle. I have seen them
filled by a fluid of the colour of the ink of the cuttle
fish, when these organs have been reduced to a scir-
rhous state. Though tlie arteries proper to the
coats of hydatids be very small, yet the watery liq-
uor whicli fills the hydatid, is secreted by them, and
in some cases even bone.

The hydatid is probably nourished by absorp-
tion, and not by continuous vessels from its cyst,
and may be compared in structure to the echinus es-
culentus of Linnaeus ; tbat is, absorbent vessels
take up its nourishment from the containing cyst ;
and in like manner, the small hydatids, contained

within a larger hydatid, after being separated from
34?

266 OF HYDATIDS.

it, or loosened from the ovarium, in which they were
formed, suck up their nourishment from the liquor
of the hydatid, which contaius them. By what ves-
sels the liquor, which has been absorbed, passes in-
to the cavity of the hydatid, or forms young hyda-
tids, we do not know ; probably such vessels exist
as in the echinus. If hydatids contract, on the ap-
plication of a stimulus, it must be granted, that these
are under the influence of nerves, though these
nerves be so small as not to be obvious to our imper-
fect senses.

'^ Of the different states, in which hydatids are
found,

^^ Hydatids are found in different states. The
rudiment of the hydatid is connected to the coats of
the pregnant hydatids, and appears with other small
hydatids, iu the form of small excrescences, which
are attached to the large pregnant hydatids, xlfter
n, time, these small hydatids are detached from the
parent hydatid.

^^ Hydatids are subject to diseases.

" Hydatids sometimes burst within their sacs.

^< We sometimes meet with tumours, which are
made up entirely of pieces of coagulable lymph and
hydatids, the water having been removed by absorp-
tion ; hence the tumour does not communicate a
sense of fluctuation, as when the hydatids were en-
tire.

*^ The external coat of hydatids has sometimes
been converted into bone-

OF HYDATIDS. 267

"t have several preparations, which afford a
striking illustration of the manner in which bone
is formed on the coats and sac of hydatids. The
ossification begins from a few central points on the
coats of the hydatid, and by subsequent depositions,
the pieces of bone gradually become larger and
larger, so that at length a considerable mass of
bone is formed.'^

*' 0^ the manner in which the cysts of hydatids are
formed.

"The sac, containing the hydatid, seems to be
formed in consequence of the irritation of the hyda-
tid. In the same manner, where a large quantity
of purulent matter has been contained within the
viscera, we generally observe a sac, provided with
arteries, veins, nerves, and lymphatics, as is ob-
vious from the very varied contents of these differ-
ent sacs, and the spontaneous removal or absorp-
tion of their contents. There are also similar in-
stances in the vegetable kingdom, as in the pro-
duction of galls from the oak, &c.''

" Of the effects of hydatids, on the organs which
contain them.

*^ Hydatids, which attain a considerable bulk,
not only mechanically affect the organ within which
they are lodged by their pressure, but, by the ir-
ritation which pressure gives, produce still fur-
ther changes upon it. On acccount of the particu-

268 OF HYDATIDS.

lar stimulus, which hydatids, as living animals,
give, the organ containing them, or to which they
are attached, undergoes still further changes, ia
consequence of an action excited ; which perhaps
may not improperly be termed specific: in proof
of which, the organs, witliin which hydatids are
contained, or to which they are attached, are soon-
er, and to a much greater degree aft'ected, than by
the ordinary fixed dropsical cysts, whether of the
natural or preternatural kind. Thus a large quan-
tity of water, accumulated in the ventricles of the
brain in hydrocephalus internus, sometimes occa-
sions in an infant a disunion of the bones of the
cranium from each other, and the head attains an
unnatural bulk. No part of the cranium becomes
soft, thin, or is absorbed. But if hydatids are lodg-
ed in one of the ventricles of the brain, (which is
not uncommon in sheep,) the cranium over that ven-
tricle becomes soft, and may be cut without turn-
ing the edge of. the knife, and loses considerably
of its thickness, and in some cases holes are form-
ed in it, though t!ie dura mater remains entire be-
tween the cranium and the brain ; and even though
the cyst, containing the hydatids, is still covered
by a seemingly sound portion of the brain, and [»ia
mater. The same happens in the human body;
for in the first case stated, where an hydatid of the
size of a goose's egg was found in the right ven-
tricle of the brain of a man, covered by a gelati-
nous matter, without any fibrous adhesion to the
membrane lining the ventricle, the cranium was

OF HYDATIDS. i269

found to be much thinner on its right side than on
the left, and in particular, the riglit parietal bone
was not thicker than a wafer. In like manner, the
pleura, peritonaeum, and vaginal coat of the tes-
ticle have been greatly extended for a length of
time, but the containing membrane continues entire;
whereas, when hydatids are collected within these
membranes, a slight degree of inflammation is ex-
cited ; this is followed by adhesions, the cyst con-
taining the hydatids is destroyed, by which the
hydatid escapes from its original situation.

" There is a much greater disposition to the
destruction of the cysts, which contain the hyda-
tid, and other containing parts, than when water is
accumulated within the shut cavities. Cases se-
cond, third, fourth, fifth, and ninth, are marked
proofs of this fact, and also the case which occur-
red to Dr. Home. The hydatids were in that in-
stance probably generated within the liver, from
which they extended to the abdomen, and also up-
wards towards the thorax ; and had the patient
lived but for a short time longer, they probably
would have gotten into the lungs, as the diaphragm
was extremely thin opposite to the sacs of the hy-
datids : the hydatids might also have gotten into
the brandies of the trachea, and been discharsred
by coughing.

'• In the same manner, hydatids, formed in the
substance of the kidneys, have worked their way
out of the pelvis of that organ, and have been dis-
charged with the urine.

sro OF HYDATIDS.

" As hydatids seldom prove fatal, when tliey
have found an outlet, and as there is a disposition
in nature to discharge from the body, an attempt
should be made to assist the efforts of nature by art.

** In the first place, a tumour tilled with hyda-
tids, situated in the extremities, or on the exter-
nal surface of the body, may be with safety remov-
ed. Hydatids, lodged within the cavities of the
body, m.ay also be extracted, provided the organ
containing these has contracted an adhesion with
the containing parts, as was done in case seventh,
with complete success. Plater* has related the
case of a young woman, who had a tumour in the
right hypochondrium, which was very painful, es-
pecially when she lay on the left side ; it at length
burst, and a large quantity of a serous fluid was
discharged, besides a number of hydatids, after
which the patient obtained a complete cure. Gna-
tannics testimony is equally strong. He has relat-
ed a case, in which the parietes of the abdomen
over a tumour in the region of the liver, became
very thin, and the tumour, iu consequence of vio-
lent coughing, at length burst externally, and three
hundred entire hydatids, together with a quanti-
tity of serous fluid, were discharged. The open-
ing remained fistulous for some time, but at length
closed, and the patient recovered. In the same man-
ner, when hydatids have been accumulated with-
in the uterus, these may be removed from it, as

* Sec Obs. Solort. Mantissa. Obs. xviii. p. 44.

OF HYDATIDS. 271

was done by Dr. Kilgour of Musselburgh, ^vith
perfect success. A lady was supposed to be in la-
bour, and the doctor was sent for to deliver her.

^^ The pains were at first very slight. After
some time, a bleeding came on, which led the doc-
tor to examine the parts.

" He found the os tincae a little dilated, and
discovered that the uterus was filled by hydatids.
The bleeding continuing, he was induced to endea-
vour to remove the hydatids, which he accomplish-
ed, and brought away a basin full of them. The
lady got well in a feAV days, and afterwards had
four very healthy children. Thus the cause of the
tumour is removed, which is not ejQFected by open-
ing a fixed dropsical cyst.

" In many cases where there has existed a swell"
ing of the belly, it has suddenly disappeared on the
discharge of hydatids, by vomiting and purging.

" After a time, should another such tumour be-
gin to form, as in cases second, fourth, and sixth,
in these circumstances, though it is by no means
certain that the sac and the containing parts ad-
here to each other, if the tumour be stationary, it
may even, in some such cases, be advisable to
puncture the sac with a large trocar, and empty it
of some, or of the whole of the hydatids ; or if this
cannot be accomplished, to inject into it the smoke,
or the infusion of tobacco, or a very weak solution
of camphor, (»r to give mercury, or some other sub-
stance which may kill the hydatids, but which i«*
not dangerous to the patient.

sra UF HYDATIDS.

'^ Prudence bovvever suggests the propriety of
endeavouring to ascertain, by experinicnts on ani-
mals, the eifects of those liquors which are to be
used as injections. The effect of the smoke of to-
bacco in case eighth, in which hydatids were lodg-
ed in the lungs, is an inducement to the prosecu-
tion of such experiments ; and tliere is even rea-
son to suppose, that camphor, turpentine, and some
other su!)stances, which are very destructive to
worms and insects, and which are readily and safe-
ly absorbed in such quantity, as to communicate
their taste and smell to the blood in the human
body, might in cases of hydatids be of use, when
taken into the stomach, or even when applied to
the skin of the patient."

^^ OJ the concomitant symptoms.

*^ As the history of the symptoms, occasioned by
hydatids, can be collected only from a variety of
cases, I have subjoined several of those which have
fallen under the observation of my father, and of
myself.

^^ Case 1. A stout man, twenty years of
age, complained of constant headach, chiefly on
the right side, followed by a dilatation of the pu-
pil, and epileptic fits, which proved fatal to him.
On dissection, the cranium was found to be much
thinner on the right than on the left side, particu-
larly the right parietal bone, which in many places
was not thicker than a wafer. On opening the
right ventricle of the brain, a cyst about the size of

OF HYDATIDS. 278

a goose's eg^ was found within it, filled with
a watery liquor, and surrounded by a gelatinous
matter, which did not adhere to the meralirane, lin-
ing the ventricle. Dr. Grieve Maclcewzie, who
bad attended the patient, was so obliging as to
send the cyst to my father, which appeared to mc
of the same structure as that of hydatids.

"Cases. A stout man, twenty six years of
age, had a large swelling, in which fluctuation
could be felt, connected witli tiie concave part and
under edge of his liver. As there had' been no
symptoms of inflammation or suppuration, my fa.
ther supposed the swelling to be owing to a cyst,
filled with hydatids within the liver. Mh Jin-
dreic Woody who also visited the patient, was of the
same opinion.

^' Soon after this, the patient vomited a great
number of hydatids of different sizes. lu the
course of the four following years, the sac filled
again, and dischargd itself into the stomach repeat-
edly. The liver was sensibly enlarged, and had
descended about an inch lower than the edges of
the ribs, and was somewhat more sensible to tho
touch than usual. The patient's liver gradually
became smaller, and at length retreated within the
margin of the chest.

The patient has enjoyed perfect health for these
ten or twelve years past.

'< Case 3. My father was consulted by a wo-
man, forty years of age, who had a large swelling

within the left side of her belly, which resembled
3d

3,74 OF HYDATIDS.

a dropsy of the ovarium ; but as she h^d suffer-
ed more pain in it than is common in that disease^
he gnspected that it might be owing to a cyst full
of hydatids. About a fortnight afterwards, the tu-
mour subsided during the night time, and the pa-
tient told him that she had passed several waterj
stools with skins in them.

" Case 4. Mr. D. C. about thirty years of age,
consulted my father, on account of a large tumour
within the left side of the belly, in which there was
the fluctuation of a liquor, and as there had been
no symptoms of inflammation and suppuration, he
supposed it to contain hydatids. Several months
afterili'ards, in the year i775, be was again called
to tlie patient with his surgeon, the late Mr. John
Balfour.

" A tumour, in a state of inflammation, project-
ed between the twefth rib and os ilium of the left
side, and there was an opening of the skin, at the
point of the tumour, through which it seemed prob-
able that the contents of the tumour would soon be
discharged,

*< It was therefore agreed to enlarge the open-
ing in the skin, and on introducing the finger into
the wound, and pressing on the abdomen, the fluc-
tuation of the liquor in the cyst was distinctly per-
cei ed. An incision was tiierefore made into it,
and four pounds of hydatids were discharged.

"The orifice closed in a few weeks, and the pa-
tient considered himself for several years as cured.
But after a time^ the patient said he begau to feel

OF HYDATIDS. 275

another tumour forming within his belly, in near-
ly the same place as the former ; and a tumour ac-
tually formed, which gradually increased in size,
but did not give much uneasiness, or prevent him
from following business. The tumour still contin-
ued to grow larger, and in the year 1794, my fa-
ther was again desired to visit the patient with his
surgeon, Mr. Dewar.

'' An acute inflammation had occurred, in the
same place as formerly, which was followed by
suppuration. The tumour soon burst, and dis-
charged several pounds of a turbid milky matter,
in which there appeared to be portions of liydatids.

** Two days after, feculent matter was discharg-
ed from a hole, that had been eroded in the left
side of the colon. This, notwithstanding the open-
ing, healed in a kindly manner, and the patient en-
joyed good health for several years afterwards»
He died from a very different disease.

" Case 5. The abdomen of a man, twenty
eight years of age, swelled greatly, owing, as was
supposed, to ascites.

** There was an unnatural opening at the umbil-
icus. On enlarging, and perforating likewise, the
containing parts with a large trocar, about sixty
pounds of hydatids were discharged ; and the late
Dr. Bate, physician in Montrose, informed my fa-
ther by letter, that the swelling was gone, and the
patient had recovered.

" Case 6. About thirty years ago, the late Mr.
W, Anderson^ surgeon in Edinburgli^ carried my

276 OF HYDATIDS.

father to" visit a man forty years of age, who had a
swelled liver, which was followed by ascites, jaun-
dice, and the discharge of hydatids by stool, and
who died in the course of six weeks. My father
expected to find a sac with hydatids attached to the
stomach or intestine, and communicating with them;
but instead of this, the outer part of the sac, con-
taining the hydatids, was found entire, and did not
adhere to the alimentary canal. On opening the
cyst, the concave part of the liver was found wasted
to a considerable depth, and at the bottom of the
cyst, the branches of the biliary ducts were seen
■without dissection, bare, and greatly enlarged, with
a number of holes in their sides, through which the
hydatids had passed into the duodenum. The
great enlar^^ement of tlie biliary ducts was proba-
bly produced by the irritation of the hydatids,
and by the mechanical obstruction caused by the
pressure of the hydatids, on the lo>ver ends of the
biliary ducts, to which tlie pressure of an enlarged
lymphatic gland, which lay over the common duct,
had probably contributed.

" Case 7. In the year 1783, my father was

consulted by Mr. twelve years of age, who

had a swelling in the upper and right side of his
belly. The swelling gradually increased very con-
siderably. In the under part of the swellii;g, the
liver was felt in a sound state. At last the fluctua-
tion of a liquor above the solid part of the tumour
became very obvious.

OF HYDATIDS. 277

" As the patient had not lost his appetite for
food, had no frequency or fulness of pulse, no bil-
ious disorder, no symptoms of inflammation, suppu-
ration, or of scirrhus in the liver, my father imput-
ed the fluctuation, which he perceived on applying
one hand to the upper part of the tumour, and strik-
ing it with the other, to hydatids, contained in a
sac above the liver, between it and the diaphragm,
and the gradual descent of the body of the liver to the
increase of the sac containing the hydatids. As tlie
tumour continued to increase in size, my father pro-
posed to the late Mr. W. Inglis and Mr. F. Be-
waVf surgeons, who were now called to him, to make
an incision into the sac, which was agreed to, and
performed with much caution.

The peritonaeum lining the containing parts,
was found to adhere to the cyst, which, from the
long continuance of the swelling, seemed probable.

" On dividing the external coats, a thick, but
soft semi-opake membrane presented itself, atid on
cutting this, eight pounds of a clear liquor were dis-
charged, but no small hydatids. On examining the
soft membrane, within which the liquor had been
contained, it proved to be of the same structure as
other hydatids, and the coats were somewhat thick-
er than any of these, owing probably to its greater
size.

^» My father now laid hold of the large hydatid
with his fingers, and by pulling it gently, he detaclied
the whole of it from the tough external coat, form-
ed by the peritonaeum which inclosed it. After the

are of hydatids.

operation, the wound was carefully covered by
pledgets, and thick compresses, over which a broad
flannel roller was applied, in order to exclude
the air, to support the liver, and to keep the oppo.
site sides of the cyst contiguous.

*' In a few days the patient became feverish ;
he suifered much from thirst, his pulse qiickertlian
common, and there was a discharge of purulent
matter from the sore, a suflBcient proof of previous
inflammation in the sides of the cavity,

" The cure icas completed within ten weeks,
I have seen the patient frequently since he under-
went the operation. He has had no return of the
complaint. He is now nearly thirty nine years of
age, and enjoys perfect health, and is one of the
stoutest men in Edinburgh. It may be worth while
to observe, that in this case, and in case fourth, no
blood vessels were visible on the proper coats of the
hydatids, nor in two other such cases, in which the
blood vessels of the liver, and particularly the blood
vessels of the cysts, which contained the hydatids,
and which were of large size, and had been fillt'd with
coloured size injection. In all these four cases, no
part of the liquor which the hydatids contained co-
agulated ; when ardent spirits were mixed with it,
or by boiling it ; from which it appears that the
liquor, contained within the hydatid, is materially
different from that of a common dropsy of the belly,
or that of the ovarium.

