>*•. }'~$T~ * *i -, > *3i'^!P^r? - w ,*■ ;<" « V ^ 'r Surgeon GeneraPs Office :./,,/,, •> fain v> S ~t7Zo ^. <„.i>'y't$ -.^ A N INAUGURAL DISSERTATION 0 N Worms of the Human Inteftines. SUBMITTED TO THE EXAMINATION OF THE Rev. WILLIAM LINN, d.d. p.t. Prefident; AND TO THE TRUSTEES and FACULTY O F QUEEN'S COLLEGE, NEW-JERSEY; FOR THE DEGREE OF DOCTOR of MEDICINE, WITH THE RIGHTS AND IMMUNITIES THEREUNTO APPERTAINING. -------— / By henry m. van solingen, OF NEW-YORK. ------■-- MISERIS SUCCURRERE DISCO. VlRG. new-york: PRINTED BY T. AND J. SWORDS, No. 2J, WILLIAM-STRlET.' TO THE REVEREND WILLIAM LINN, d. d. Prefident, p. t. of Queen's College, New-Jerfey; AND, Minifter of the Reformed Dutch Church in the City of New-York j WHO, From affiduous Attention to the Duties of his facred Profeffion, and by his eminent Learning and Piety, has contributed to The Advancement of Religion, AS WELL AS The Good and Peace of Mankind: THIS DISSERTATION IS INSCRIBED, With every Mark of Refpecl, By his obliged, Humble Servant, The AUTHOR. C A N INAUGURAL DISSERTATION 0 N Worms of the Human Inteftines. INNUMERABLE are the caufes that give rife to difeafcs incident to man: fome of them, whilft they appear innocent, and portend little danger, are, at the fame time, both ferious in their nature and termination. For the truth of this, we need only advert to the inftance of human worms; the confideration of which I propofe to make the fubjed of the following dilTertation. Every part of the human body has indeed been known to be affeded with worms; but it is only thofe mfcfting the inteftinal canal that are particularly to be confidered here. Their division is generally into three kinds—Afcarides, Lum- bricus teres, and Taenia, or Eumbricv.s latus. Of O A L'ISSLRT.ATION ON WORM-; Of the ASCAR IDES. THE afcarides, Galen has defined, as " be- ing fmall worms, generated chiefly in the lower part of the inteftines." They are of a fmall fi/e, and pointed at both extremities. The head, in molt, is not cafily detected. Their colour is generally white, but in fomc it has been found changed by the focces. They abound in great numbers in the colon and rectum, and are frequent- ly thruft out with the excrements. Baglivius* informs us, he knew a young man, who, being fuddenly attacked with diarrhoea, voided an hun- dred. They excite an intolerable itching, efpeci- ally about the verge of the anus, tcncfmus, and other troublefome fymptoms. The afcarides have a great refemblance with thole worms which we frequently fee in cheefe, in point of colour, figure, and fize. Profeflbr Van Doeveren-f- believed them to derive their origin thence; and Van Swei ten J knew a man, who, as often as he ate white cheefe, two days after felt a troublefome itching about the anus, occasioned by the afcarides. But • Epift. ad Andry, p. 698. + D flerrar Inaug. p. 31. % Com. in A;, p. 135;. OF THE HUMAN' INTESTINES. 7 But cheefe worms are found to differ widely from afcarides. They undergo a change in their form, which the afcarides do not—They are blunt- ed at the extremities, and the afcarides are fharp. Of the LUMBRICI TERES. THE lumbrici teres, or round and long worms, with which children are ufually troubled, are (by Hippocrates called *ty«*« r^yy***?, by Celfus Teres,) commonly about fix inches long, and fometimes a foot •, but the male is generally fmaller than the female. They arc of the thicknefs of a goofe- quill. Their colour is white, and both extremi- ties terminate in a point. The number prefent in the bowels at a time is very various, fometimes only one, two, or three. But If we may judge from the furprifing number of eggs which have been {^n in them by meanS of the microfcope, we will not be aftoniihed at the amazing number of worms prefent in fome perfons, which we find related by fome authors. Clericus mentions the cafe of a boy and girl, who were killed by taking arfenic, having upwards of an hundred of the teres lumbrici in their interlines. Gabucinus 8 A DISSERTATION ON WORM. Gabucinus faw one hundred and feventv-fcven that were voided at one turn by a eii 1 -, and, to come nearer home, a woman in this city, a patient <>t mine, paffed, in four and twenty hours, consider- ably more than an hundred, and moft of which were pretty long. Of the T JEN I A. THE taenia, or lumbricus latus, by fome is called the Solitary Worm, becaufe it has been be- lieved to be always alone. Hippocrates called it Tany, hence its-denomination, Tape-worm. No fpecies of inteftinal worms is more deftruc- tive to human nature, or more difficult to be to- tally deftroyed: It fometimes equals in length the whole inteftinal canal-, the