" Case 8. I had occasion to visit a man thirty
two years of age, with my father, in 1801, on ac-

et HYDATIDS. 279

count of a pain in the right side of his breast, be-
hind the mamma, which was not removed hy bleed-
ing, or the application of a blister. He had no op-
pression or difficulty in breathing, and could sleep
on either side, or on his back, and his pulse was
not at all affected. He was relieved on coughing
up portious of h\ da':ids, and also some entire hyda-
tids, some of which were of the size of a hazlenut,
and others as large as a walnut, and he sometimes
coughed up tl ese in such quantity, as would have
jUlied a pint bottle.

" The larger hydatids contained a clear viscid
liquor, and the smaller ones a yellow liquor, which
he said had a bitter taste. A few days before
coughing up the hydatids, the patient suffered very
acute pain in his breast, which he compared to that
of a pointed instrument entering his breast ; and
for two or three minutes before the hydatids were
discharged, he was seized with violent coughing,
and a sense of suffocation, which continued for two
or three minutes. For eight months afterwards, he
occasionally coughed up hydatids. The disease
began when he was fourteen years old.

*^ We recommended to him the smoking of to-
bacco, and drawing the smoke as deeply as he
could into his chest. He did so, and during the
following eight years^ he had no return of his dis-
order.

" Hydatids have frequently been accumulated
in considerable quantity within the cavity of the ab-
domen, and have proved an impediment to the pas-

280 OF HYDATIDS.

sa^e of the feces, aud evea to delivery ; as iu the
followins: case.

" Case 9. I had occasion to examine the body
of a woman, who had been for a very long time iu
labour. The natural efforts being inadequate to ex-
pel the child, it became necessary to have recourse
to the forceps to extract it. The patient ex-
pired three days afterwards. On examining the
body, I found a large mass of hydatids of different
sizps, connected with the upper part of the rectum,
and which had impeded delivery.

•^ Case 10. In this case, a man of mid'Ue age
had been afflicted by a dropsy of the belly, and
jaundice for some time^ when three or four tumours,
of diiTerent sizes, appeared in different parts of the
parietes of the abdomen. These, when pressed, evi-
dently contained a fluid.

" The patient lived only for a few months.

" On dissection, the above mentioned swellings
were found to be hydatids, adhering to the perito-
neum lining the belly.

" There were at least one hundred hydatids of
different sizes within the cavity of the abdomen,
some of which adhered to the liver, the others were
floating loose in the large quantity of water which
filled the belly.

"Case 11. This case was treated by Dr.
Home in the clinical ward of the royal infirmary.
I obtained the following from the journals of the
hospital.

OF hydatids; ssi

" JSTovemher 5, 1807.
''The skin, and the white part of the eyes of a
young woman, have a strong yellow tinge. Her
abdomen is remarkably enlarged ; and on examin-
ation, two large, distinct, moveable tumours are per-
ceived, considerably elevated above the surface of
the general swelling. One occupies part of the
umbilical region, and rises a little above the um-
bilicus, is circumscribed, hard, unequal, and some-
what moveable. The other is seated in the epi-
gastrium, towards the left side ; is uniformly round-
ed, immoveable, firm, and elastic. The veins of
the integuments covering it are tortuous and enlarg-
ed. There is also felt a general hardness along
the right side of the belly. She does not suifer
pain on motion, or on pressing any part of the ab-
domen. General health and spirits little impaired,
though she has become considerably emaciated
of late. Pulse ninety ; heat and respiration nat-
ural ; mouth dry ; tongue clean ; appetite and di-
gestion good ; body costive ; feces commonly of a
natural colour, sometimes black, never whitish.
Urine at times rather scanty ; very dark coloured,
and tinges linen of a deep yellow. Six years and
a half ago, she caught a fever, by which she was
confined to her bed for weeks. During this illness,
she could not lie on her right side without pain^
and before her recovery, discovered in the right hy-
pochondrium, a ftimoitr of the sizeof a teacup, which
was for about a year and a half stationary. Has

had pain of the right hypochondrium, shooting to
36

282 OF HYDATIDS.

the right shoulder, and more lately oedema of the
legs. General swelling of belly has come on grad-
ually. She lingered for six weeks under Dr.
Homers charge.

^^ Dissection. The integuments of the abdo-
men were found to be very thin over the large tu-
mour in the epigastric region, which was filled by a
large quantity of yellowish limpid fluid. 'The sac
containing this fluid, being laid open from end to
end, was found to consist of two coats, the external
of a dense and firm texture, the internal thick but
very tender, of a light yellow colour, very elastic,
and adhering; loosely to the external cyst. ' From
the inner surface of this internal membrane, there
were numerous distinct masses of cauliflower ap-
pearance, varying much in size, of a beautiful
whiteness on the surface, and were yellow and ge-
latinous internally.'

^^ The fluid in this sac appeared to contain nu-
merous very minute hydatids.

^*This tumour was situated within the sac of the
peritonaeum, and adhered pretty generally to that
membrane. * Tlie tumour was entirely connected
on one side with the left lobe of the liver. The
tumour, which was during life felt at the umbilicus,
was found to consist of two lobes, a larger and a
smaller, of the same appearance as the former tu-
mour, to which it was connected by a production of
the left lobe of the liver, but no communication sub-
sisted between the cavity of the first sac, and this
tumour, when cut into/

OF HYDATIDS. 28S

^^ This sac was found to contain numerous hy-
datids, some of which were very large, and on their
internal surface, there were cauliflower productions ;
others were placcid, ruptured, and apparently tend-
ing to putrefaction, but containing smaller hydatids,
which were entire and spherical, and all of them
tinned with bile. ' The liver was found placed on
the right side of the body, its right lobe was low
down on the right side, where it had been distinct-
ly felt during life ; it was somewhat hard, but oth-
erwise of natural appearance; almost the whole of
the left lobe was converted into an enormous sac,
similar externally to the former, occupying the tho-
rax, adhering to, and pushing up as far as the
third rib, especially on the left side of the dia-
phragm, which was very thin, and with difficulty
separated from it. This sac was found, when open-
ed, to be lined with a delicate membrane, similar
to that of the^rs^ sac^ but exhibiting no cauliflow-
er protuberances. Within it was contained a large
quantity of serous like fluid, and an immense num-
ber of hydatids of various magnitudes and colours,
and all of a spherical form, some exhibiting on their
internal surface, cauliflower like processes, others
containing smaller hydatids.

" The gall-bladder and gall ducts were very
much enlarged. The other abdominal viscera
were much deranged in situation, but quite natural
in structure, excepting the left kidney, which was
much enlarged, and very flaccid. An hydatid of
some size adhered to the mesentery, and three

284 OF HYDATIDS,

small hydatids, like globules, were found within
the cervix of the uterus.

^^The thoracic viscera were sound, and the
heart was remarkably small. No hydatids were
found in the brain, which was quite healthy."

** Case 12. The last case 1 shall mention, oc-
curred to Dr. Duncan, sen. whose account of it is
subjoined, with the history of the appearances af-
ter death, by himself, which fully explained the
most remarkable circumstance in the history of the
case, the disappearance of the tumour in tlie right
hypocliondrium iu the horizontal position.

March 18, 1807-

^^ John Brown, a labourer, aged thirty eight.
The whole abdomen is very much enlarged, and
affords to the touch a distinct sense of fluctuation.
When in the erect posture, there is observed, aluiut
the upper part of the hypochondriac, and extending
over the greater part of the epigastric region, a
large circumscribed tumour, possessing evident
fluctuation, which subsides immediately on his as-
suming the horizontal posture, when a uniform tense
swelling occupies the whole abdomen.

" Pressure applied under the margin of the
false' ribs, on the right side, excites so considerable
a degree of pain, as to cause him to wince under it.

''' The skin over the whole body, and the tuni-
ca adnata of both eyes, are of a deep yellow colour.
The urine also is observed to have a very dark yel-
low appearance ; and linen, when immersed in it,

OF HYDATIDS. ^ 285

is very deeply tinged. The alvine excretion is said
to be of a white colour, and rather thick consist-
ence. ' He is affected with occasional sickness, and
inclination to vomit ; but he has never complained
of pain in the epigastrium. He complains of great
dyspnoea, which is always most severe in the
morning, and is induced on stooping forward or
making any exertion.

" He is also much affected in the evening, par-
ticularly at first lying down, with a severe cough,
which, by his account, is extremely urgent, except
when lying on the left side ; and is accompanied by
a different, though copious viscid expectoration, hav-
ing a bad taste and smell. It excites the dyspnoea
to a great degree, which then requires the erect pos-
ture. ' Pulse one hundred ; tongue white ; great
thirst ; heat moderate ; urine very scanty ; belly
costive ; and he is distressed with frequent tenes-
mus; appetite much impaired ; sleep disturbed by
frequent startings.'

<^ Dissection. The dropsical water in the ab-
domen was as dark coloured as the urine of the pa-
tient was on his admission, and gave a deep yellow
tint to cloth immersed in it. The impregnation from
bile had indeed gone further, than in any case Ire-
collect to have seen ; for the cartilages of the ribs
were coloured by it to the centre. The surface oi
the liver had somewhat of a mottled green colour,
very like to many marbles, and more especially to
the Portsoy serpentine. The substance of the liv-
er had also the same appearance, witli the excep-

£8G OF HYDATIDS.

tion of tlie centre of the right lobe, which was ra-
ther of an olive, or dirty yellow colour. The liver
was of an uncommon bulk, and the convex surface
was more prominent than usual towards the middle.

"^ This was not owing to any ilisease in the glan-
dular part of the organ, but to a sac of a yellow
colour, and of the size of a large orange, though of
an oval shape, and irregular in its surface, situated
in the region of the portae of the liver.

" Over this sac, which was filled with hydatids,
the vena portarum, the hepatic artery, and its great
branches, as also the hepatic nerves, which were
much larger and much harder than common, pass-
ed; and the branches of the hepatic nerves could
lie distinctly along the gall ducts.

"' The hepatic, cystic, and common ducts were
so much stretched in their course along the surface
of the large sac, as scarcely to admit of air to pass
through them.

^* The ductus communis was much enlarged in
the portion not compressed next the liver.^ The gall
bladder contained but a small quantity of bile, and,
from being contracted in several places, had an irreg-
ular figure, and scarcely exceeded in size that of si
child's at birth ; and over this bowel there was a
broad preternatural membrane, uniting the liver to
the great arch of the colon. The lymphatics from
the liver did not contain bile, and were not coloured
by it.

^^ The adjacent parts betrayed marks of pre-
vious inflammation. The stomach and great arch of

OF HYDATIDS. 287

the colon were more intimately united than usual by
the omentum ; and there was also a strong adhe-
sion between the liver and kidneys. All the parts
adjacent to the liver, more especially the kidneys,
were tinged of a deep yellow colour.''

" Conclusion.

^' The preceding history of hydatids seems to
me to have established the following propositions.

" 1 . That hydatids are not peculiar to any one
part of the human body, and are most commonly
connected with the investing membranes of the liv-
er, ovaria, or kidney. v

" 3. That there is no resemblance between the
hydatids, which are peculiar to quadrupeds, and
those of the human body, as is obvious, by com-
paring the preceding description of the hydatid
of the human body, with those of the hyda-
tids of quadrupeds, which have been published by
Hartmannus,^ Tyson, Pallas, Schroeder,\ Fonta-
na, and E. Home, Philos. Trans, for 1795.

" 3. That there is every reason to conclude,
that hydatids are animals.

"4. That observation and experiment have not
yet determined in what manner hydatids are gener-
ated, or deposited within certain bowels.

" 5. That as the smaller hydatids adhere to the

inner surface of the larger, that larger hydatids may

be called pregnant; or that these animals are mul-

* See Mis. Nat. Cur. Dec. 2. an. 4to.
t See Schrosder de Hydatid.

Q88 OF HYDATIDS.

tiplied like some vegetables, by the adhesion of the
smaller hydatids to the coats of the larger hydatids.

<-' (i. That the coats of the bowels containing the
hydatids are much more frequently destroyed, than
when water only has been collected within them ;
hence the hydatids escape from their original
situation, and sometimes find their way by unnatur-
al passages into the intestines, urinary or biliary
canals, into the windpipe &c.

'* 7* That many patients recover on the dis-
charge of hydatids.

^^ 8. That hydatids may even, when adhering to
one of the bowels of the abdomen, be removed by
incision, providing there exists an adhesion between
that viscus and the parietes of the abdomen.

NOTE.

" Since the preceding sheets were printed, I accidently turn-
ed up the first volume^of the London Medical Communications,
and was much gratified to observe, that what I had affirmed might
have happened in the case treated by Dr. Home, had actually ta-
ken place in a case described by Dr. Foart Simmons, who had
stated, ' that on pressing the thorax, hydatids poured out in great
quantity from that cavity into the abdomen, and on introducing
a finger at the part, from which thej issued, we found that it had
passed with case into the thorax, through an opening in the up-
per and fleshy part of the diaphragm.

"The sternum being now carefully removed, a most sin-
gular appearance presented itself to our view: On the right
side the liver was seen extending from the spine of the ilium up
to the fourth rib.

" As the diaphragm was pushed so high up on that side, the
right lobe of the lungs was compressed into a very small space,
but without being apparently diseased. Tiie heart and pericar*

OF HYDATIDS. 389

(lium were likewise in a sound state, but the texture of the left
lobe of the lungs was in a great degree destroyed by suppurac
tion.

" In tracing the course of the great cyst, already spoken of
as filling the left side of the abdomen, we found it perforating, as
it were, the diaphragm, and then expanding again, adhering to
the pleura and mediastinum, and filling almost the whole of the
left cavity of the thorax. The upper part of this sac communi-
cated in several places with the diseased lungs, and on pressing
the latter, matter flowed into the cyst. We introduced a probe
into one of these passages, and it passed far enough into the sub-
stance of the lungs to account for the expectoration of pus through
these channels.

" If the patient had lived much longer, it is possible sho
would have coughed up hydatids, as one of the openings from the
cyst into the lungs was large enough to admit a goose quill."
This affords an additional, and very strong illustration of a par-
tial absorption taking place in that bowel within which hydatids
were lodged, and ofthe formation of an unnatural passage, through
which the hydatids might have escaped into a branch of the wind-
pipe. The case recorded by Dr. Collet in the second volume of
the Trans, ofthe college of physicians of London, forms an im-
portant appendix to the former case, for in this instance, the hy-
datyds, which were originally lodged within the liver, were dis-
charged by coughing. It is stated, there was at first observed,
•' an irregular tumour, not very large, seated in the lower part of
the epigastrium, about four or five fingers in breadth, below the
xiphoid cartilage, extending itself towards the right hypochon-
drium.

" In the most prominent part of it, a fluid is distinctly per-
ceived, which seems to be immediately under the common in-
teguments.''

" Dr. Buker^ who has subjoined his remarks on the case, haa
ohserved ; ' If then a conjecture on a subject, which is at pres-
ent obscure, and which admits of no demonstration, may be
hazarded ; is it not possible, that, by the gradual operation of
37

i290 OF HYDATIDS.

morbid effects, a communication may have been opened between
that tumour, (alluding to the tumour situated above the navel,)
and a branch of the trachea ?' From what had occurred in sev-
eral of the preceding cases, it seems to me certain, that such a
communication had existed, and that the hydatids which were
discharged by coughing, had been generated within the liver."]

'^ In the second volume of the Medico Chirur-
gical Trans, p. 260, is a case of hydatid in the
braio.

" A robust young woman began to complain of
pain, and of swimming in her head, about the year
1808.

" These symptoms were always increased by
motion, particularly by stooping.

*^They continued till April 1810, when she
was seized, without any previous warning, with a
fit. The surgeon who saw her at this time was
struck with the complaint she made of a fixed acute
pain of the head, and with the ferrety appearance
of h«r eyes. For some time afterwards she had a
fit every third or fourth week. On the twentieth
of August, she had three fits in one day, accompa-
nied by derangement of the stomach, by screaming,
and other indications of great sufferings. These
attacks continuing till September, she had theft
nearly lost her hearing. Shortly afterwards she
lost the sight of her right eye, and in fourteen days
more, that of her left,

** Her smell was completely gone, and the ol-
factory nerves were insensible to the stimulus of
hartshorn ; lier speech and power of deglutition

\'ERMINOUS DISEASES. 291

were very much impaired, and her left side became
paralytic. Dec. 11th she died.

^^ Dissection. On removing the dura mater, the
pia mater was seen elevated over the right hemis-
phere by a taraour, which was found to be an hy-
datid, about three inches long and two broad. It
was imbedded in the substance of the brain, by
which it was very lifierally supplied with numerous
minute vessels of the size of hairs, which were par-
ticularly abundant at the lower part.

'^ The symptoms were supposed, by the medi-
cal attendants, to arise from some organic affection
of the head, as was afterwards demonstrated.''!

IV. TREATMENT OF THE TRICOCEPHALUS.

§ CLXII. Consumption, nervous epidemic fe-
vers, slow nervous, and mucous fevers, are the
chief diseases which seem at present (313) directly
to favour the development of this worm in the in-
testines. Inflammation and dilaeeration of the intes-
tines, occasioned by its presence (314), seem to orig-
inate rather from the prevailing atony of the viscera
than from the bite of the tricocephalus.

§. CLXIII. So soon as those diseases, during
which this worm is developed, are cured, and the
tone of the intestines restored by a strengthening
diet, it is expelled ; because the circumstances
■which favour the unfolding of the eggs, having ceas-
ed, they cannot again multiply in the human intes-
tines.

292 TREATMENT OF

This bein^ admitted, it follows that nothing
more is requisite for the expulsion of the tricocepha-
lus, than to cure the disease with which it is usually
associated.

But if these worms being in great numbers,
should contribute to reduce the patient, we should
prefer the use of those stimulants, which we have
noticed as proper for the expulsion of worms, such
as camphor, assafoetida, valerian, muriate of ammo-
nia, and others.

V. TREATMENT OF THE ASCARIS VERMICULARTS.

§. CLXIV. We sometimes sooth the itching
and irritation excited by these worms, collected in
the rectum, by introducing through the anus a piece
of bacon tied to a thread, which, after some time, is
to be withdrawn, and with it all the ascarides ver-
miculares attached to it. This method is repeated
several times, till the worms are destroyed.

^ CLXV. Clysters of geoffroya surinamen-
sis,(^i5) of as8afoetida^[2i^) of veratriim sabadil-
Za,(317) of tepid milk well salted, or of simple wa-
ter salted. (218) are the best remedies to drive these
worms from the large intestines. Enemas of ole-
um ricini, and plugs of soap smeared with this oil,
are very useful. Tenesmus, hemorrhoids, swell-
ing, tension and inflammation of the anus, symp-
toms sometimes occasioned by ascarides vermicu-
lares, particularly when there is inflammation of
the intestines, ought to be treated with clysters and

1

VERMINOUS DISEASES. 29S

emollient fomentations, and in general, agreeably
to the indication of peculiar circumstances.

We should endeavour to supply the loss of
the natural mucus, destined to lubricate the inner
surface of the intestines, with enemas of mucous
and gelatinous substances. (319)

§ CLXVl. The ascarides are certainly feeble
worms, but very difficult to destroy ; they are ca-
pable of exciting, for a long time, a number of
morbid phenomena.fisiSO)

Hence it is necessary to continue the treatment,
even when these worms seem to have disappeared
entirely. The minute embrions of the female as>
caris vermicularis, though deposited alive, are not
perceptible at the instant,(221) and still less visible;
thus the sick, already subject to these worms, if
they too suddenly abandon the curative regimen,
are again attacked with them when they think them-
selves well.

§ CLXVII. The use ot these injections is not
in general sufficient to distroy these worms, which
sometimes ascend the intestinal tube, and which
have been found not only in the small intestines,
but even in the stomach and oesophagus(SSii) ; for
this reason the treatment should be rendered more
active by remedies taken by the mouth, among
which are to be preferred camphor,(223) valeri-
an,(234) muriate of barytes,(22f») iron,(SS6) and
sublimed zinc,(337) etc. Rosenstein says, (228) that
these worms may be driven from the body by eat-
ing raw carrots, and by drinking a great quandty

294 TREATMENT OF

of the juice of the beet or beech, to procure a copi-
ous discharge. Some persons have highly recom-
mended injections of tobacco : but according to He-
berdeii'S observations(2S9) and my own, they have
been attended with more inconvenience than advan-
tage. The sulphuric elixir of Mynsichty{^30} ad-
ministered with the remedies already noticed, has
often produced wonderful effects, because, with this
remedy we give more tone to the first passages,
the solids regain their strength, and the supera-
bundant secretion of mucus of the intestines, which
is the vehicle and aliment of the ascarides vermic-
ulares, is diminished. (231) The inhabitants of
Abyssinia readily relieve themselves from these
worms, according to Bruce's account,(333) with a
spiritous infusion of the flowers of the Banksia Jibys^
sinica,{2^.S)

§ CLXVIII. To prevent the generation of the
ascirides vermiculares, it is useful to invigorate and
strengthen the abdominal viscera, especially the
large intestines ; conformably to this idea, besides
the articles recommended as purgative,(334^) the
patient, if in a condition to do it, should often mount
a horse, locally to strengthen the parts which give
rise to the development of this species of worm.

[Mr. Charles M. Clarke, in his Diseases of Fe-
males, p. I67j says, " a strong decoction of the semen
santonici is the most efficacious of all the injections
in use. With this the rectum should be filled ; but
the quantity thrown up should never be so great as
to produce great distention of its cavity, lest the

VERMINOUS DISEASES. 295

coats of the bowel being stimulated, it should con-
tract hastily and expel the glyster, Avhich acts with
more certainty, if it remains for some time. This
operation, repeated for a few successive days, will
seldom fail to remove, for a time, the ascarides and
the symptoms they produce.

Purgatives employed alone are of little service ;
but during the use of the glysters they ought to be
occasionally exhibited."

Of these worms Dr. Fisher says, " they reside
principally in the rectum. A brisk cathartic will
remove part of them ; but medicines which have to
pass through the stomach cannot be depended on.
Anthelmintic enemas, such as oil, a solution of sal.
marin. or sal. martis, repeated once in a day or
two, for five or six times, very seldom fail of des-
troying them."

A medical friend of mine was lately entirely re-
leived from a violent irritation of the rectum from
these worms, by introducing once only a sort of
large bougie into the bowel, smeared with whale
oil. In these cases, if other remedies fail, the spir-.
it of turpentine should be tried. If it should pro-
duce any considerable pain of the rectum, this in-
convenience might be easily removed by some mu-
cilaginous injections ; or by castor oil taken by the
mouth. The oil might be previously taken, and the
turpentine injected half an hour before the oil would-
be expected to operate.]

296 TREATMENT OF

VI. TREATMENT OF THE LUMBRICOIDES.

§. CLXIX. We do not, says Rosenstein,[2S5)
so easily succeed ia expelling the lumbricoides ;
for this purpose he prescribes the five following
rules, by the aid of which I can affirm, that I have
never failed to destroy them.

1. The medicines should be administered in the
morning, at the hour of breakfast, because the worms
also acquire the habit of taking food at this time,
and in this manner they are disposed to eat those
substances which destroy them.

2. The medicines about to be taken are first dis*
solved in tepid milk, hydromel, or mercurial wa-
ter,(536) and before the patient goes to stool, he
should take a clyster of lukewarm milk, in order
to bring the worms to the interior portion of the
rectum.

3. The patient should take care not to prepare
the mediciiies himself which he is to take, or to smell
of them, because these worms secrete themselves in.
order to avoid their odour.

4. When a physician proposes to expel them
by internal means, he should omit the use of exter-
nal applications, that the worms may not hide
themselves. If however the patient, after having
swallowed the vermifuge, should experience vio-
lent pain in any particular part of the lower belly,
and convulsions should occur, this would indicate

LUMBRICOIDES. m'

that the lumbrico'ides had assembled at this point,
and were attempting to perforate the intestines. (^37)

The worms should then be expelled immediate-
ly, and this may be effected by rubbing the part
with petroleum, and applying, between two pieces
of linen, a cataplasm, prepared with the tops of
absinthium, garlics, rye meal, and the fresh gall of
an ox. f 238)

5. For some days before the commencement of

this course, the patient should abstain from every
article of diet containing milk, using only the gross-
er, hard, and salted aliments, as onion pottage, and
aromatic dishes ; if practicable, he should take, the
precediug evening, a piece of herring, without,
drinking after it.

This sort of life fatigues them, and they re-
tire to the lower intestines, whence they are more
easily expelled. The salt herring contributes to
make them suck up the medicines with more avidi-
ty and in greater quantity. (S39)

§ CLXX. The semen contra vermes mixed with
jalap,(S40) the seeds of thechenopodium anthelmin-
ticum,(34!l) the bark, of angelica, (242) assafoeti-
da,(243) the geofifroya suvinamensis,(244) the po-
lypodium filix mas,(345) the spigelia anthel-
mia,(S46) Valeriana officinalis,(347) the anthelmin-
tic drops of ^arf7naw??,(24i8) the preparations of
iron,(249) mercurials,(250) sulphur,(251) are reme-
dies which experience has demonstrated to be effi-
cacious for the destruction and expuUion of lum-

bricoides.

38

498 TREATMENT OF

*f,:Jlosenstein informs us, tlip.t he bas often prt-
scribed, with success, the sulphate of iron combined
with the seeds of the artemisia santonica and jal-
ap. (^53) He also recommends garlics as an excellent
remedy against worms, and advises them to be eat-
en fasting, or on bread and butter, or boiled in milk,
or to take the expressed juice, combined with an
equal quantity of oil of almonds, (oleum ricini I
think better,) adultorated with lemon juice, or sugar,
and then to purge the patient with the elixir of rLu-
barb.(353)

Probably the smell of garlic and assafoetida
obliges these vermins to descend into the lower por-
tion of the intestines, where they are more easily
expelled by purgative medicines.

§ CLXXI. jBisse^ boasts of fetid hellebore, (2it4)
against tiiese worms, which he administers dry and
in powder, in the dose of fifteen grains to an adult ;
he also gives a drachm of syrup prepared with its
juice. Lille strongly recommends(3i>5) a mixture
of a scruple of the extract of black hellebore, (V.^iG)
and half a scruple of sulphate of iron ; he dissolves
it in an ounce of centaurea benedicta, by adding to
them syrup of violet or honey ; the dose is a small
spoonful in the morning, fasting.

§ CLXXIl. The green bark of the fruit of the
walnut, prepared in different ways, is a very ac-
tive and powerful remedy for the expulsion of
worms. (^57) Fischer says much in favour of the
extract, which, according to him, will destroy the
lumbricoides in two minutes. He dissolves two

LUMBRICOIDES, 299

drachms of this extract in four drachms of canella
water, and gives fifty drops of this solution to a
child from two to three years old ; and after seven
or eight days he prescribes a mercurial laxative,
I have several times directed, with success, the oil
of walnut expressed without heat, particularly when
rendered more active by the juice of lemon, and af-
terward purging with oleum ricini.

^ CLXXIIl. But of all the remedies hitherto
announced, there is no one of them, according to
my observations, whicli is more active or more
certain than camphor.

This substance, administered according to rule,
expels lumbricoides with facility and promptitude,
and at the same time strengthens the intestinal tube
and the whole body, as we have already said. (258)
This remedy kills these worms in an instant, per-
haps because its penetrating and volatile odour
acts by restoring in a surprising manner the ex-
citement of the first passages, and those parts which
are sympathetically connected with these organs,
relieving the convulsions and spasms occasioned by
worms, and preventing the cause of them.

§ CLXXIV. Other remedies have of late been
recommended against worms and among these
Fordichey(2^^) bestows many praises on the filings
of tin and the seeds of the asteraisia santonica, And
SchewandimannC^^QO) equally commends the con-
serve and other pharmacuetic preparations of hel'
minthochorton.{2Qi) Having no particular expe-
rience of this last remedy, I can only relate what

800 XREATMENT OF

is said of it by the French physicians, who assure
US that they have used it with the greatest suc-
cess. (262)

[ The Stizolohiiim, Volichos pruriens Linn.^
or CowitcJi, is one of the most safe and effectual
anthelmintics, at present known. It destroys not
only taeniae, but also lumbricoides and ascarides ;
and as it acts mechanically by piercing and wound-
ing these animals, it will probably be found a val-
uable remedy for every species of worms which in-
habit the alimentary canal.

** This exotic plant grows in warm climates, es-
pecially the West Indies. The pods are about
four inches long, round, and as thick as a man's fin-
ger. The outside of the pods is thickly beset with
stiff brown hairs, which, when applied to the skin,
occasion a most intolerable itching. The ripe pods
are dipped in syrup, which is again scraped off with
a knife. When the syrup is rendered by the hairs
as thick as honey, it is fit for use. It may be safe-
ly taken from a teaspoonful, to a tablespoonful, in
the morning, fasting. The worms are said to ap-
pear with the second or third dose, and by means
of a purge, in some cases the stools have consisted
entirely of worms.'' Mr. Kerr has given a botan-
ical description of this plant in the Medical Com-
mentaries, vol. ii. It is also described and figur-
ed by Dr. Woodville, in his Medical Botany. Mix-
ed with molasses or treacle, it is better preserved
and administered than in any other manner. Mr.
W. Chamberlainey in his Practical Treatise ou this

VERMINOUS DISEASES. 301

article, says, " For the tape- worm, long experience
has taught me that the cowhage fcowitclij does
not prove so effectual, as against the other worms,
unless the quantity of setae be doubled. In very
obstinate cases, I sometimes find it necessary to in-
crease the quantity of setae even to a threefold pro-
portion ; for these worms will not easily be made to
let go their hold ; which they are as tenacious of,
as they are of life." A child of Mr. C. five years
old, swallowed by stealth, three or four ounces of
the syrup of co witch, "without any other inconven-
ience than a diarhoea, which did her more good
than harm."

Though this medicine is generally perfectly
safe, yet there may be instances in which it would
be improper to give it, as in cases of inflammation
in any portion of the alimentary canal, and in ex-
cessive irritation &c. of this passage.

In Massachusetts it is more used than formerly,
and is gaining reputation. It commonly proves
more certainly and speedily beneficial, when its use
is preceded by an emetic or cathartic, or both ; and
when a purgative, as castor oil, is occasionally in-
terposed. This should be done every second or
third day, during the exhibition of this article, if
there is the least costiveness. It has often been
regretted amon: physicians, that no anthelmintic
medicine, taken into the stomach, seemed to pos-
sess the power of fully destroying the ascaris.
There is much reason to believe that the cowitch,
as mentioned above, will prove an exception toihie

aoa TREATMENT OF

opinion. These bristles, or bairs, are liable to be
injured, probably by age, and more certainly by
becoming damp and musty. Whatever destroys
their strength and elasticity, destroys the proper-
ties on which their activity and usefulness de-
prncl.

Dr. Fisher, as quoted, p. 253, says, *' The tere-
tes (lumbricoides) resemble the common earth-
worm generally ; but the difference is sufficient to
prove tbem a different species. In some cases they
are found to be very numerous ; one thousand
and nine were discharged from a child in the
space of ten or twelve days. In common cases
the amalgam of tin never fails to kill them. I have
combined the tin and quicksilver in various propor-
tions, and added different substances to render the
amalgam pulverable. The following formula is
considered the best ; — to five parts of melted tin, add
two parts of quicksilver ; mix them, and add one
part of testaceous powder ; keep the amalgam melt-
ed, and rub till the smallest part of it disappears ;
when the mixture is cold, a little additional livigat-
ing will reduce it to an impalpable powder. Let
three or four drachm« of this powder be divided
into twelve doses, two of which arc to be given in

a day.

This quantity will generally be sufficient for a
child ; hut sometimes six, or even twelve addition-
al doses will be required. If we wish to keep the
bowels more open, a little calomel may be added.
Should the symptoms be very severe, a large dose

/

VERMINOUS DISEASES. SOS

of calomel should be given ; otherwise we may lose
the patient before the amalgam has time to operate.*
Sometimes we find the patient in a lethargic stupor,
and the action of the stomach, of course, suspended;
at other times, the canal is in a state so debilitat-
ed and relaxed, that the powder passes undissolv-
ed ; in neitber of these cases will this preparation
produce any effect. Worms, killed by tin, or its
amalgam, are never discharged entire, but are ei-
ther partially or wholly digested. " I had under
my care a boy, of about three years, who had the
usual symptoms of worms. I gave him tin to no
purpose. In the course of six months every kind
of anthelmintic was tried iu vain. At length I
gave him a scruple of calomel, and before it operat-
ed, injected the smoke of tobacco, till it passed by
his mouth. Daring the operation of the medicine,
which was very severe, he discharged one of the
teretes in a spiral coil, like a bean vine, which had
twined round a small twig; it was incapable of be-
ing extended to a straight line, and had obviously
grown in that form.

''\ presume that it must have been lodged in the
appendix vermiformis. A worm in this situation,
sometimes, and I believe generally, proves fatal.
This is the only instance, within my knowledge^
of its being dislodged.''

This amalgam of tin, for v/hich we are indebt-
ed to Dr. Fisher^ is a safe and valuable remedy,

* And this will more certainly save tlie patient, if the calo-
mel be accompanied with a decoction of the spis^elia marilandi'
CO. A. T.

S04 TREATMENT OF

I once saw a few doses of it produce a consid-
erable salivation for two or three days.

The symptoms of the lumbricoides very gener-
ally subside after its exhibition, though the worms,
as the doctor remarks, arc rarely discharged in a
visible form.

In 1782, M. Chahert published a work on the
verminous diseases of animals, in Paris. He men-
tions a preparation, which he considers as a per-
fect remedy for all the worms which inhabit ani-
mals. C. Ji. HudolpM, see p. 65 of this work, no-
tices this article with commendation. It is this,
<^ Oleum Chaherti. Olei animalis empyreumatici
pars una tribus olei terebinthinae essentialis
partibus additur et iiscum quatuor diebus elap-
gis destillatur. Olei hujus destillati vim nulla
vermiuni species eludere posse videlur, nee solum-
modo ascarides tarn majores quam minores, vel
taeniae pellit, sed distomata eti am hepatica in-
numera ejusdem ope a puella duodecim annos nata
dejecta, apud cl. Chabertum vidi. Doses satis
magnas, bobus nimirum uncias duas ad quatuor us-
que ; equis unam ad tres uncias ; equuleis, vitulis,
ovibus drachmam ; suibus drachmam semis ad scru-
pulos duos, canibus pro magnitudine diversa, por-
tionem minorem drachmam serais, vel scrupulum,
vel hujus partem dimidiam offert. Homines equi-
dem ob gustum ejus nimis ingratum saepius recus-
ant, alias meliori uti non possent antihilminthico.''
That is, — Chahert' s Oil ; one part of empyreumatic
animal oil is added to three parts of essential oil

VERlSnNOUS DISEASES. S05

f spirit J of turpentine, and after standing four days,
the mixture is distilled. No species of worms can
elude the destructive force of this distilled oil.