breadth of it is various, both in the fame worm, and In different worms. It confilts of a great number of joints, fimply connected together-, and thefe joints are fo articu- lated, that the extreme edges of the preceding iorne over the fubfequent. The extremity where- on the head is let, is fmaller than the other, and fome OF THE HUMAN INTESTINES. $ fometimes not an eighth part fo broad: the joints towards the head are considerably fhorter than to- wards the tail, and they feem gradually to grow longer from the head. The colour of the taenia is very white, being moltly turgid with chyle. Four fpecies are enumerated by Linnaeus. The firft is distinguished by fmall orifices, or mouths, placed alternately on the margin of each joint, and is called Solium Andrii, Lumkricus Idtus Coukti et Vermis cucurbitinus Plateri. The fecOnd differs in having two openings on one fide only of a joint, and is called Taenia vul- garis Andrii, Taniaprimi generis le Clerc. The third has only one foramen to be discover- ed in the fide of a joint, and this fpecies Linnasus mentions to have been very rarely found. The fourth, and laft fpecies, has two little moufchs in the margin of each joint, one oppofite to the other. Vast quantities of this worm are voided by patients for feveral years together; it is rarely B ever 10 A DISSERTATION ON WORM* ever fecn whole. We have upon record inllanetes of many yards having been voided at a time.* Olius Borrichius, a celebrated phyfician of Co- penhagen, of the lait century, tells us of a patient of his who parted eight hundred feet of this fort of worm, in feveral pieces, in the fpaceof a year. Doctor Tyfon, of London, had a fimilar in- france of great quantities of this worm being voided for feveral years together, in pieces from two to fix yards in length -, which all put together would exceed the length of that of Borrichius. Bex though the exact length of this worm can- ;t0i be afcertaincd, yet it is undeniable that It is prodigioufly long, as appears by thofe pieces men- tioned above. The illustrious Van Daeveren re- lates the cafe of a young man, who ejected a bro- ken piece of the taenia that meafured 40 cubits.-f- In the Philofophical Tranfactions we have a defcription of a part of this worm that contained 507 joints •, arid, to conclude this part, we mail instance one other cafe that the illustrious Boer- haave * Doftor Buxton, a phyfician of this city, has in his poflef- fi"n, a broken part of a txnia, 24 fe:t long, and with its Nead complete. T A cubit is 18 inches. OF THE HUMAN INTESTINLS. II haave defcribes, which he fays meafured 300 cubits, and confifted of 21,600 joints. It is unknown, as yet, whether each joint fe- parately constitutes a whole animal. It is won- derful that each part poffelTes the fame power within itfelf as the whole animal :* it fupports life, moves, and adheres to the other parts. Some in- jections, tending to afcertain this truth, feem to prove that thofe many joints we fee in each taenia constitute only one worm.-f- ------e en ' ----- Of the ORIGIN and NOURISHMENT of INTESTINAL WORMS. THE various opinions which have been hand- ed down of the origin and nourifhment of worms, are not expected to be prefented in fb fmall a work as this. Some ancient authors believed them to arife from putridity,^ and others to have been coeval with the body. Galen, writing upon this fubject, fays, " That thofe worms do not arife from a feed, but from putrid matter." The celebrated phyfician, De Lifle, obferved in his own * A fimilar inftance is in the Polypus. f Doctor Monro's Works. X Gilcn. I 2 A DISSERTATION ON WORMS own daughter, a child eleven weeks old, whole nelts of worms -, and the mother, as yet, had af- forded no other kind of nourifhment but that of the breast. Hence he concludes the worms to be congenial with the body. The eminent phyfician Van Doevert.n, collected many obfervations of fcetufes that had worms in the intestines whilst yet in the mother's womb. It is however believed to be a univerfal law of nature, " that every ani- mal is generated from an egg." This appears efpeeially to be the cafe, fince eggs have been dis- covered in the ovaria of viviparous animals.