Under the direction of the celebrated Chabertf
I have seen it expel not only the large and small
ascarides, hut taeniae also, and innumerable hepat-
ic distomata. from a girl twelve years old. He
considers ti«e following doses sufficiently large ;
namely, for neat cattle from two to four ounces ;
for horses from one to three ounces ;* for colts,
calves, and sheep, one drachm ; for swine from half
a drachm to two scruples ; for dogs, according to
their age and size, a drachm, or a scruple, or half
of this quantity.

Men indeed, from its unpleasant taste, sometimes
refuse it; but excepting this inconvenience, a better
anthelmintic cannot be used. Rudolj)hiy vol. i. p,
493.

More reputed remedies for the lumbricoides
might be enumerated ; but with such as are alrea-
dy before the physician, or even with a part of them,
properly administered, I think he will have noth-
ing more to wish.

Dr. C. Chisholm, of Bristol, England, has pub-
lished an instructive paper on the Malls Dracun^
cuius, or Gruinea-worm in the eleventh vol. of the
Eiinb. Med. and Surg. Journal for 1815.

Dr. C. concludes his communication in the fol-
lowing manner.

* Has this medicine ever been given to the horse for bots
in the United States? If not, it well deserves a trial. Ji.T.
39

S06 TREATMENT OF

*' It now remains to oifer my observations on
the prevention and cure of the dracunculus. Nev-
er was there a disease, to which the medical pre-
cept, sublata causa, iolHtur morbus^ more di.stinctly
applies, than this. The result of the application
of this precept at Point Saline, in Grenada, is a
manifest exemplification of the means, by which
this is to be effected, and precludes the necessity
for saying more of the subject here. As to the cure
of the disease, that is to be accomplished by the
destruction of the insects. I used a variety of
means, but none were effectual, till I had recourse
to mercury.

" Mildly saturating the system with this medi-
cine, destroyed the insect. I since then find that this
medicine has been long used by others for this pur-
pose. At that time, 179^^, I knew of no auihority
for it. Linnaeus says, " Infuso mercurii subl-mati
corrosivi Swietenii intra dies SO, qui alias 40 edu-
citur." (Syst. Nat. Tom. i. p. 2. 1075.) In phthi-
riasis, and other diseases ol' the exanthemata viva,
mercury has been long known, as an effectual rem-
edy, externally applied ; but in dracunculus it is
not so : the remedy must pervade the system, in or-
der to destroy the insect, or its ova. It is unneces-
sary to detail the variety of means employed in dif-
ferent countries. They are of doubtful effect, how-
ever vaunted of — asafoetida, garlic, the root of an-
gelica, sulphur, &c. &c. Some gentlemen, consid-
ering the disease as an inanimate substance, recom-
mend the extraction of it by a painful surgical ope-

VERMINOUS DISEASES. 90r

ration ; but the opinion is as irrational, as the cure
is unnecessarily cruel.
" October 31, 1814.'*

The subsequent facts and cases, though not
precisely within the scope of Brera^s Treatise, will
be interesting to the medical reader, and not with-
out use to the physician.

Mr. W. Lawrence, in the Sd vol. of the Med-
ico Chirurg. Trans., has given the case of a wo-
man, who voided a large number of worms, by the
urethra. " Mary P. aged twenty four, a single wo-
min of a healthy and strong constitution, was seiz-
ed in the winter of 1806, with retention of urine,
requiring the daily use of the catheter. She com-
plained of great weight in the bladder, pain about
the loins, and numbness of the thighs ; she seldom
passed any water, and when she did, only 5 a few
drops, much tinged with blood.

" It was deemed a case of calculus, but nothing
of that nature could be detected by the sound." After
remaining along time without relief, she was, in the
summer of JS09, greatly emaciated, and her consti-
tution much deranged.

Her tongue was furred, and frequently assumed
a typhoid appearance ; her appetite was lost ; she
complained of pains in the loins and bladder, and
had passed no water for six months, except by the
assistance of the catheter. About this time she was
seized with violent fits whenever the use of the in-
strument was delayed longer than usual, or when
the pain and burning heat in the bladder were

508 TREATMENT OF

particularly great. " As the symptoms, denoting
the existence of some mechanical irritation in the
bladder, were still unrelieved, Mr. Barnett, her
medical attendant at the time, sounded without find-
ing any indication of stone ; the examination gave
great pain, and produced in the patient a sensation
as if the instrument had struck against a hall at the
top of the hladdrr. From this time the sense of
weight became more considerable, and she felt a
fluttering within her, as if something was moving ;
this was so distressing as to oblige her to continue
constantly in bed, to which she has since been al-
most entirely confined ; the quantity of urine had
become considerably diminished ; it had been nec-
essary at first to use the catheter twice a day ; af-
terwards once a day, once in two days, and lastly
once in three days was sufficient. 8he went on till
the beginning of August, using such means as are
generally employed in afi*ections of the bladder,
without the slightest alteration. In fact, her con-
stitution was daily suffering more and more. She
was unable to get up, and was continually torment-
ed with a distressing pain in the head, which she
had never felt before. The least noise alarmed
Ler. The appetite was entirely gone, and she took
nothing but liquids in very small portions ; she
could get no sleep without large doses of opium.

<^ The fluttering in the bladder was more violent,
and according to her own account, so strong as to
be perceptible to the hand ; and the bladder itself
much distended, even after the water had been

VERMINOUS DISEASES. 309

drawn off, and so tender, that the weight of the bed
clothes cou'd not be borne.

*^ A very careful examination was again made
with the sonod, and produced the same feeling as be-
fore, of its striking against a ball in the bladder.
This was followed by an exceedingly violent con-
vulsive fit, in which the patient was so agitated, that
five or six persons were required to hold her."

Soon after this *^Mr. Bavnett was much sur-
prised, on removing the catheter, to find insinuated
through its orifices, what appeared to him a round-
ish worm, about the size of a piece of bobbin, an
inch and a half in length, and of a white colour.
At this time Mr. B. gave me an opportunity of see-
ing the case ; we examined very carefully with the
sound, with the same result as before, and agreed
that the catheter should be again left in the urethra,
as it had been before, in order to throw further
light on the cause of the patient's sufferings.

" Three worms were now brought away, two of
them most curiously entangled in the orifices of the
instrument, and the third coiled round the end. As
we had now gained some information concerning
the cause of the symptoms, Mr. Burnett attempted
for its removal, at my suggestion, to dilate the ure-
thra on the plan recommended by Mr. Thomas, in
the first volume of the Medico- Chirurg. Transac-
tions, The sufferings of the patient were so con-
siderable, that this could not be followed to the de-
sired extent. The effects of the spirit of turpen-
tine in cases of taeniae, determined us to try this

310 TREATMENT OF

remedy. Two drachms were given at bed time in
a little warm beer, producing no other sensation
than that of a pleasant warmth at the stomach.
The influence of the medicine on the urinary secre-
tion was very manifest by its subsequent effects ;
the bladder was painfully distended on the follow-
ing morning, though the water had been drawn off
the evfning before, and at this time the catheter
was used only once in three days. A pint and a
half of urine was evacuated.

" A double quantity of the medicine was repeat-
ed in the evening, producing no other effect than a
profuse perspirat on during the v.hole of the night,
and a strong inclination to make water in the m(un-
ing. She made no effort to assist this disposition,
as the length of time, for which the catheter had
been employed, made her suppose it would be use-
less. The feeling became at last so urgent that she
yielded to it, and passed a pint and a half of water,
containing four worms ; the only natural evacua-
tion of urine she has had during Mr. Barnetfs
attendance. The continuance of this treatment did
not produce success, corresponding to such flatter-
ing appearances.

" The medicine, on the fourth time of using it,
produced most violent pain in the head, and much
fever, which were followed by erisipelas over the
whole body, but more particularly in the face. All
subsequent attempts to use it, even in diminished
doses, were attended with a recurrence of these
symptoms. From the first trial of the oleum te-

VERMINOUS DISEASES. 511

rebinthini however, to this time, the patient's health
was on the whole very considerably amended ; she
recovered her appetite, rested at night without opi-
um, and was so much relieved from the feelings
about the bladder, that she could remain up four or
five hours in the day. Mr. B. now injected into
the bladder equal parts of the oil of turpentine and
water, which produced only, according to the pa-
tient's expression, an increased fluttering in the
worms. On withdrawing the catheter, four worms
came away. The repetition of this injection pro-
duced the same constitutional irritation and erysip-
elatious inflammation, as the internal use of the
medicine had before done. The fits which had be-
fore so much distressed her, were again renewed.

" As these means had failed, Mr. B. introduced,
on the 3^d of February, a very large catheter,
opened at the end, and furnished with a stilette,
that filled the orifice when it was introduced ; on
withdrawing the stilette, a free passage was left
for the contents of the bladder. In less than half
an hour, nine worms came through, with a table-
spoonful of sandy matter. Four of these were five
inches and a half in length." In this way the pa-
tient continued to discharge worms, till Mr. jBar-
nett supposed that as many as six hundred had
been voided. Twenty two were disciiarged ..tone
time. Mr. B. tried olive oil as an injection ; af-
ter its use the fits were less violent. October, Ibl 1 ;
a large abscess formed near the vagina in June last
attended with severe constitutional symptoms, and

815 TREATMENT OF

every appearance of the patient's sinking ; wheu
it burst into that cavity, she was greatly relieved.

The whole nimiber of worms discharged to this
time, could not be less than eight hundred or one
tnousaad. In figures xii and xiii, plate IV. of this
work, is an engraving of a large and a small worm,
of the natural size. The latter were only voided
on one occasion.

<'The large worms are mostly from four to six
inches in length, and the largest was eight inches;
they are slender in the middle, where they appear
uniformly as if broken ; they increase gradually in
both directions from this mi Idle point, and then
decrease again to the two extremities.

" When placed in water, after immersion in spi-
rit, they are bent at this middle point, and lie in the
form represente«l in the drawing. — They are soft
when voided, and of a yellowish hue. The numer-
ous figures and descriptix)ns of Goeze^ do not make
us scquainted with any such worms."

Dr. Fisher^ as above quoted, says, " worms of
various kinds, and their eggs, must be frequently
conveyed with our food into the stomach ; where
they generally perish : in some few instances how-
ever they have been known to live and grow ; but
they have been supposed incapable of propagating,
either in the alimentary canal, or any other part of
the body.

" Perhaps the following case may furnish an ex-
ception to the general rule.

VERMINOUS DISEASES. 313

'^ A. woman of middle age, whose voracity was
unquestionable, gave me the following history of her
case. Some years before, she had been attacked
with a disagreealde, painful sensation in the lum-
bar region. 1 presume from her account of the seat
of it, that it was in the kidneys: soon afterwards
she suspected that she discharged, with the urine,
some small worms ; a careful attention confirmed
her suspicion : the worms, when first voided, kept
moving in the urine, and died in about half an
hour. A few weeks afterwards she found, that in-
stead of worms, she discharged very small winged
insects, all of which, I believe, were dead ; these
soon disappeared, and with them all her com-
plaints. Subsequent to that period, the same
symptoms had recurred, two or three times every
year.

*• She gave me one or two of each kind of these
little animals, preserved in spirit. They were, I
presume, the same species in different states. The
worms were about two thirds as long as the larg-
est maggots foiind in cheese ; but probably not
half so large in circumference. The flies or gnats
appeared to be about twice as large as the winged
aphides, or lice found on cabbages ; but all of them
were so much contracted and changed, by the ac-
tion of the spirit, that with the naked eye I could
obtain but a very imperfect idea of them. I deter-
red examining them with a microscope, hoping to
obtain some in a better state of preservation ; but in

this I was disappointed ; the woman, finding that no
4(1

314 TREATMENT OF

relief was to be expected from medicine, was very
unwilling even to think of such a subject, to her so
very disagreeable ; and, in the mean time, those that
I had preserved in a phial, by accident, were
thrown away. 1 regret very much that I could not
obtain more particular information respecting them ;
it might not indeed be of much practical utility, but
it would gratify our curiosity to know whether the
same species could be found elsewhere ; and if it
could, its history might enable us to account more
satisfactorily for the appearances. These worms
probably proceeded, at least in the first instance,
from ovula, which had passed the stomach and lac-
teals to the kidneys.

^*The ascarides indeed sometimes enter the uri-
nary passages from without, and may be supposed
capable of penetrating as far as the kidneys ; but to
them the salts of the human body are not disagree-
able ; to these worms it was otherwise ; it is prob-
able that in water, the element natural to the lar-
vae of gnats, they would have lived very well ;
but in urine they suffered, and in half an hour di-
ed.

" Whether the eggs were all taken in at the same
time, their hatching being suspended to different
periods, by the powers of the living body ; or
whether they were received at different times ; or
in fine, whether those discharged at the several suc-
cessive periods, were successive generations, prop-
agated within the body, I shall not undertake to
determine."

VERMINOUS DISEASES. 315

Dr. Alexander Munro, in his Morbid Anatomy,
page 060, after having spoken of intestinal worms,
goes on to say, that, " besides the species of worms
already treated of, others of a diflferent description
have been occasionally discharged by stool. I al-
lude to caterpillars, or the larvae of insects. I
sent for examination, several specimens of them to
Mr. Leach, who favoured me with the subjoined
report. ' They are the larvae of insects as follows :

*^No. 1. The ova of the musca vomitoria.

^^ My friend Donovan informed me, that he had
seen the larva of this insect in the intestines of a
body in a state of putrefaction. The eggs most
probably were deposited at the mouth, or anus, and
the larvae had found their way thither on their
hatching* which soon happens.

^' Nos. S, 3, and 4 are larvae of three unknown
species of coleopterous insects.

^' No. ILL is figured in the Medical Journal,
vol. viii, p. 4?, fig. viii. I am pretty certain, that
it is what the farmer calls the wire-worm. Of
what insect it is the larva will soon be made known,
as Sir J. Banks, at this time, is breeding a great
many, in order to ascertain this important fact.

** Nos. 5, and 7? larvae of the papilio brassicae,
or some species much allied to it.

^^ No. 6. The pupa of some musca. Species un-
known to me."

Some years ago, a woman, now living in Bid-
deford, Maine, had an issue for a long time, in the
bach of her neck.

3IG TREATME'NT OF

At this period, which was in warm weather,
she was confined in a dark and dirty apartment.
At length the issue healed ; soon after which a tu-
mour rose at the part, hust and discharged a great
number of maggots or larvae ; it is said, a teacup-
ful. For several months these animals seemed to
be confined to the part, occasionally crawling out.
The sore healed a second time, soon after which
the patient felt these larvae to spread from the late
ulcer to the head, producing in their course most se-
vere pains, described by her as itching, biting,
stinging, and gnawing sensations. Some time after
these sufferings, the larvae were discharged, at
times, from the ears, eyes, nose, and mouth, vary-
ing in number and size, sometimes one hundred in
twenty four hours ; some as small as a hair, and
others almost as large as a pipe-stem, and two
thirds of an inch long.

Dr. Dean, of Eeddeford, who gives me these
particulars, adds, " it is about four years since this
woman has been tormented with these vermin,
which still trouble her, May, 1816." Two of these
larvae came to me in good health, after having been
some weeks discharged, and travelling more than a
hundred miles. To one 1 offered the refreshment
of some new milk, passing it nearly round it on a '
smooth piece of wood. When it first came to the
milk it was apparently tasted with pleasure, but on
advancing further and bringing its body into full
contact with the milk, the animal soon expired,
seeming to suffer paiu. The surviving traveller

VERMINOUS DISEASES. 317

was shut up in an empty, dry pill box ; after some
months, 1 cannot now ascertain the exact time, as
the insect was not then in my possession, the box
Was opened and the inhabitant found to have pass-
ed throui^h the intermediate changes to las perfect
state. A scientific friend recognized him as the
Tenebrio Molitor of Linn, or the mill beetle.
This gentleman observes, *' the larvae must have
been introduced into the cellular membrane in the
state of eggs. It is indeed surprising that larvae,
which naturally feed on meal, flour, bran, &c.
should be able to exist in such a situation. It was
too moist for them to go through their metamorpho-
sis, and the larvae therefore quitted it when about
t(» put on their perfect and ultimate form.'' This
poor woman lias never had the consolation of kuow-
ing that these troublesome inmates cannot arrive at
that state in which they propagate while under her
skin. On the contrary, she thinks they are constant-
ly multiplying and growing, and that she can nev-
er survive their existence.

Dr. Frank, of Vienna, relates the following
case of a gardener's wife, near Vienna, who, after
being tormented for seven w^hole years, with an al-
most uninterrupted and very painful headach, at
last had been relieved by a lucky chance. She was
twenty four years of age, not subject to any kind
of sickness, when she began to be seized with a
very troublesome and frequently returning head-
ach, which gradually became more violent, drove
her almost to despair, and extended over the whole

318 TREATMENT OF

heady even to the maxilla inferior. This head-
ach was intermittent ; sometimes the patient suffer-
ed uninterruptedly for two or three months, and
at others the pain was but slight. During this pe-
riod the patient not only felt a dryness in the nos-
trils, but also a very trouljlesome sensation of an
entire stoppage in these parts.

The physicians being now of opinion that all
possible remedies had been exhausted, she was ad-
vised by one of them only, to take a pinch of snuff
frequently. This soon caused a very moderate
secretion of phlegm, for which reason the palient
resolved to heighten the irritative power of the
snuff, by mixing it with a little marjoram and assa-
foetida, both of which irticles she had in the house.