— From the great variety of opinions delivered to us concerning the generation of worms, it will not be wondered at, that the molt learned men in natural hiltory have found fo much diffi- culty upon the fubject. In Baglivius we read of worms feen in the pericardium equalling in length the whole palm of the hand. Du Vek.nl/ tells us of a child, five years old, that constantly complained of a pain about the root of the nofe; fhe kept her bed with a flow fever—convulfiuns at length feized her, and /he died: after her death a worm was found in the longitudinal finus of the brain, five thumbs; hreadth long, and not unlike an earth worm. SwAMMERDAM, OF THE HUMAN INTESTINES. Ij Swammerdam, who was fo fkilful and quick- lighted, after carefully considering all things, con- feiTes " it is the moft difficult thing in the world to explain by what means worms are generated in living bodies, &c—I acknowledge," fays he, " for my part, that I have met with fo few fatisfactory experiments in this matter, that I have not yet any thorough knowledge of the fubjetft: although I have fttn many worms, and worms of various forms, in the living and moving bodies of terreftrial as well as aquatic and aerial animals, but I cannot, in this matter, come to any folid and certain determination." When worms are prefent in the intestines, they, no doubt, muft be nourifhed, as they are fupport- ed and grow; and this nourifhment is afforded by our aliment. Some are of opinion that they live upon the chyle; and others think they live not only on the chyle, but on the blood likewife.— Van Doeveren mentions a taenia, which a friend of his faw expelled, where a drop of blood was if- fuing from the orifice, or mouth. We have like- wife a defcription of a worm* a foot and a half long, and an inch and a half diameter, which was voided by the anus-, it was full of blood, and, for feveral days after its expulfion, the perfon loft, to * Med. ElT. and Obf. vol. ii. p. 336. 14 A DISSERTATION ON WlRMS to appearance, fome pounds of blood. The worm was dead, and made up of a number of rings like the earth-worn. It appears they draw nourishment fome time.-. from tiv fubltance of the ltomach and bowels, for v.e very frequently difcover them in the cavity of the abdomen, and a perforation made into the in- teftines. Heifter opened the corpfe of a boy, (even years old, who had been troubled for fome- time with grievous pains of his abdomen-, and although he had an excellent appetite, yet he ap- parently died of emaciation. In the abdomen was found a quantity of yellow water, which being abforbed, he diicovered many round and long worms; and though the body was opened the day after its death, lee found only one living worm among the great numbrr prefent. The fmall in- teitines were perforated with many holes, and con- te:ned yet many more worms, but every one dead.* We have the hiltory of a young woman's cafe who had fuffered under many difeafes, and died in conlequence of worms; her abdomen was found abounding with them. In other cafes not the in- t^llines alone were perforated, but the heart and hver were eroded.—The late Doctor Bond,f- of Philadelphia, * M.rgag. Let. xxx'w. Art. 36. X i\'--'J. Ooi'.rv. \-j). i. p. -2. OF THE HUMAN INTESTINES. 15 Philadelphia, relates a cafe of a Quaker lady who had considerable part of the liver eroded by a worm.* Of the CAUSES of WORMS. INFANTS labour more frequently and griev- ously under worms than adults; hence arife in them other difeafes : their intestines being replete with a glutinous matter from the nature of their aliment, which affords a nidus for worms. It is daily to be noticed that children of the poor, far more often than others, labour under this com- plaint, on account of the want of proper food. Many crude indigeitible vegetables, immature fruits, legumina, fweets, cheefe and frefh fifh, tend exceedingly to produce the pituitous matter which favours their production, particularly in perfons of debilitated habits. The feafbn of the year favours much the pre- difpofition to worms. It is mentioned by Van Swieten,-}- that it was obferved at Beziers* in the year * I am informed the celebrated Doclor Monro flie-.vs pre- parations of interlines which were a&ually eroded by worms. ■f Com. in aph. 1362. tb A DISSERTATION ON WORM- year i~;a\ to have feized many in the manner of an epidemic. Although *orms were frequent at other I'eafons among the inhabitants, yet, irr fh*r year, petfon; of both fexes, of all ages and confti tutions were afflicted with them, and that to fuch a degree a^ to prove mortal to fome. Remedies were adminiftered in vain, if not given very strong and powerful, that the worms might be forced out, either upwards or downwards—many of which came alive from the body. The SYMPTOMS of WORM'.?. IT is not furprifing that worms produce fo many evil°», if we only confider the great fcnfibility of the intestines, which exceeds that of almoft every other part-, and the fympathy, which fubiifts between them and every other part of the body: Then, if we confider the ufes they are deftincd tes in the animal ceconomy, with the affections that are attendant on worms, as fordes, gnawing pains, fpafnis, flatus., tormina, &c. it will fufficiently appear that this difeaic is at times exceedingly diftreffing. The numerous fymptoms which are attendant on worms in the bow J.-,, affect much more fenfi- blv OF THE HUMAN INTESTINES. I? bly infants than adults, which is plainly enough understood by perfons who are acquainted with the animal ceconomy. Thefe are as follow:— The abdomen becomes hard and distended with air, rumbling norfe takes place frecjuentry in it, fetid breath, jaaufea and vomiting.; the appetite is at times impaired, then again it is ravinous and infatiable; heart-burn, hiccup, and transient pains of the belly, which are fevere and lancinating when the ftomach is empty: acei&tion or remiffion of thefe pains after taking of food, great thirlt and palenefs of the countenance. The adnata of the eyes is tinged with a leaden colour—the inferior palpebrae become tumid, are circumfcribed with a bluifh ring, and the pupils are dilated;* an itch- ing of the nofe—the upper eye-lid becomes enlarg- ed, as if inflated—frequent ftarting in fleep, and grinding of the teeth.—febrile fymptoms occur throughout the day, with pain of the head, and fometimes delirium—an involuntary difcharge of faliva, particularly during fleep. Doctor Friend enumerates, among the molt frequent fymptoms of worms, a dry cough, which is exceflively troublefome. C The • It may be doubted whether the dilatation of the pupils may be conCdered as a fymptom of worms, as the fymptoms of hydrocephalus are very fimilar to thofe of worms, and are often confounded. IS A DISSERTATION ON WORMS The belly is mostly bound—The urine is frothy and of a whitifh appearance. Many other worfe fymptoms arife from their prefence, as eroding and perforating the intestines, as mentioned already: nor are examples wanting to fhcw that worms give rife to various convulfivc and nervous affections. The fymptoms of afcarides, though not very dmgerous, yet, if their number become great, and happen to perfons of fenfible, delicate habits, they produce much uneafinefs in the body. They induce an intolerable itching in the intettinum rec- tum, and this itching may increafe fo much that, by the confent of the different parts, it may be propagated, and excite fpafmodic affections in the neighbouring parts, as difficulty of voiding urine, ftrangury, hemorrhoidal flux, &c. DIAGNOSTIC SIGNS of WORMS. THE many dangerous fymptoms induced by the prefence of worms in the body, render it very neceffary that a phyfician fhould understand the fymptoms indicating the real nature of the difeafe, leaft OF THE HUMAN INTESTINES. ig leafl he prefcribe remedies proper for worms, when the complaint requires very different medicines. In infants worms are manifestly more eafily de- tected than in adults. ♦ Each fpecies of worm are fald to have peculiar figns and fymptoms diitinguifhing their prefence: Thus pains, gripings, heart-burn, and trouble- fome fpafmodic fymptoms, more frequently indi- cate the teres lumbrici than any other. The taenia, it is faid, is accompanied with a much more depraved appetite, emaciation and fyncope, with an enlarged abdomen, &c. though this latter often happens when the teres alone are prefent. The proper figns of the afcarides are a vehement itching of the anus, tenefmus, and frequent incli- nation to ltool. Notwithstanding, all thefe fymp- toms may occur, yet no worms may be prefent; but, when worms are discharged from the bowels, it is prefumable that the fymptoms proceed from that fburce. In the Edinburgh Medical Effays, Profeflbr St. Clair* relates a cafe of this nature—A boy, four years of age, complained of pains of his ftomach, itching of the nofe, ftartings in fleep, and * Vol. ii. p. 294. 23 A PttSsTRTATION ON WORVS and would wake vrry much terri&edj and aftcr- wards, sleeping or waking, he kept continually rubbing his nofe—convulfions fucceeded, and he died the fixth day—having tried many remedies indicated in fuch a cafe. The body was opened, and the ftomach and inteftines diffected through- out their whole length—no worms appeared; bat about two ounces of a vifcid'fafcftance, like gelly, was found situated at the beginning of the inteftmum jejunum. The Illustrious JVXorgagni* mentions another cafe of the falacy of fymptoms—A boy, fcventeen months old, was fuddenly feized with a diarrhoea, attended with cough and itching of the nofe: in a few days he died. Upon infpesfting the body, there were no worms found in the inteftines. Doctor Armftrong+ relates a cafe of a boy " who lay very itujpid, pulfe low and quick, tongue foul, and breath fetid; he had no found fleep, but (lumbered with his eyes half fhut; he grind- ed his teeth, had inward fits, and was fometimes threatened with convulfions—after a few days he died. The body was opened, and the ftomach and the whole inteftinal canal examined, but not the leaft appearance of worms." The * Er'.lt. xzxi. art. 5. dc caufxs et fed. ire, re. | Difcal'cs&f Children. , OF THE HV*IANi INTESTINE?. 