Soon after the use of this sternutatory, on blow-
ing her nose, a living worm dropped out, which, ac-
cording to her description, perfectly resembled the
common grub. The complaint still continuing with
equal violence, she concluded perhaps still more
worms might exist, and therefore resolved to in-
crease the portion of assafoetida in the snuff, when,
soon after, live more worms, similar in every re-
spect to the above, issued from the nose ; and some
days after, three more made their appearance ; and
in short, forty eight worms were gradually voided
through the nose ; then followed a vast quantity of
phlegm, and even several pieces of pseudo-mem-
branes : the headach was, for the most part, gone ;
only a painful sensation remained for some time,

VERMINOUS AFFECTIONS. 319

which however, some months after, quite disap-
peared.

Dr. Frank is disposed to think these worms
had their seat in the sinus frontales, in the two an-
tra highmoreana, and the cavum uaricum, which
supposition seems to be, in some measure, confirm-
ed, by the patient's feeling much pain in the ossa
frontis, which induced her to take the resolution of
having several teeth successively extracted. He
also thinks the constant irritation of the worms in
these parts, might have brought on a chronic in-
flammation, productive of the pseudo-membranes,
voided after the worms. Med, and Phijs. Jon^rnalf
vol. XXXV, p. S53.]

VII. TREATMENT OF GENERAL VERMINOUS
AFFECTIONS.

§ CLXXV. If we call to mind, that worm fe-
vers, like gastric fevers, are really nervous fe-
vers,(263) and that the worms which appear dur-
ing their course originate from the asthenia which
prevails in the whole body, and particularly in the
stomach and intestines, (^64) and that in mucous
diseases the origin of worms is the same ; the prac-
titioner has therefore nothing more to do, than to
cure the general asthenic diathesis, whether it be
severe or slight, in order to expel the worms, and
to remove the tendency to their return.

V CLXXVI. The use of emetics, so much re-
commended by writers, and especially Vanden-
'Bosch,[2Q5) is, without doubt, sometimes advanta-

320 VERMINOUS AFFECTIONS

goous in those fevers which have heen called vet-
minous, because by this means the stomach is clear*
ed of corrupt materials, which, being there retained,
wouhl contribute to the production of worms.

An emetic also, by agitating the whole system,
gives energy and force to the organs which perform
the natural functions. The abuse however of emet-
ics, as well as purgatives, by producing a greater
loss of the fluids, may also produce the opposite ef-
fects, as we every day see. The weakening of the
solids, the increased secretion of iiuids, the aug-
mentation of the asthenic diathesis, and a disposi-
tion suited to the propagation of worms, are the con-
sequences of an excessive use of evacuants how-
ever given. (266)

^ CLXXVII. Besides, the first indication in
the treatment of these affections should be deduc-
ed from the general form of the disease ; and the
whole treatment should be directed to increase the
excitement of the whole system ; that is, to strength-
en the body.

The treatment suited to simple typhoid fevers,
whether they are violent, mild, or slow, is the same
as that adopted in general verminous complaints,
more especially as those remedies are the most effi-
cient,fii67) which are used both to conquer these
dangerous astheniae, and to expel those worms
from the body, which occasion its derangement.

PRESERVATIVE TREATMENT. S21

VIII. PRESERVATIVE TREATMENT.

§ CLXXVIII. After expelling from the hu-
man body, the worms, by which its orgaag were
injured, either locally, or sympathetically, and
consequently its functions deranged, we are not to
regard the cure as complete, till the slightest dis-
position to a new development of them is removed.

We have before remarked, that the atony of
the solids, and of the whole body,(268) is one of
the most essential circumstances, which favour the
production of worms. For this reason a universal-
ly stimulant regimen, invigorating particularly the
stomach and intestines, by giving activity to the
solids, by diminishing the morbid dissolution of the
mucous fluids, by opposing the degeneracy and
consumption of the parts of the body, and by giv-
ing strength to the organs destined to carry on the
animal functions, must necessarily incommode the
worms, destroy them, and at the same time excite
the actions requisite to expel them, and to prevent
their reproduction. (:i69) A stimulant regimen
therefore, adapted to the debility of those who
have been freed from worms, is of the highest im-
portance.

This mode of treatment corrects the predisposi-
tion to worms, by giving vigour and healthy ac^
tioa to the stomach and intestines.(^70)

END OF THE FOURTH LECTURE,

41

NOTES

TO THE FOURTH LECTURE.

(1) See §§ LX, LXT, LXII, CI, CII, CIIL
(S) See H LXVIII, LXX.

(3) See ^ LXVIII.

(4) Traite des maladies des evfans, etc. p,SiG^
see Burserius, Institutionum medicinae practicaef
vol. iv, P. II, Mediolani, 1789, 8°, p. 179.

(5) See Vogely de usu vomitoriorurn ad ejicien-
das vermes^ Gottingae, 1764', 4°.

(6) See § LXI.

(7) See §§ LXXIV. Affections vermineuseslo'
calesi XCVII. Jl Sections vermineuses sympathi'
ques.

(8) The people imagine, that remedies, taken to
expel worms, are more effectual at the new moon,
or near the end of the full moon. Bisset, Phelsumj
Meady Rosensfeirij and other physicians of great
repute, have also recommended these days as most
proper to undertake the treatment of worms. With-
out doing injustice to names so well entitled to the
public estimation, I would say with Block, Traiti
de la generation des vers des intestins, etc. p. 108,
that if these worms had eyes, or if the light of the
moon diffused heat, we might then admit the pos*

FOURTH LECTURE. 323

sibility of this planet's having some influence on
worms, on remedies, or even on diseases.

(9) See § I.

(10) This is the pretended anthelmintic power
of bitters, as the professor of the Decima judicious-
ly remarks in his JVotes a la Matiere medicale de
Cullen ; see tome vi, note no. 83,

(11) See § LXXll, no, S.
(IS) See § LXXIX.

(13) ilnatrijpsolos;ia ossia dottrina delle frizio'
ni die comprende il nuovo metodo di agire sul cor*
po umanoy per mezzo di frizio ni fatte cogli umori
animali, e colle varie sostanze che nlV ordinario si
somministrano internamentej edizione quarta^ vol.
ii ; Pavia, 1799, 1800, 8°.

(14) See Anatripsologittj vol. i, art. v.

(15) See Anatripsologia, vol, ii. art. ii^ vol. ii,
art. IV. Frictions on the abdomen of children with
the two following liniments, are of great ultility.

1, Take a drachm of ox gall and of Venice
soap, and form them into a liniment with a con-
venient quantity of oil of tansy.

S. Digest for twenty four hours in a warm place,
in a sufficient quantity of gastric juice or purified
saliva, two ounces of ox gall, half an ounce of pul-
verized socotorine aloes, and of prepared cucumis
colocynthis, and make the whole into a linimeut
with fat.

(16) Cepa officin. class, hexand. ord. monogyn.
biennis ; scapo nudo inferae ventricoso lougiore,
foliis teretibus.

324 NOTES TO THE

(17) Allium officii! . class, et ord. praeced. pe-
I'ennis, caule planifolio bulbifero, bulbo composito
stamin. tricuspidatis.

(18) A woman, tormented with taenia, took, dur-
ing six months in succession, one or two slices of
garlic, and at the close of this period, voided a
piece of taenia ten metres sixty decimetres long ;
see Rosenstein, Traite des maladies des enfans.

(19) ^issef reports that he expelled an entire
taenia, which had resisted all other means, by the
use of garlics boiled in milk.

(SO) See Taube, Geschichte der kricbel-krank-
heit, p. 207.

(21) The following are the principal formulae ;

1. Garlic, or alliaceous wine. Put an ounce
of bruised garlics into some good wiue and simple
essence of absynthium, let them stand ten hours,
strain off the liquor and preserve it for use.

3. Syrup. Macerate a pound of bruised gar-
lics, in two pounds of boiling water for one hour,
in a close vessel ; filtre the liquor, and add two
pounds of very pure sugar, and make a syrup.

3. Spirit for external use. Take six ounces
of sulphuric ether, an ounce of bruised garlics, and
a drachm of grated camphor, mix. This spirit
renders more active the liniments, mentioned in
no. 15.

(S2) Semen santonicum officin. class, synge.n,
ord. poly gam. superfl. perennis suffructic. ; foliis
caulinis linearibus piiinato multijidis, ramis indi^

FDURTH LECTURE. 325

visiSf sjiicis secundis reftexis, fioribus quinque
floris.

(S3) 1. Electuary. Take two drachms of Va-
leriana offic. and of semen santonicura, thirty grains
of jalap root, and of oxyrael scillae, sufficient to
make an electuary. The dose is a teaspoonful ev-
ery three hours.

S. Infusion. Steep for an hour, in a tepid
place^ four ounces of mentha, and of gentian, in
two ounces of canella water, half an ounce of bruised
semen santonicum ; strain and add two ounces of
syrup of succory with rhubarb, and six drops of oil
of nutmeg. Two spoonfuls are given three or four
times a day.

3. Powder. Take six grains of semen santoni-
cum, of jalap, and of pure sugar for a single dose.

{2-h) Confection. Put any quantity of semen
santonicum into a confectioner^s vessel ; dissolve a
small quantity of starch, with a sufficient portion of
refined sugar ; let the semen santonicum ferment,
and add more starch and sugar, till the semen san-
tonicum is covered with them.

Bolus. Take an ounce of pulverized semen
santonicum and of black sulphur, fsidfuretiim ni-
grum mercurii ? J of resinous jalap and of cinna-
mon bark in powder three scruples, white sugar

seven ounces ; dissolve these in water and boil to a
coiisistence ; mix the whole and form the mass into
boluses.

The dose for a child is from one to two drachms*

326 NOTES TO TUB

(Sij) Chenopodium anthelminticum ojie, class,
pentand. ord. digyn, ; ferennis in Pennsylvania :
foliis ovato-oblongis dentatiSf racem. aphyllis.

(26) On the weather and diseases of South Car-
olina, etc. p. 71.

(27) Jalapa offic. class, pentand. ord. monogyn,
foliis difformis cordatis^ an^ulatis, ohlongis lanceo-
latisque, caule voliibili, pedunculis unifioris.

(28) Historiacicutaeaqiiaticae ; Basileae, i679f
iP, cap. XV. p. 224.

(29) As may be seen in the preceding and sub-
sequent formulae.

(30) A plant wliich grows in the island of Gre-
nada.

(31) See Duncan f Medical CommentarieSf vol,
ix. p. 36.7,

(3C) S-Ssa-foetida office, succus giunmiresinosuSf
concretuSy obtentus ex incisione radicis ferulae assa-
foetidae ex class, pentand. ord. digyn. perennis
per siae, foliis alternatim sinuatis obtusis.

(33) 1. Bolus. Take three grains of assa-foe-
tida, and of root of white dittany, and with honey
make a bolus.

2. Milk. Take a drachm of assa-foetida, and half
an ounce of purified sugar, mix them intimately in
a mortar, and pour on it six ounces of rue water.
It is given by spoonfuls.

3. Pills. Two drachms of assa-foetida, half a
drachm of sulphate of iron, five grains of prepared
squills, are mixed together with some yolk of egg;

FOURTH LECTURE. SSf

this mass is made into pills of seven grains each,
and the patient takes two every two hours.

(31) Plaster, Take equal parts of assa-foeti-
da and semi-^itreous oxide of lead, of yellow wax
and galbanum melted, half the preceding quantity ;
heat them and form a plaster.

(35) In this case, it is combined with wax and
saffron. See ^natripsologiaf voLi^ p. 198.

(36) See Eggert, Commentatio de virtute art'
thehnintica Geoffroyae surinamensis, adjectis ob-
servationibus recentioribusy MaT^burgi, 1791, 8°.

(37) Two or three drachms of this bark are boil-
ed in a sufficient quantity of water, to eight ounces.
Combined with valerian, it is more efficacious.

(38) JWces jaglandis immaturae offic. class,
monogyn, ord. polyand. ; arbor, foliolis ovalibuSf
glabris, subserratis subaequalibus,

(39) The decoction or infusion is given in doses
of one or two drachms. Two drachms of its aque-
ous extract are also dissolved in half an ounce of
cinnamon water. Fifteen, twenty, or thirty drops
of this are given to children, twice a day. The
rob is less disagreeable to children.

(40) J)e la generation des vers dans le corps de
Vhomme, etc. vol, ii, art. ii.

(41) Comment, de vermibus in corp, hum, etan-
tlielminticQ, Stradae, i75i,p. 14.

*(43) See Recueil periodique, T. vi, p. 305.
(14) Journal de Medicine^ T. xviii, p. 416.
Defranciere administered it in this manner, and

* (No. 42) is omitted in the notes by Br^ra. ,(i, T.

S28 NOTES TO THE

boaste'l of it as a specific against worms. With
each (lose of this may be given, two ounces of oil
of walnut, and an ounce of sweet wine, well mixed
together.

(43) Camphora offic. ex arljore Indiae orienta-
lis lauro camphora dirto ; class. Enneand. ord. mo-
nog., foliis tripolinerviis lanceolatovatis. From
the hranches of this tree, a resino-volatile substance
is obtained ; when sublimed we call it camphor.

(46) De campJiorae vi anthelmintica, Gottingaey
1759, 4°.

(47) See Rosenstein, Traite des maladies des
enfanS) etc,

(48) See my case in note 70, of the third lec-
ture.

(49) This remedy may be easily given in an
emulsion of gum arable.

In this way Fy^t^Z succeeded in expelling a tae-
nia seven metres forty two decimetres in length, in
clysters or in pills ; it may be advantageously
combined with assa-foetida, or mixed with theriac-
al water ; or with an infusion of valerian, etc. It
is also administered in powder with semen contra^
the bark of geoffroya surinamensis, etc.

The dose should be adapted to the condition and
debility of the patient. It is prescribed in doses
from a grain, to a scruple, and even half a drachm.

(;'iO) Filix mas qffic. class, criptogam. order, fill-
ces ; frond, hipinnatis, pinnis obtusis ; crenulatis,
stipite paleaceOf florihus uniformibits.

FOURTH LECTURE. S25

(51) Historia plantarum, lib. ix, cap. xxii.
(33) De simplici Medicina ed. Ricci, lib. viii.
(53) Opera, lib. xxviii.

(5-1) J\rachricht vom Klinisch — institut %u Er-
langen, p. 44, 46.

(55) See §^ CXLVI, CLXVIII.

(56) Spigelia anthelmia qffic. class, pentand.
ord. monog. annual caule herhaceo, foliis summis
quaternis,

(57) Jlmoenit accadem. tome v.

(58) Gentleman's Magazine for the year 1751?
p. 544.

(59) To make a good decoction of it, take two
handfuls of the spigelia anthelmia plant, boil it in
two pounds of common filtred water, and add six
drachms of lemon juice and two ounces of syrup of
peach flowers.

(60) Spigelia offic. class, et ord. praeced. pe-
rennis ; caule tetragono, foliis omnibus oppositis.

(61) See Essays, and Observations of Physic
and Literature, vol. ni,p. 151.

(6:3) Praktische arzneimittellehre, T^i,p.d05.

(63) Tanacetum qffic. class, syngen. ord, poly-
gam, superflua, foliis bipinnatis incisis serratis,

(64) Traite des maladies des enfans, etc,

(65) The anthelmintic pills are made of the ex-
tract, according to this formula ;

1. Take six grains of the extract of tansy, and
of semen santonicum, of resin of jalap four grains ;
distilled oil of tansy one drop ; mix and make pills

of tvTo grains each, which are given in one doae to

43

SSO NOTES TO THE

adults. Four giains of sulphate of iron may be
added, or what is still better, some sublimed muri-
ate of mercury.

S. Take half a drachm and six grains of the
extract of tansy, of assa-foetida, and of santonicum,
twelve grains of sulphate of iron and sufficient honey
to form the whole into pills of one grain each.
Eight or ten of these are given, every two or three
hours.

(66) Valeriana sylvestris officin, class, triand,
ord. monogyn, perenniSf fioribus triandriSy foliis
omnibus pinnatis,

(67) Jlnnus medicus primus, p. 103, 164; se-
cunduSf p. S^8, S26.

(68) Electuary of Stork. Take three grains
of the root of Valeriana offic, of jalap root and sul-
phate of potass ; add four ounces of oxymel of
squills and make an electuary. It is prescribed in
spoonfuls.

(69) Semen Sabadillae offic. class, poly gam. ord,
monogyn, Veratrum sabadillae ?

(70) Aiisserl. arzneymittel. Ed. iv, p. 363.

(71) Vermischte chirurg. Serif ten, Derlin,
1783,iiB. p.71.

(7^) JBriefe an Aerzte, Berlin, 1784, 8^.

(73) Veckoslcrijf for loekare, Och JYatur for-
hare, etc. StockJwhn, 1783, 8^.

(7"^) A woman having an intermittent fever, in-
stead of taking cinchona, as is common, took, by
mistake, in the night, two drachms, and even more,
of powdered sabadilla, mixed with the diiferent

FOURTH LECTURE. 331

doses of Peruvian bark. Two hours after, intole-
rable pains took place, followed by violent convul-
sions, restlessness and spasmodic trembling, which
threatened the life of the patient. CaUed to her
assistance, I found her cold, without pulse, her eyes
turned up, her face covered with cold sweat, and
the belly tumid and greatly distended. An emet-
ic was administered, and she discharged from her
stomach a considerable part of tlie poison she had
swallowed.

By drinking milk, and the use of repeated clys-
ters, the poisonous force of the sabadilla, still re-
maining in the body, was neutralized, and twelve
hours after, the abdominal pains ceased, the swell-
ing of the belly disappeared, the convulsions and
spasmodic tumors, subsided, the pulse rose, and
respiration became natural. It is remarkable, that
the patient was restored from this accident, and
was cured also of her fever.

(75) Traite de la generation des vers, etc. p.
109. Though this article belongs to the animal
kingdom, I have nevertheless allowed myself to re-
duce it to the class of minerals, because the ammo-
nical preparation, most frequently used by practi^
tioners for the expulsion of worms, is the muriate
of ammonia, which, in the classification of remedies,
may pertain equally to the animal and mineral
kingdom.

Besides, it was not judged convenient to make
a separate article for a single remedy.

(76) Berlinische Manning saltigkeiten, 1 Band,

332 NOTES TO THE

(77) The formula of the anthelmintic drops of
Hartmanrif is this ; Take three drachms of the an-
iseted liquid carbonate, a drachm of the essence of
absynthium, and twenty grains of assafoetida dis-
solved together ; twenty, thirty, or forty drops are
given two or three times a day.

(78) See Med. Communications , etc. London^
1798, 1. no. 25.

(79) S&e Duncan^ s Med. Commentaries for the
year 1791, dec. 3, vol. vi. 1792, no. 3.

(80) De ejicacia terrae ponderosae salitatey
etc, Gottingae, 1794^, 4°.

(81) Erfahrungen ueberdie Salzsauren scJiweV'
erde, etc. Erfurt, 1793, 8°.

(85) Chemische AnnaleUf Hannoverer, 1793,
8°, p. 270.

(83) De corticis nlmif et terrae ponderosae sal-
itate usu medico, Erfordiae, 1793, 4f, p. 2.

(84) Medicinische hemerkungen, etc. Zerbst,
1793,8°.

(8.^) ZoonomAa, i. B.

(86) Solution of muriate of barytes half a
drachm, distilled water an ounce, common syrup
two drachms.

An adult takes thirty, forty, or sixty drops of
this, three or four times a day. It may be combin-
ed also with some aromatic water, or stomachic
tincture. It is always prudent to begin with a
small dose.

It is given in powder with sugar, or valerian,
in the dose of four or five grains, two or three times
a day.

FOURTH LECTURE. SS3

It may be made into a mass for pills with the
extract of conium macalatum, of hyosciamus and of
gentian.

(87) Dissertatio ie vermibus, Jenae, 1707> 4°.

(8S) Observationes de fehribus, Hannov, 1745,
jp. 143.

(89) Dissert, de vermibus intestinalibus homU
num, etc. p. 68, 71.

(90) See Journal de Medecine etc. tome xii,
an I76Q, mois de jiiin, no. 3, f. 506.

(91) Traite des Maladies des enfans^ etc. p,
303.

(92) See no^e 65, the formula for pills ; take
twenty grains of assa-foetida, seven grains of sul-
phate of iron, .and balsam of Peru, sufficient to make
the whole into pills of three grains each ; the pa-
tient is not to take more than two or tliree a day.

(93) Take half an ounce of socotorine aloes, a
drachm of ass^.foetida, of myrrh, and of camphor ;
two drachms of sulphate of iron, six drachms and
forty drops of ammoniacal succinum, and sufficient
syrup of absynthium to form them into pills of three
grains each. Take three or four a day.

(94) Such are in Italy, 1. the waters of Saint
Vincent and of Courmayeur, in the dutchy of
Aoste ; S. the water of the valley of Sole in the Ty-
rol ; 3. the water of Saint Maurice in Upper Ag-
nedina ; 4. the waters of Bogieriane, dc Dar&o in
the Valcamoniquc ; 5. the mineral waters of Reco-
aro in the Vicentin ; 6. the acidulated v/aters of
Brandola in the environs of Modcna ; 7. tbe waters

334 NOTES TO THE

of Chitignano, and the holy water of Chianciano in
Tuscany ; 8. the acidulous, couimonly called red
water of the environs of Viterba.

(9ij) For example, the water of Coldogno near
Lecco, the waters of Irmia, of the river Mela, of
that commonly called Biisana in Valtrompia, the
water of Rio in the island of Elba, etc.

(96) See Wedel, Jlmoemtates materiae medi-
cae, Jenae, 17^1? p« '^7l» Hoffmann, Medicinara-
tionalis Systematica, tome iv, j^cirt V, j?. 8ii. Van^
JJoevereUf Dissert, de vermibus intest. homimim,
etc. BagliviiiSp Opera, ed, ix, Antwerpiae, 1719>
4°. p. 60.

(97) Mercury introduced into the living stom-
ach and intestines of man is oxidized ; by taking
from the animal substance the oxidizing principle,
if certainly renders it less energetic.

This assertion is not made at random, as some-
body has imagined, when I mentioned it for the first
time in the Anatripsologia, vol. i. §> XXXIII, p^
86. In a case of volvulus (iliac passion) which I
treated with mercury in the civil Hospital of Crema,
I obtained from the excrements of the patient, a true
black oxide of mercury. A young lady of this city, ^
seized with a violent inflammation of tiie intestines,
took four ounces of mercury every day for a fort-
night. On examining her excrements, 1 obtained
from them two scruples and a half of black oxide of
mercury.

By this remedy we arrested repeated inflamraa-
tlon of the bowels, tending to a general sphacelus

FOURTH LECTURE. SS5

of all the small intestines, and she recovered sur-
prisingly.

But 1 defer to another opportunity the details of
these interesting cases.

(98) Hunter recommended the use of wine and
a nutritive diet to his patients under mercurial fric-
tions.

The celebrated Moscati assures us that the cure
of the lues venerea is also accelerated by a slight
mercurial friction and a full diet.
, (99) Weilcard, prospitto di un sistema piu
simplice di medicina, etc. Pav. 1796, 8", v. ii, jp. 76.

(100) Mercury is oxidized, by rapid audcontin-
ual motion ; and in this state is efficacious against
worms.

(101) The oxides of mercury already noticed,
are advantageously prescribed, in combination with
other active vermifuges ; such as geoffroya sur.,
valerian, etc.

(102) The black sulphuret of mercury is also
administered with other anthelmintics.

(103) I have already mentioned this method in
the first decade, tom. i, jp. 70, of my Commentari
medicif Pavia, 1797> 8°. A more extended de-
scription of it is given in my JVotes de medecine
pratiquBf on the various diseases treated in the
Clinical Hospital of Pavia, in the years 1795 and
1798, part II, cap. v.

(104) See Rosensteinf Traite des Maladies des
fnfans,

{iOTA See Hosenstein^ Traife* etc.

536 NOTES TO THE

(106) As camphor, oil of turpentine, castor,
succinate^ nmmonia, tincture of opium, and assa-
foetida. suiting the dose to the circumstances of par-
ticular cases.

(iOr) See Anatripsologia, vol. i, p. 129.

(108) A Treatise on the Scurvy by J, Lind,
Edinb. 1753,8". p. 86.

(109) Bee J\led. Transactions, published by the
Col. of Physicians in Londony 8°. v. i, no, % p. 54ii

(110) See Berlinische, Sammung zur befoer'
derung der Arzneywissen schaft, iv B ,part HI,
1773, arf. II, p. 234.

(HI) Hunczovsky medicinische chirurg. beob-
achtungen^ Wien, 1788, 8°.

(112) See Med. Trans, loc.cit,

(113) See Med. Enq. and obs. Phila, 1789, 8°.
art. II.

(114) See Med. Essays and Obs. by a Society
at Edinb. vol. v. part I, p. 89.

(115) P. E. Fothergill. See Med, Obs. and
Enq. by a society of Physicians in London y v. vi,
1784. Meadf Recueil des Oluvres physiques et
medicinaleSf torn, ii, Bouillon, 177% 8°. p, 264.
Marx, Observata medica, etc. Sibbern in collec-
ian. societatis medicae, Hauniens, vol. ii.

(116) See §§ CLV, CLVI, CLVIF, CLVIII,

(117) De Zinco ej usque florum usu medico,
Lugduni Batav. 1772, 4°.

(118) See Hurlebusch, Dissert, zincum rnedi-
cum enquiriens, Helmstadvii, 1776, 4°. 77. 40.

(119) Systematische lehre von den einfachen

FOURTH LECTURE ^

und gehraiicMichsten, zusammengesctzen arznei-
mittel, Marburg. 17H9, 8 ; p. 277-

(120) Einrichtung de klinischen instituts %n
Jena, 1783, 4^.

{i%i) See § CXXXII.

(123) Among the cold sulphuerous waters which
abound in Italy, the preference should be given, in
my opinion, to the mineral waters of Saxony in the
dutchy of Aoste, of Saint Genesio in the environs
of Turin, of Retorbido near Pavia on the other side
of the Po, of the valley of Imagna, of Saint Pelle-
rin, and of Truscorio, in the territory of Bergaine,
as well as the waters of Milzanello near Brescia.

(I'c4) See § V.

(1^5) See § XlII, toward the end.

(126) See § LXXXllI.

(137) Borsieri institutionum medicinae practi-
cae, vol. iv, part II, p. 179.

(138) Ilufeland, Journal der practischen arz-
neykundi und Wundarzneykunst, 1 B. Jen. 1795,
8°. p. 439.

(Iv9; The case is related by Dr. Vogel, in the
Journal der Erfandungen, theorien und Widers-
priiche in der JSTatur und Arzneywissenschaft,
Gotha, 1797, 8\ no. 23, p. 124.

(130) Bisset gave fifteen grains of it at once

with the greatest success ; see Borsieri, the work

cited, p. 178. Ettmueller expelled a taenia also

with gambogia, as may be seen in his case related

by Hufeland, in his journal already cited, tome iii;,

p. oSi. Besides, this substance caters into all the
43

338 NOTES TO THE

remedies most commended for the expulsion of tae-
niae.

(131) See^CXVII; see Rosenstein, Traitt
des maladies des enfans, etc.

(133) Dr. Fricke, of Brunswick, has several
times succeeded in calming the very severe symp-
toms occasioned by the presence of taeniae. See
Journal der Erjindungen, etc, Gotlia, 1795, no, 1%
'p, 135.

(134) See § CLVI.

(135) Sec^CXlV.

(136) See § CXXVII.

(137) See § CXXIX.

(138) See % CXXXT.

(139) See ^ CXXXII. >

(140) See % CXXXllI.

(141) Notes of the first lecture, no. 41.
(143) Traite des Maladies des emfans, p. 399.

(143) Van-den- Bosch, Historia constitutionis
epidemicae verminosae, etc. p. 353,

(144) See § X.

(145) See ^ CXXXIV.

(146) Copious draughts of cold water in sum-
mer, have frequently contributed, according to
Goeze^ Versucheiner JSTaturges. etc, p. 298, to ex-
pel entire taeniae. In the village of Chat near
Loudon, there is an inn with a fine garden, where is a
spring called Blatlebridge-wellSf which contains ia
solution sulphate of soda. This water is regard-
ed as a powerful remedy against taeniae ; in fact,
there are keft in an apartment of the house, more

FOURTH LECTURE. 399

than fifty taeniae of different species, in as many
vessels, which have been discharged from the body
by the use of this water. I am persuaded that the
same good effects, if not better, migrit be obtained
by the bitterish water of Modena, from the salt wa-
ter of Moutezibio in the vicinity of Modena, from
the waters of Saint Christopher in Faeutin, and
from those of Montecatini in the territory of Pistoia.
(147) See Journal der Erjindungen, TJieorien
und Wider spriische, etc, Gotha, i^^t, 8^ no, 23,

i». 1^7.

(14)8) Histoire de la societe de medicine, an,
1776, /?. 3:i6.

(149) •YovUf tuta, facilisque methodus ciiran-
di calculurUf scorhutum, etc, Lugd. Batav, 1778,
sect. V, p. 29.

(150) Dissert, de praestantissima acidorum vir-
tiite anihelmintica, Franco/, ad Viad. 1779, 4^.

(151) JUiss, de vitae determiminda a'eris fixi
in corpus humanum salutari eJUcacia ; GottingaCf
1783, 4°.

(152) Miscellania medico physica, edit. J. A.
Scherer, Viennae, 1795, p. 43, 116.

(15 3) Such are in Italy the acidulous waters
of the Tyrol, the baths of Coldiero in the Vero-
neskf the baths of Saint Martin, and the thermal
waters of Bornio in the Valteline, the acidulous
water of Asciano, near the baths of Pisa, the bath
Montalceto in the Siennese, the acetous of Rome, etc.

(l54) Take carbonate of soda two drachms,
acidulous tartrite of potass six drachms^ and of su-

349 NOTES TO THE

gar an ounce and a half; the whole to be reduced
to a very fine powder.

If this powder is moistened with water, and
stirred, bubbles of carbonic acid gas will be disen-
gaged The dose is a drachm and a half, to two
drachms, every four hours, in some ounces of pure
wattr.

(155) To imitate the water of Seltzer^ I use the
following method. Dissolve six drachms of sul-
phuric acid in thirty six ounces of distilled foun-
tain water. Mix the two solutions at the instant
you would us ' them.

(156) See § CXXXIII.

(157) Journal encyclopedique ou universel, an-
nee 1781, tome viii, part 11, p. 3 i2.

( 1 58) Goeze, Versiicheiver JVaturg. etc. p. 373,

(159) See Block, Traite de la gen, des vers,
etc. p. 115.

(160) See § CXXITI.

(161 j Instead of the hyacinth confection, the
conserve of violets may be employed.

(163) See § CXXill.

(163) Trattato delle principali e piu frequente
malatta esterne ed interne di Gian-Frederico Her-
renschivand, Bassano, 1"^9S, 8"^, torn, ii, p, 166.

Ilerrenschwand directs his patients, when the
stomach is sound, to take two successive mornings,
fasting, and two hours after a light supper, two
drachms of the male fern root, if they cannot pro-
cure the female fern, gathered in the fall, and dri-
ed in the shade. This preliminary arrangement

FOURTH LECTURE. rf4t

is not attended with any incovenience. Tlie third
day a powder composed of twelve grains of pul-
verized gamboge, thirty grains of carbonate of po-
tass and two grains of turpentine soap, dissolved to-
gether in a cup of tepid water, is to be administer-
ed fasting. This powder usually produces two or
three vomitings, and as many stools in the space of
two or three hours. These evacuations are ren-
dered more easy by drinking, after each vomiting,
a cup of luke warm water, or two cups of tea.
Three hours after, an ounce of American oleum ri-
cini is to be administered in a cup of broth ; the
American oil is far preferable to ours, though that
will suffice if the other cannot be had. This dose
of oil is repeated in an hour ; and if the worm
should not appear, another ounce of oil is to be
again given in two hours after. But if the worm
be not discharged, a clyster of equal parts of milk
and water, and three ounces of oleum ricini, must
be injected toward evening, by which means the
worm will come away entire and with ease,

(1«>4) The armed human taenia; ste^XIV,
and pi. I, fig i, ii, iii. The unarmed human tae-
niae ; see §. XIX, pi. I, fig. v.

(16,1) In Russia it made a great noise. Prince
Barantinski, treated by M. J\rouffer, was twice
cured of taenia. The Swiss were in a condition,
to experience every day the happy effects of these
two methods. The repeated success obtained from
^ouffers method, published by the French phy-
sicians, effectually contributed to its reputation in
France;

34g NOTES TO THE

(166) See^VII.

(167) Goeze, VersucheinerJS'aturg.etc.p.^/^Q,

(168) See ^ VII.

(159) Rosenstein, Traite des Maladies des en-
fans, en note^'p, 343.

(170) The number of patients which I have
cured of taeniae by JSTouffer^s method, amounts to
seven. The taeniae were all armed and very
young.

(171) See note no. 183.

(172) See pi. I, fig. iii.

(173) See § CLXXVIII.
(1^1) See § CXXIII.

(175) Histoire de la sociHe royale de Medicine,
an, 1776, p. ^79.

(176) Praelectiones de cognoscendis et curan-
dis praecipuis corporis humani affectibus, etc,
p. 652.

(177) Observata chirurgica, Jlltenburgi, 1776j
8°. Fasc. ii, p. 127.

(178) Med. Cases and Observations, etc. p. 60^.

(179) Journal de Medec. etc. vol. xlix, p. 44,
333, 450.

(ISO) See ^ CXXT.

(181) Catuputia major; ricinus major (oleum
ricini ; seu ol. palmae Christi ; vel ol. de kerna)
offic. biennis Indiae utriusque ; class, monoeciae
ordin. monadclph. foliis peltatis, subpalmatis, ser-
ratis.

(18S) Versucheiner JSTaturgeschichte, etc. p.
303.

FOURTH LECTURE. S43

(1S3) Ved Hiingerbyler de oleo ricini medica-
mento pergante, et anthelmintico praestantissimo,
trihiirgi—Bres;ov. 178O, 8°.

(184) Medicina clinica, Ticini, 1794, 8°. vol,
hp. 146.

(185) See Venel, Precis de matiere medicale,
augmente de notes par Carrere, Paris, 1787, torn,
ii, p. 387.

(186) See ^ CXXXII.

(137j See Journal de Medecinef an, I768, torn,
XXV iii, p. 44.

(188) See § CXXXV.

(189) See note no. 115.

(190) See § CXLVIIT, Case and § CXLIX.

(191) Traite de la generation des vers, etc. p. 2S.
(19S) Tlie J^ew Dispensatory, iii edit. London,

1770, 8°. p. 303.

(193) Arsenic and antimony are very often
combined with tin.

(191) See Hagin, Diss, exhibens stanmim, Re-
giomonti, 1775, 4\ part I, § XXV.