21 The QAUSE of the,. SYMPTOMS. } hne . ■■ : ALMOSTjaJl\the fymptoms of worms may be explained from the wafte of the chyle, a certain matter fui-niflied by the worms, and £bpm irrita- tion of the inteftines. •* By the. y/onms confuming the chyle, may.be explained the hunger,. palenefs, emaciation, debi- lity, and bound belly, with the belching of wind, and rumbling noife of thehowels. From the matter furnifhed by the worms, we may understand the caufes of diarrhoea and fetid breath. By irritating the inteftines, they caufe naufea, vomiting, fyncope, itching of the nofe, and va- rious convulfiye affeftions, as epilepfy, convul- fions, &c. The METHOD of CURE. FROM the nature and fituation of worms, the following indications feem aptly to arife. I. To 2} A DISSERTATION' ON WORMS I. To deftroy the neft of worm;, diflodge them of their lurking-places and kill, or induce fuch a ftate of the ftomach and inteftines, as is incompatible with their existence. II. Being dislodged pr killed, they are to be expelled from the body. The firft indication very often fuffices alone, as worms being removed from their fituations, and weakened, are often expelled with the forces, by the periftaltic motion of the inteftines; but as this is not univerfally the cafe, it becomes neceffary to form another indication for their expulsion. The remedies recommended for the firft inten- tion may be divided into fuch as act, i. By their poifonous quality ; 2. By their mechanical power; and, 3. By the conjoined action of each of thofe. Those which act by their poifonous quality are cabbage-tree bark, Indian pink, male fern, worm- feed, and common fait. Cabbage-tyftbark.] It has a mucilaginous fweetilh talte, and a difagreeable fmell; it is given in form of powder, decoction, and extract. It produces OF the human intestines. 23 produces fome ficknefs and purging, fometimes violent effects, as vomiting, delirium, and fever; which are fuppofed to arife from an over dofe, and are faid to be relieved by taken warm water, cafter-oil, or a vegetable acid. In the Weft- Indies, where its ufe is better understood, they ufe it by way of infufion, and begin with fmall dofes, and when cautioufly and properly adminif- tered, it affords an excellent anthelmintic, efpeci- ally for the expulsion of the lumbrici. Indian pink. ] This plant is made very fre- quent ufe of in this country, and it proves a pretty certain vermifuge. It is commonly administered in infufion; and its purgative effect, affifted by fome fuitable medicine. From the experiments of Doctor Francis Home, it appears that it produced the expulsion of worms, when they had evaded other remedies. He fays he found it neceflary to continue the me- dicine eight or ten days, and, during the ufe of it, he never difcovered any giddinefs, blindnefs, convulfions, or other dangerous fymptoms enu- merated by authors, to arife from the ufe of it. —-He gave to a boy, eight years old, ten grains twice a day, and to an adult, an half a drachm four times a day. : Male fern.] 24 A DISSERTATION ON WORMS Mi < fern.} This remedy is the celebrated fpecitic of Madam Noufer, of Switzerland* tor the cure of the taenia—Having attracted the no- tice of the practitioners of France, her fecrft, after being tried at Paris under the direction of fome eminent phyfician>, was purchafed by the French King, and publifhed by his order. The virtues of this plant were well known to the an- cients, as early as the days of Diofcorides; but it is faid to have been entirely neglected. Galen mentions the fuccefsful ufe of it, and orders it to be drank with mead. In the Academy of Sciences of Paris, in the year 1701, Marchand made many experiments upon its ufe, and declares it to be a certain remedy in expelling all kind of worms. Doctor Duncan, in his Medical Cafes, has exhibited a cafe of taenia, wherein the powder of the male-fern proved fuccefsful. He adds, " If the prefent practice fhall confirm the opinion of the ancients, the restoration of this article, to the lift of the materia medica, may be confidered as a circumftance of importance in the practice of me- dicine." He fays alfo, he has every reafon for prefuming that the expulsion of the tsenia was, in a great meafure, owing to the influence which the fern Of THE HUMAN INTESTINES. 2$ fern powder exerted, as a degree of ficknefs at the ftomach arofe before any other medicine was exhibited. The root of the male fern, in powder, is di- rected to be taken in water, to two or three drams in the morning, no fupper having been ate the preceding night—It generally fickens a little—A brifk cathartic is given a few hours after, confift- ing of calomel, fcammony, and gamboge. This frequently brings off the taenia entire -, if not, the medicine is repeated at due intervals. The French phyficians recommend fome pre- cautions, which they affirm are elTential to the fuccefs of the remedy, as giving fome panada and an injection, which they prefcribe the night be- fore, to lubricate the inteftines, and prepare the primas viae. Worm-feed.] This feed has an unpleafant fmell, and a very bitter tafte -, and, on account of thefe qualities, the form of powder and decoction is rendered inconvenient—It is celebrated as a vermifuge, and is readily taken mixed with molafles. In the Medical Commentaries, vol. viii. page 213, the fuccefsful effects of the anthelmia ber- D mudenlls, 2t5 A DISSERTATION ON WORMS mudenfis, or common worm-grafs, is mentioned as an anthelmintic, while, at the fame time, it i. perfectly inorfenfive. It is fuppofed to be the fame plant from which the femen fantonicum, or worm feed, is taken: It may be given in infufion; but the author found the following a pretty cei tain vermifuge—R. Anthelm. Occidcntalis (common worm-grafs) unciam unam, Canell. Alb. fcrupulos dues, pulv. jalap, fcrupttlum unum, vitriol, carul grana decern M. From ten grains to two fcruplcs may be given once or twice a day, according to the age of the perfon. Common fait.] From the experiments related in the Medical Commentaries, vol. viii. page 342, and thofe of the ingenious Doctor Rufli, of Phi- ladelphia, of the fudden and powerful influence of this fait in killing worms out of the body, I have been led to mention it here. In the experi- ments alluded to, a watery folution of this fait be- ing applied to earth-worms ftrongly convulfed them in one or tv/o minutes, in three they became motionkfs, and in four minutes they died. Doctor Rufli fays, he " administered many pounds of common fait, coloured with cochineal, in dofes of half a drachm, upon an empty ftomach in the morning, with great fuccefs in destroying worms." We OF THE HUMAN INTESTINES. 2£ We might go on to enumerate many more ar- ticles which act by their deleterious quality, but the limits of this diflertation will not permit. Thofe of the moft approved efficacy have been felected, and briefly treated. 2. The mechanical medicines act directly and indirectly upon worms. Those of the firft kind are cowhage, filings of iteel, and powder of tin. Cowhage.] The efficacy of this plant is now indifputable, and the dangerous confequences ap- prehended formerly from its contact with the coats of the ftomach and inteftines, are now hap- pily removed, The parts of this plant which are made ufe of, are the fpiculas or hairy fubftance growing on the outfide of the pod. Thefe are given mixed with molafles or common fyrup. The fpiculas of one pod are faid to be a fufficient quantity for an adult. A Practitioner* who refided in the Weft- Indies, previous to the late war, made feveral ex- periments to determine whether the innocency of the remedy, when taken into the ftomach, was to be attributed to the mode of its exhibition, or to » Doftor Samuel Kiflsm's Inaug. Eflsy. 28 a dissertation o\ woK'ri th<- mucus with which the ftomach is lined -, judge- ing its activity might be blunted by the fyrup of the one, and mucus of the other, which, however, proved not to be the cafe. He applied to the back of one of his hands a fmall portion of the dry fpi- cula*, and to the other a like quantity mixed with fyrup, without being able to perceive any difference in their effects, in point of duration or feverity: Hence he concludes the ftimulating properties of cowhage are conveyed into the ftomach with it. I\ the next experiment he blended a final! quantity of the fpiculx with fome faliva, and put it to the back of his hand; at the fame time he took fome dry cowhage into his mouth, and ob- fcrved that what he had applied to his hand quick- ly produced confiderable uncafinefs, while that which was taken into the mouth had no fenfible LrTcct. Findivc; its Simulating effects to be fo gentle and inoffenfne upon the parts lining the mouth and inteftines, and not knowing any other quality to which its properties as an anthelmintic could be