(195) A patient entered the clinical institute of
the hospital of Pavia, in the winter of 1/97? who
was suspected to have taenia ; he took six grains of
tin filings three or four times a day. Being called
by the government to Milan, I committed the pa-
tient to the care of aa intelligent physician, my col-
league, who, after the manner of the English, pre-
scribed, in one day, an ounce of the filings of our
tin. Returning two days after to Pavia, I found
the patient attacked with a genuine saturnine colic.

344 NOTES TO THE

and with a begiuniug paralysis of the lower extrem-
ities. In less tlian a week, we succeeded in curing
liim of this terrible disease ; one singular fact oc-
curred, which was, that his urine deposited a
drachm, and even more, of a very white powder,
which being attentively examined, was found to be
a true white oxide of tin. The tin he had taken
was not pure, but coutainsd lead, though in very
small quantity.

(196) See § CLIV.

(197) Traite de la gen. des vers, etc. p. liO.

(198) Versuch. J\*aturges, etc. p. ^77*

(199) See Med. Observations and Enquiries,
hy a Society of Physicians , London, vol. iv.

(SCO) With this remedy, I have hitherto cured
of taeniae, four individuals.

(iOl) See Block, the work cited.

(20^) Mi^ observata cliirurgica, Fasc. ii, p.
127.

(SOS) Bilfingerf de Tetano^ lib. singul. Lin*
davae, 17^3, 8^.

(SO-i) Fordyce, Fragmenta chirurgica et medi'
ca, Londini, 1784, 8°.

(205) Guy^s Poicder of Etiiiopia. Take seven
ounces of pure rasped tin, an ounce of mercury, a
drachm of sublimed sulphur, triturate the whole
thoroughly in a mortar, to a very fine powder.
The dose is from twenty to thirty grains twice a
day. The auriim musivum, is one of the most effi-
cacious remedies employed against taeniae, partic-
ularly the armed taenia. This preparation, more

FOURTH LECTURE. 345

active than the powder of Guy, ought to be thus
compounded.

Melt twelve ounces of very pure tin, and add to
it three ounces of mercury ; let the mixture cool,
triturate it in a mortar to a very fine powder; while
triturating the mixture, add seven ounces of sub-
limed sulphur, and three ounces of muriate of am-
monia.

The dose is ten grains, twice a day. '

(206) Fothergill, Med. Observations and Enq.
etc. Lindmann ; see Salzburg, Medicin. chirurg.
Zeil. 1791, i B. p. 304, recommend to give an
ounce of tin filings for six days in succession, and
direct a purgative the seventh.

(207) Observata chirurgica, Fasc. ii, etc.

(1^08) It is not long since M. Mathieu, decorat-
ed with the honorable title of Counsellor of the
Court, by the present king of Prussia, who granted
him besides a handsome pension for life, made pub-
lic the method, which, for a number of years, he had
employed with so much success, against both spe-
cies of taenia.

Humanity will always be indebted to Frederick
William III for having made kuown, for the bene-
fit of the world, a method which must be more effi-
cacious than any other which has hecn recommend-
ed to this day.

The electuaries wliich M. Mathieu administers
to his patients arc mild ; the first is marked A. the
second B.

44

346 NOTES TO THE

The First Electuary, A, Take an ounce of
Tery fine English tin filings, six drachms of the
root of the polipodium filix mas, half an ounce of
semen santonicum, a drachm of the resinous root
of jalap, and of sulphate of potass, and of honey
sufficient to make an electuary.

Secoml Electuary, B. Take two scruples of
the pulverized resinous root of jalap, and of sul-
phate of potass, one scruple of scammony from
Aleppo, ten grains of gamhoge, and of honey suffi-
cient to form an electuary.

Those who may be inclined to adopt this meth-
od to expel taeniae, must observe the four follow-
ing rules :

1. For some days previous, the patient is to be
confined to a suitable diet, that is, he is to eat salt-
etl substances, — for example, herrings, light por-
ridges and broths, and leguminous articles.

2. The treatment is begun by administering to
the patient, every two hours, a teaspoonful of the
electuary A. This course to be continued two or
three days, till the worm is perceived to be in the
intestines, and then,

3. The patient is to take electuary B, and of
this he also takes, every two hours, a teaspoonful,
till the worm is expelled.

The discharge of the worm is facilitated by tak-
ing some spoonfuls of fresh oleum ricini, or by some
clysters of the same oil.

4. The age, sex, and temperament of the pa-
tient may require a consitlerable modification of the

FOURTH LECTURE. 547

dose of these remedies ; for this reason the treat-
ment ought to be directed and modified by a well
informed physician.

Finally, it is to be borne in mind that the vir-
tue of the electuary A. depends in great part on
the root of the polypodium filix mas ; hence this
root should be fresh, and its internal hard part on-
ly should be reduced to powder.

This powder w ill have a reddish colour ; see
Hartenkiel, Medlcinisch'chiriirgische, Zeitung,
1800, 2 Band, p. ;i93.

(209) See §^ XXVII, LXXXIV, et seq.

(210) See §^ LXXXIV, LXXXV, LXXXVI.

(511) I have been the first to use this plant;
I have found it very efficacious in asthenic drop-
sies, in obstructions, scropula, and generally in
all crises of languor and inertia of the lymphatic
system. The figure of this very useful plant may
be seen in the first part of my Annotazionimedico'
pratiche sulle diverse malattie trattate nella clini-
ca medica di Pavia negV anni 1797 and 1798, and
its description; with practical observations, may be
found in the first part, cap. iii, of the same work.

(512) Toxicodendres officinaucc, or the rhus-
radicans and toxicodendron of Linnaeus. I have
employed with the best success these two very poi-
sonous plants in cases of languor of the nervous
system, and principally in palsies, following ner-
vous apoplexies.

This is not the place to report the really won-
derful cures effected by the leaves of these two
plants.

348 NOTES TO THE

I announce the fact merely to encourage pliy-
sicians to avail themselves of these remedies, when
the indication requires the invigorating of the ner-
vous force, and the powerful excitement of the
whole system of vessels.

They are administered in form of powder,
the eighth part of a grain in sugar, two or three
times a day, augmenting the dose to two grains,
administered three or four times a day. If the pa-
tient, after commencing their use, feels a degree of
cardialgia, or ratiier, a heat in the stomach, it will
then be necessary to lessen the dose. The botan-
ical characters of these two plants are the follow-
ing. Rhus radicans Linn, class. pentand,ord. tri-
gyn.ffuliis ternatiSffoliolispetiolatis ovatis nudis
integerrimis, caide radicante. Jlhus Toxicoden-
dron Linn, class, et ord, praeced,, fdtiis ternatis,
folcolis jjetiolatis angulatis jjuhescentibus, caute ra-
dicante.

(J 13) See §§ LXXXVII, LXXXVIII, and
LXXXIX.

(^i-ii) See the note no. 15, Lecture III.

(215) See § CXX.

(^16) See § CXIX.

(217) See § CXXVII.

(2iy) Dr. Heberden says, see llosenstein, Tra-
ite des Maladies^ des enfans, etc. p. 319, that a
man seized with violent pain of the stomach, nau-
sea, vomiting and constipation, lost entirely his ap-
petite and sleep, and soon became emaciated, and
was lio longer able to walk. The hardened stom-

FOURTH LECTURE. 34d

ach retracted near the sploe. His urine resem-
bled serum, and deposited a whitish sediment. Af-
ter taking a number of medicines without relief, by
the advice of some one, he began to drink salt wa-
ter. He dissolved two pounds of muriate of soda in
four pounds of water, which he took in the space
of an hour. This drink deranged him much, and
at length excited violent pulling, which hrought up
a quantity of worms, and he evacuated several
more in six or seven bloody stools, after an obsti-
nate costiveness of fourteen days.

Recovered from these operations, he again took
the same quantity of salt water. The effect was
nearly the same, and he evacuated the residue of
dead worms. After being thus cured, he habituat-
ed himself to take, three or four days after each
full moon, half a pound of muriate of soda in a
pound of water, to secure himself in his improved
state. It is very probable, that if he had dimin-
ished the dose of salt, he would have obtained
the same good effects, without suffering the de-
rangement and palsy which his treatment induced.

(;^19) Clysters of emulsion of gum arable, de-
coction of rue, and solutions of starch, are also
very good, etc.

(220) See § XXXVIII.

(321) See § LXII.

{22>2) See § XXXVIII.
{2zS) See § CXXIl.

(3^4) See § CXXVf.

' {225) See § CXXX.

350 NOTES TO THE

(556) See ^ CXXXI

(557) See § CXXXIV.

(328) Traite des Maladies des enfans, etc,
(239) See Rosenstein, the work cited.

(330) The sulphuric {^vitriolic J Elixir ofMyn-
sicht. Take an ounce and a half of the plant
mentha piperita, and of salvia offic. ; an onnce of
calamus root, of galanga minora and of flowers of
cassia fistularis ; three drachms of cardamomus mi-
«or, two ounces of lemon peel cut and bruised ; in-
fuse them in thirty six ounces of rectified spirit of
wine ; digest three days, filter and express the li-
quor, and add six ounces of diluted sulphuric acid ;
the dose is from sixty to a hundred drops.

(331) See § XXXIX.

(333) Voyage aux sources du JSTil, etc,

(333) A handful of the flowers should be in-
fused in four pounds of wine or beer, for twelve
hours. This plant belongs to the tetrandia mono-
gynia,

(334) See ^ CLXXVIII.

(335) Traite des Maladies des enfansetc.p. 330.

(336) We have already remarked, that mer-
cury, boiled in water, imparts to it some of its par-
ticles. Instead of a solution of mild muriate, we
may make use of sublimed mercury (mercurius dul-
cis) or the decoction of tansy.

(337) See § XCV.

(338) See § CX.

(339) See ^ CXXXIV.

(340) See §§ CXV, CXVII.

FOURTH LECTURE; 551

(241) See§ CXVl.
(24^2) See § CXVIII.
(2i4-31 See ^ CXIX.
(;^44) See § CXX.

(245) See ^ CXXITI.

(246) See ^ CXXIV.
(347) See § CXXVI.
(248) See ^ CXXIX.
(S4y; See § CXXXI.
(2.>0) See^ CXXXir.
{'Zdi) See § CXXXVII.

(252) Traite des Maladies des enfans, etc,
page

(253) The Elixir of Rhubarb, Take three
ounces of rhubarb from Alexandria, an ounce of
raisins, half an ounce of the white substance of the
orange tree bark, two drachms of liquorice root,
four scruples oicardomomus minor ; the whole be-
ing cut and bruised, digest during two days in two
pounds of choice wine ; strain aud add half an
ounce of the extract of tansy, and three ounces of
white sugar.

(234) Helleboriis foetidus offic. class, polyan-
drla, ord. poly^ynia, perenniSf caule miiltifloro fo-
lioso, foliis pedatis, Bisset advises fifteen grains
of the«<e leaves dried and pulverized, to be taken
in some syrup, prepared with the juice of the same
leaves. To this dose may be added a small quan-
tity of the elixir of rhubarb.

(255) Traite des palpitations dn coenr, etc.

NOTES TO THfi

(236) Hellehorus niger, sen melumjiodium qffic,
class, et Old. praecedent. perenuis, alpin., scapo
subbifloro subnudo, foliis pedatis,

{257) See ^ CXXI.

(258) See § CXXIL

(259) Fragmenta cliirurgica, et medica, eic.

(260) Helminthochorton historiay natura atque
vires ; Argentorati, 17*^0, 4°.

(261) Conserva helminthochorton Linn, Furus
helminthochorton seu coralina melitochorton, lemi'
tochorton ; coralina Corsiana ofjic, class, cryjjto-
gamia, ord. algae.

It grows in the island of Corsica, on the bor-
ders of the sea ; the French physicians have used
it, with the greatest ad^'antage, for the expulsion
of lumbricoides. Gazette de Sante, 1777-

(262) Tbe helminthochorton is administered in
powder, in the dose of a scruple or half a drachm,
combined with the root of tbe polypodiura filix mas,
or in decoction, — with any other vermifuge.

(263) See §§ C, CI, CIII.

(264) See § CII.

(265) Hist. Constitiitionis epidemicae vermi'
tiosaCf etc. f. 57.

(266) See ^ CIV.

(267) Such are assa^oetida § CXTX ; cam-
phor, §r CXXII ; Valeriana oific. §. CXXIV ; mu-
riate of ammonia, ^ CXXIX ; muriate of bar\tes
§CXXX; the preparations of iron, § CXXXI; |)e-
troleura, § CXXXIII; muriate of soda, §CXXX1V;
sublimed zinc, ^ CXXXVl.

FOURTH LECTURE. .153

(268) See ^§ LX, LXI, CIV.

(269) See ^ CVIII.

(270) Which is obtained from the use of the
cinchona offic, cascarilla, the preparations of iron
anil other similar articles, and by nourishing diet;
in fine, by a treatment truly tonic in its full extent.

[A few words to the general reader shall close
the book.

If any one, not having a medical education,
should ttiink of prescribing anthelmintic medicines,
he is desired to reflect, that this cannot be done ei-
ther with safety or any prospect of advantage,
till he shall acquire the following information, — a
knowledge 1, of the structure of the human body ;
3. of the vital properties and functions of the vari-
ous organs of this complex system, in a sound state ;
3. of the deviations from this state, which occur in
the many diseases to which the body is subject :
and 4. of the medicinal virtues of the several arti-
cles called anthelmintic, both as they affect the in-
testinal worms, and the living body they inhabit.

The injunction, rightly to exercise the facul-
ties we possess, is so obviously reasonable, and of
so high authority, that it could not receive any new
force or extent of application from any thing which
could be here said, even if it were proper to dwell
on the subject in this place. It is sufficient to re-
mark, that this improvement implies a knowledge
of our talents, a cultivation, and a proper direction

of them.

45

354 NOTES.

Faculties, not understood, cannot be trusted ;
such as are neglected will not become better, and
an effort, not well directed, is more likely to do
barm than otherwise. If we could suppose that
the several individuals of a society were to relin-
quish their ordinary and well known occupations,
and each to assume a new pursuit with which he
had no acquaintance, — we should find that the con-
fusion and wretchedness of this perverted and un-
happy community would be in exact proportion to
the zeal and activity of its members.]

END OF THE NOTES TO THE FOURTH LECTURE*

EXPLANATION OF THE PLATES.

PLATE FIRST.

Fig. I. The head, neck and commencement of the part less ad-
vanced in age of a human armed taenia, (cucurbitina.) — c, The
head furnished witli crotchets or fangs. — 6, Protuberances of
the head in form of crotchets — a c c, Length and gradual
enlargement of the neck — c rf, The neck of the taenia grad-
ually becoming the body. The less complete rings of the
neck become broader and longer in proportion as they approx-
imate a d.

Fig. II. The body of a human armed taenia, (cucurbitina,) not
yet developed, but of the same species as that of Fig. Ill,
though the rings are narrower and without visible alternate
papillae.

Fig. III. Pieces of a middling armed taenia, (cucurbitina,) twen-
ty five metres one liundred and fifty decimetres long.— •
aaaaaa, Lateral papillae of one side. — b bb b b b. Lateral
papillae of the other side, as they are both alternately dispos-
ed.— c c, A double knot found in the body of the taenia.

Fig. IV. A human taenia unarmed (broad) of Marx. — «, Head
without arms. — a b. Its neck. — c c cc, Single knots. — d dy Dou-
ble knots. — ^, Rings longer and broader than are found in the
body of this taenia.

Fig. V. An unarmed (broad) human taenia of Bonnet.'— -A.^ The
head without arms. — A B, The neck — B C, The narrowest
part of the body — C D, The broadest part of the body, con-
tinuing to the end.— c c cc c, A longitudinal groove or de-
pression parallel to the length of the worm, and perfectly vis-
ible in these points. — ?n j«, Small perforated papillae that are
observed on the surface of the rings.

Fig. VI. Another head of an armed (cucurbitina) taenia, of the

356 EXPLANATION OF THE PLATES.

natural size.— «, The anterior part of the head, where the
tube is seen naked. — 6, The neck.

Fig. VII. Head of an unarmed (lata) taenia, hardened by Bon-
net in spirit of wine, in which it remained three years ; this
is a magnified view. — F, The head. — b b, Tube of the probos-
cis. Bonnet supposed this dark line to be the mark of union
of the lips of its mouth.

Fig. VIII. Anterior part of the head of a human armed (cucurbi-
tina) taenia, observed with the microscope, — abed, The four
lateral canals, opening in a square; they traverse the whole
length of the worm. They are also called papillae , small
mouths, and stigmata. — ef, A crown, in form «>f small crotch-
ets or hooks, circular and stellated, in the centre of which is
situated the tube.

Fig. IX. a r, The head of a human unarmed (lata) taenia, seen
through a single lens, having about it whitish ^himentsffffff

If'

Fig. X. Three long rings of a large armed (cucurbitina) taenia,
situated immediately after the neck, at the beginning of the
body. — a b c, Lateral alternate papillae.

Fig. XI. Three rings of a large armed (cucurbitina) taenia, ta-
ken from the widest part of the body. — a b c, Lateral papil-
lae.— d e, The longitudinal central canal, corresponding with
the longitudinal groove, which is also observed in the broad
taenia (taenia lata), as in fig. V, c c ccc. This canal is
commonly called the middle canal, and begins wijth the tube.

Fig. XII. Pieces of a broad taenia, in which we see a knotty
line or stroke extending through the body. Its exterior form
is not constant. According to Bonnet it sometimes resem-
bles a blue or purple tliread, as in this fig. rrr.

Fig. XIII. The knotty line rrr, of fig. XII, which, examined
with the mictoscope, is an assemblage of ovaries, (considered
by Bonnet us a glandular body,) in form of a flower c c.