attributed, more particularly as he had adininiftvr- ed it in tincture and decoction, without any evi- dent advantage, he made the following experi- ment, which removed the objections:— To OF THE HUMAN INTESTINES. ICj To a number of earth-worms, when quiet and undifturbed, he applied fome cowhage, and as foon as it came in contact with them, they manifefted figns of uneafinefs, by their violent agitation; and the fame thing was noticed when applied to them united with molalTes or fyrup, and it eventually proved their death. Filings ofjleel] This preparation is exhibited againft the lumbrici and tsenia. Some phyficians have administered it to the quantity of a drachm in a day, which was repeated for feveral fucceflive clays. Powder of tin.] This has been fuppofed to act as a poifon to the worms, from the arfenic that is combined with it in its pureft ftate; but from the length of time a worm can live in a folu- tion of white arfenic, it is more likely that the tin acts entirely by its mechanical property upon the worms. Proflssor Alfton published in the Medical ElTays, vol. v. page 90, an empirical remedy of tin againit worms, from which he experienced great fuccefs. The method he prefcribes for ufing it was as follows:—For an adult perfon, to have two ounces of the pureft powder of tin mixed with 3Q A DISSERTATION ON WORM^ with cisjht ounces of common fyrup or molafles, and previously to its exhibition, to have the bowels well emptied by an infufion of fenna and manna, eye. The day following, fuppofe Monday, he diretfts one half of this mixture to be taking early in die morning, upon a fafting ftomach. On Tuefday, at die fame time, he orders a fourth part of it, and, on Wednefday, the remainder, in like manner as the former-, and laftly, on Thurfclay he again directs the patient to be purg- ed by the above purgative medicine, to evacuate, the worms in the body. The celebrated Doctor Mead* found the file- ings of tin a moft efficacious remedy againft the taenia, and made ufe of it for a very long time before he publifhed it. He took equal portions of filings of tin and red coral, reduced to a very fine powder -, a drachm of which he directs to be taken, made into a bolus, with conferve of the tops of wormwood, twice in a day. The mechanical medicines which act indirectly upon the worms, are vomits, purges, and thofe remedies that give tone and vigour to the ftomach and bowels. 3. The * R. Meau'i Pja.-:epa Med. cap. de Lumbricis. OF THE HUMAN INTESTINES. 3 I 3. The remedies which act by their mechanical and poifonous qualities conjointly, are calomel and jalap. Thefe are fafe and powerful; they often caufe an evacuation of worms when given with other intentions. II. The worms being diflpdged or killed, they are to be expelled from the body. This indication may be fulfilled, by exhibiting in constitutions that are pretty ftrong, all thofe purgative medicines accounted draftic, as gam- boge, fcammony, infufion of fenna and falts, &c. &c. &c. But in children powdered rhubarb alone, or united with mercurius dulcis, is an effectual purgative, and anfwers extremely well. From the situation of the afcarides in the in- teftines, medicines taken by the mouth very rare- ly preferve their efficacy until they arrive at the inteftinum rectum, as thefe worms are princi- pally feated in it; hence they are more im- mediately and effectually killed and expelled by clyfters of an oily, acrid, or fweet nature, and by acrid fuppofitories, with remedies of a like na- ture; but what many thinjc more fafe and cer- tain remedies, are clyftes of lime-water, injections of fulphurious mineral-waters, and the vapours of tobacco thrown up. Clysters 32 A : fSSHRTATI \ ON worms, >:e. Clysters adminiftered againft the afcarides ought to be iVeo'eee.tiy repeated, as fometimes thev do not infeft the rectum in great numbers; and in that cafe the few that do, get feared in the folds of the rectum. I \ the London Medical Tranfactions we have an account of a boy, who, as often as he perceiv- ed fymptoms of .ifcarides, immediately took an half pound of common fait, diflblved in water ; in confequence of which he voided them, and af- terwards recovered. After having exhibited fome of the foregoing remedies, and having expelled the worms, it will beadvifeable to give, at proper intervals, fome gentle cathartic; and fhould the inteftines be much debilitated, fome itrcngthening medicines ought to be taken, as bark and red wine -, at the fame time, ufing exercife: and indeed nothing feems to be more deftructive to worms, or more effectual in preventing their generation, than good living. THE END. f- ■