Fig. XIV. ggg, Three clusters of ovaries, shown in fig, XIII,
and seen through a larger lens.

Fig. XV. One of these clusters of ovaries insulated and seen
through the microscope.

EXPLANATION OP THE PLATES. 33f

Fig. XVI. Triple knots of a small armed (cucurbitina) human
taenia, noticed by Werner.

PLATE SECOND. .

Fig. I. Fragments of a large human armed (cucurbitina) taenia,
which exhibits the joints or articulations as connected with
each other, of the natural size, taken from the largest part of
the body of this worm. — a, A small mouth opened in one of t!ie
lateral papillae. — b c d, Other orifices in the opposite lateral
part.' — e, Another little opening in the lateral part. — -f, An-
other similar orifice in the opposite lateral part. — g h, small
alternate mouths. — 1 23 4 5 6, Small successive openings on
one side only — it, small openings on the opposite lateral
part, and in this way through the whole length of the worm.

Fig. II. Two of the largest knots of the great armed human tae-
nia.— a h, Papillae with small open mouths, situated on one
side only, as in fig. I.— -c, Reciprocal connexion of tlie rings.

Fig. III. One of the papillae with the small open mouth, which
are seen on the lateral parts of the large human armed taenia.
The aperture is of the natural size, and Goeze observes,
that it seems to be divided by a central line.

Fig. IV. Three ovaries of the unarmed human taenia (lata), mag-
nified by the microscope (no. l,tube A.) Small eggs enclosed
may be seen. These ovaries are more pointed than those of
the armed human taenia, (cucurbitina.)

Fig. V. Eggs pressed from one of the small mouths that are seen
in the large articulations of the great armed human taenia
(cucurbitina). These ovaries are also magnified by the mi-
croscope, (no. 6, tube A.)

Fig. VI. Four eggs of an armed human taenia (cucurbitina,) ex-
pressed as above, and viewed with tiie microscope, (no. 1,
tube A.) — a bed, Hemispheres, or rather ovaries, in which arc
seen an immense quantity of other small eggs.

Fig. VII. Two other eggs of the same species of worm, magni-
fied by microscope (no. l,tube A.) These pretended eggs
are in truth, two real ovaries full of eggs.

S58 EXPLANATION OF THE PATES.

Fi(j. VIII. A cluster of vesicular worms, which, connected with
another like it, was found in the two lateral ventricles of the
human hrain. Its form resembles that of a small bunch or
cluster. In each ventricle, ti. is assemblage of worms was pa-
rallel with the plexus choroides, as exlnifited in pi. III. — n aa^
Tlie petiole or stem of tlie vesicular verminous cluster. — b b.
Little bladders or A'esicles, wiiich constitute the vesicular
human worms (hermits) attached to and pendent froiii the
petiole. — c c, Vesicular worms that are smaller and almost
imperceptible to the naked eye.

Fig. IX. A human vesicular worm, (hermit) enlarged by the mi-
croscope.— a, The head, similar to tiiat represented, pi. I,
jBg. VI. — a b, The neck. — b c, The bladder, or rstlier the bo-
dy of the worm, the outer membrane of which has been re-
moved in order to raise its circular fibres.

Fig. X. A bladder taken from the medullary substance of a
sheep's brain ; on its internal surface are seen different small
white clusters, united togetlier, wl)ich are so many families of
the social vesicular worms. They are represented here of
the natural bigness. — a h cd e^ Five separate families.

Fig. XI. Another similar bladder of the natural size, in which
the abovenamed worms are in part detached and artificially
distended — a y c r/ 1;/, Social vesicular worms distended.-—
gS^s^r Points where they are attached to the family or mater-
nal bladder. — hhh, The real head of these vesicular worms.
— ilk, vSocial vesicular worms found interiorly with the head
turned inward.

Fic^. XII. A B, Two social vesicular worms, which form a part
of the families already described and magnified b}^ a weak
lens, (nos. 1,2.) — aa^ Head of the worm.— -66, The posteri-
or part furnished with two points in form of crotchets, with
which it fix6s itself to the small bladders or vesicles repre-
sented in figures X, XL

Fig. XIII. Lobe of the medullary substance of the brain (►f a
sheep which had vertigo, in which may be seen « 6 c, the nat--
ural size of the cavity which contained the little bladders of
fi"-. X and XI.

EXPLANATION OF THK PLATES. 559

Fig. XIV. A piece of the torn membrane, which constitutes the
little bladders above mentioned.

Fig. XV. One of the social vesicular worms, which, collected in-
to a family or colony, are situated on the vesicles of figures
X, XI, insulated, compressed and viewed, with the micro-
scope (no. 6.) — a &, Protuberant wrinkles, which cover two
thirds of the body, in a spiral manner.— c rf, Two very mi-
nute vesicles, or rather papillae for the purpose of sucking. —
e. The crown, with the crotchets elevated on its surface.

Fig. XVI. Another of the social vesicular worms already demon-
strated, enlarged by the microscope (no. 3, tube A,) a little
compressed but well distcned. — c 6, Its body covered with an
infinite number of small molecules. — c c, Tite tail already fix-
ed to the bladder. — (/JrfJ, The four minute vesicles or pa-
pillae which suck. — c/, Tlie crown v/ith double crotchets.

Fig. XVII. A third worm of tiie aforesaid social vesicular fami-
ly, attached to their portion of the bladder, and magnified by
microscope (no 4, tube A.) — «, Its adhesion to the bladder.
—6 6, Its body detached.— -c (/ e. The papillae for sucking,
torn.— /, The crown with the crotchets seen on its surface with
the tube.

PLATE THIRD.

A horizontal section of tlie brain made in order to expose i\\e-
two lateral ventricles, in each of which is discovered an as-
semblage of human vesicular worms (henniis,) extending along
the course of each plexus choroides. — a a a, Circumference of
the brain. — A A, The two clusters of worms (one in each lat-
eral part) which, coming from the bottom of each ventricle,
follow the direction of the two plexus choroides and meet at
an acute angle, by means of a particular petiole, in the ante-
rior portion of the ventricles. — IJB, The two plexus choroides
to which adhere the clusters of human vesicular worms (her-
mits.)

360 fiXPLANATION OF THE PLATES.

PLATE FOURTH.

Fi(i. I. A male human tricocephalus, represented of the natural
size, in which the posterior part of the worm is seen to be
turned in a spiral manner.

Fig. II. The female human tricocephalus, folded in its natural
size.

Fig. III. The male tricocephalus, enlarged by the microscope
(no. 4, tube A.) — a,.The head whicli becomes insensibly round.
—a b c d ef, Course of the intestinal tube. — g /«, Transverse
lines made in form of ciowded rings. — /.:, Intestinal tube. — ■
Im, A cylindrical body, surrounded by a very thin canula,
from which it is thrust out by mere pi-essure. May it not be
a principal part of the male ? In fact in all these viscera
there is not found the smallest trace of eggs or embrios.

Fig. IV. The posterior extremity of the female tricocephalus,
(fig. II,) cut off at the commencement of the transverse rings,
and seen with the microscope (no. 4, tube A.) — a, The ex-
tremity of the tail quite obtuse, and different from that of the
male. — b c, The vermicular intestine twined round. In fe-
males it is quite filled with eggs; and de shows its course
winding round the intestinal tube, extending from / to the
aperture 5'.

Fig. V. a b. Two eggs of the human female tricocephalus, ob-
served through the microscope (no. 2, tube A.) In a contort-
ed sack several hundreds have been found.

Fig. VI. A tricocephalus of the lacerta apoda, as it is represent-
ed and described by Pallas. — a, The head, or anterior extrem-
ity, having a small button or knob. — b, The posterior extrem-
ity, or tail with double crotchets. — c. The scaly twisted part
near the posterior extremity. — A, The head, mouth and
crown, with the crotchets magnified by the microscope.

Fig. Vil. The human ascaris vermicularis of the natural size.
— ff, The head. — &j The tail.

Fig. VIIl. The iinale ascaris vermicularis, observed with the mi-
croscope (no. 4, tube A.)— .7, The head, having two lateral
oval eminences b c, separated in the middle by the mouth a.-^

EXPLANATION OF THE PLATES. 361

ad, \ slender canal, which by opening into the mouth and
then extending and contracting, unites with the stomach and
intestinal tube.— X, A triangular mass, or rather stomach.—
ef, The intestinal tube terminating in gh.—i, A small aper-
ture to give passage to the excrements and organs of genera-
tion.— d I, A small white canal, which, passing under the tri-
angular mass Xf and intestinal tube fg, reaches to the end
of the tail k I. Here the genital organs of the male are prob-
ably inclosed, which communicate externally through the ori-
fice i — / m, Very fine end of the tail, perforated by very mi-
nute bodies.

Fig. IX. A female ascaris vermicularis, magnified by the micros-
cope (no. 4, tube A,)— a, Eminences at the superior extrem<-
ity of the head, hardly visible in a dead ascaris.—?; c. Two
oval eminences like jaws, as in the male, separated by the
mouth a. — a d, A canal, which conveys the food into the stom-
ach e, communicating with the intestinal tube from /to g, be-
yond which we see tlie transparent tube gh, Avhich is proba-
bly an appendix of the intestinal tube. — i, A considerable ap-
pendix to the tail, .which is characteristic of the females. — fr,
The vagina, through which the female deposits her young. — .
I, The place where tlie small canal, forming the vagina t, is
given off. The dark bodies from f to g are fetuses, which
can be in great part expelled from the vagina fc, by simple
pressure.

Fig. X. A portion of the membrane of a female ascaris vermicu-
laris, compressed and seen with the fetuses through the micro-
scope (no. Ijtube A.)

Fig. XI. The fetus of an ascaris vermicularis, enlarged by the
microscope (no. l,tube A.)

PLATE FIFTH.

Fig. I. The entire body of a lumbricoides, so situated as to ex-
hibit its four lateral lines. — a, The trilobed head. — b, The pos-
terior extremity, or tail. — cdef, The four lateral lines.

Fig. II. Tail of tlie lumbricoides.— fr, A tubercle, under which
46

363 EXPLANATION OF THE PLATES!.

is seen the exterior opening of the intestinal tube — 6, The ter-
mination of the obtuse extremity.

Fig. III. The same tail viewed on its superior part. — a, The or«
ifice. — b. End of the tail.

Fig. IV. The head of the lumbricoides seen on its anterior part,
-^aaafl, The body of the lumbricoides, or rather the four
white lines passing in a parallel direction on the surface of the
body. — b, Anterior view of the head, having three liemispher-
ical risings in the dead worm ; these eminences are pyrami-
dal in the living worm. In the centre is situated the trilabial
mouth.

Fig. V. The external membrane of the lumbricoides, seen on its
internal part, — a bed, Longitudinal lines. — eee, Small rings,
occupying the space left by the longitudinal lines.

Fig. VI. The male lumbricoides opened longitudinally, distend-
ed and retained in this position by means of six needles.— a,
The three hemispheres of the mouth. — a 6, Oesophagus. — b h.
The stomach and afterward intestine. — i. White vessels,
the origin of %vhich is concealed by the stomach. — c,The tail.
— e c, The penis.'— f e. Seminal vesicle. — rf, Intestine.— /^g*,
Spermatic vessels.

Fig, VII. Spermatic vessels of tlie male lumbricoides out of their
natural situation. — a 6, Penis.— & c, Seminal vesicle. — c d.
Length and winding of the spermatic vessels, or vasa defe-
rentia.

Fig. VIII. The female lumbricoides opened lengthwise. — a, Tri-
fid mouth. — a b, Oesophagus. — b c, Stomach. — e/. The great
intestine coloured black, the middle part of which ce is cover-
ed by the sphermatic vessels. — d d, Great white vessel situat-
ed under the stomach and oesophagus. — g". Extremity of the
oviduct. — o' //, The beading vagina — h, The point of division
of the two horns of the uterus, wiiicli, becoming narrower and
wonderfully folded, occupy all the space between k h.

Fig. IX. The uterus of a female lumbricoides with the parts ad-
jacent, all removed from their natural situation. — a. External
wifice. — b bf Commencement of the two extremities of tlie ute-
rus itself. — e eee, Clusters of eggs included in these extrem-

EXPLANATION OF THB PLATES. 363

itie8,or rather horns of the womb. — drf, Wonderful circumvo-
lutions of the smaller extremities of the horns. — c c, End of
the horns : here after forming a vesicle, they change into del-
icate slender branches.

Fig. X. The part of the skin of the female lumbricoides, which
corresponds exactly to the white ventral line : here the ovi-
duct opens ; the whole is magnified by tlie microscope. — a «,
The white ventral line — fr, The parenchyma found under-
neath.— c, The opening of the oviduct, which at the point e
takes the name of vagina.— e. Division of the horns of the ute-
rus—.rfrf. These horns cut horizontally.

JFiG. XI. Eggs of the female lumbricoides examined with the mi-
croscope. Some a a are of a round form ; others b b are rath-
er oval. In all, independently of the outer villous surface,
we see a spiral line, regarded by JVeriier as the rudiment oi
a young lumbritoides.

EVD OF TIIR EXPLANATION OF THP PLATES.

CONTENTS.

Page.
Dedications -.-.--••3

Advertisement, Recommendation, and Prefaces • 9

FIRST LECTURE.

Examination of the principal human worms - ■ 19

I. Genus Taenia.

1. Species armed Taenia - - • 83

2. Species unarmed Taenia - - - 38

II. Genus Vesicular worms . - - 41

III. Genus Tricocephalus - - - - 45

IV. Genus Ascaris vermicularis - - • 48

V. Genus Lumbricoides - - - * 52

Appendix to the principal human worms - - - 61

Notes to the First Lecture _ . - - ■ 64

SECOND LECTURE.

Origin of Human worms ------ 99

Notes to the Second Lecture - - - - - IIT

THIRD LECTURE.

Verminous Diseases -...-_ 138

I. Local affections from worms - - - - ib.

Common and general symptoms oi worms - - 140

Symptoms of taenia ----- 146

" of Vesicular worms - - - - 148

" of tricocephalus . . - - 151

" ofascarides ----- 152

" of lumbricoides - - - - 154

II. Sympathetic affections from worms - - - 155

III. Verminous affections of the whole system - - 162

Notes to the Third Lecture - - - - - 167

QG& OONTRNTS.

FOURTH LECTURE.

Treatment of verminous diseases - - > 157

First series of vermifuge medicines - - - 194

VEGETABLE VERMIFUGES.

Allium cepa ib.

*' sativum ------- ib.

Artemesia santonica . . _ - _ 195

Chenopodium anthelminticum - - - - ib.

Convolvulus Jalappa - - - - - 196

Angelicae cortex . - - u - - ib.

Ferula assafoetida ------ ib.

Geoffroja surinamensis . _ . . - ig^

Juglans regia ------- ib.

Laurus camphora - - - - - - 198

Polypodium filix mas ----- 199

Spigelia anthelmia - - - - - - ib.

" marilandica ----- 20O

Tanacetum vulgare ------ ib.

Valeriana officinalis - - - - - - 201

Veratrum sabadilla - - - - - - ib.

Carica papaya - (note) - - - 203

Spirit of turpentine ------ 242

Pomegranate ------- Q5'2

Cowitch SOD

Chabert'soil 304

MINERAL VERMfFUGES.

Muriate of ammonia ------ 204

« ofbarytes 208

Iron 209

Mercury ------- 211

Petroleum 214

Muriate of soda 215

Tin 216

Amalgam of tin ------ 502

Zinc 216

Sulphur Sir

Fowler's mineral solution - • - - - 251

OONTKKT*. 36f

II. Treatment of Taenia 217

Cold water and mineral waters - - - - 222

Carbonic acid gas - - - - - 224

Spirit of turpentine and of ammonia - - - 225

Pol ypodium filix mas ... - - 226

Preparation and treatment of the patients - - 227

Oleum ricini ------- .235

^lercurials -------- 236

Tin 237

Tin, fern, semen santonicum and drastic purgatives 240

Spirit of turpentine - - - - - 242

Fowler's mineral solution ----- 251

Pomegranate ------- 252

III. Treatment of vesicular worms - - - - 255

IV. " of the tricocephalus - - - - 291
V, " of the ascaris vermicularis - - - 292

VI. " of lumbricoides - - - - 296

Guinea worm ------- S05

Worms &c. from the urethra - r - • - 307
Larvae of different insects - - - - -315

VII. Treatment of general verminous affections - 319

VIII. Preservative treatment ----- 321
Notes to the Fourth Lecture - - - - 322
Explanation of the plates - - . - - 355

END OF THE OONTENTS.

The reader is desired to correct the following*
ERRATA.

Page 26, line 1, Tor their — have, read its — ^has.

27, " 2, " deudroi'd, read dendroid.

42, " 5, " anteriorily, read anteriorly.

44, " 4, " papillae, reof/ papilla.

" "4, 5, " toward, read to.

48, " 3, " last, read fullest.

50, " 14, dele but.

68, " TiSffor scolopondre, rearfscolopendre.

92, " 23, " insutis, read insectis.
128, " 5, " lumbricides, read lumbricoi'des,
156, "31, " first of ventose year 9, refld Feb. 19, 1801.
160, last line, /or constituted, rearf constipated.
212, line 12, /or venerlal, rea J venereal.
256, " 6, dele comma after digitalis.
283, " 4, /or placcid, rea J flaccid.
298, " 13, " vermins, rearf vermin.

312, after 'relieved', second line, insert " to close the quotation.

313, line 1, /or voracity, read veracity.

328, last line, " uniformibus, read reniformibus.

J

^'.v -