Encyclopaedia Britannica, or, a Dictionary of arts, sciences, and miscellaneous literature : enlarged and improved. Illustrated with nearly six hundred engravings > Volume 13, MAT-MIC

468
Worms.
M E D I
both internally and externally j and if thefe fymptoms
■vrere not foon relieved, a tenefmus was brought on,
with a mucous dejeftion. Sometimes there was a gri-
ping pain in the lower part of the abdomen, a little
above the os pubis. If this pain was very fevere, a
bloody mucus followed, in which there wyere often
found afcarides alive. I hey were alfo fometimes fuf-
pefted of occafioning difturbed deep, and fome degree
of headach.
On this cafe Dr Heberden obferves, that the gene¬
ral health of the patient did not feem to have fuffered
from the long continuance of the difeafe, nor the im¬
mediate inconveniences of the diforder itfelf to have
increafed. “ It is (fays he) perhaps univerfally true,
that this kind of worms, though as difficult to be cu¬
red as any, yet is the lead dangerous of all. They
have been known to accompany a perfon through the
whole of a long life, without any reafon to fufped:
that they had haftened its end. As in this cafe there
was no remarkable licknefs, indigeftion, giddinefs, pain
of the ftomach, nor itching of the nofe, poffibly thefe
fymptoms, where they have happened to be joined with
the afcarides, did not properly belong to them, but
arofe from fome other caufes. There is indeed no one
fign of thefe worms, but what in fome patients will
be wanting.”
The above-mentioned patient ufed purging and irri¬
tating clyfters with very little fuocefs. One dram
and a half of tobacco was infufed in fix ounces of
boiling water j and the drained liquor being given as
a clyder, occafioned a violent pain in the lower part
of the abdomen, with faintnefs and a cold fweat :
this injection, though retained only one minute, a&ed
as a fmart purge, but did little or no good. Lime-
water was alfo ufed as a clyder which brought on a
codivenefs, but had no good effect. Six grains of
fait of deel were diffolved in fix ounces of water, and
injedted. This clyder in a few minutes occafioned an
aching in the redhim, griped a little without purging,
and excited a tenefmus. Some few afcarides were
brought off with it ; but all of them w^ere alive. The
uneafy fenfation in the redtum did not abate till fome
warm milk was thrown up. Whenever the tenefmus
or mucous dools were thought worth the taking no¬
tice of, warm milk and oil generally gave immediate
relief. If purging was neceflary, the lenient purges,
fuch as manna with oil, were, in this particular cafe,
made ufe of: rhubarb was found too dimulating.
But, in general, the mod ufeful purge, and which
therefore was mod ufually taken, was cinnabar and
rhubarb, of each half a drachm : this powder feldom
failed to bring away a mucus as tranfparent as the
white of an egg, and in this many afcarides were
moving about. The cinnabar frequently adhered to
this mucus, which did not come off in large quanti¬
ties, when a purge was taken without cinnabar. Calo¬
mel did no more than any other purge which operates
brilkly would have done •, that is, it brought array af¬
carides, rvith a great deal of mucus. Oil given as a
clyder fometimes brought off thefe animalcules : the oil
fwam on the furface of the mucus, and the afcarides wrere
alive and moving in the mucus itfelf, which probably
hindered the oil from coming in contact with them and
killing them.
Dr Heberden alfo obferves, that mucus or dime is
4
CINE. Appendix.
the proper ned of the afcarides, in which they live, Worms.
and is perhaps the food by which they are nouriffied ;' r—J
and it is this mucus which prelerves them unhurt,
though furrounded with many other liquors, the im¬
mediate touch of which would be fatal. It is hard to
fatisfy ourfelves by what indinft they find it out in
the human body, and by what means they get at it j
but it is obfervable in many other parts of nature, as
well as here, that where there is a fit foil for the
hatching and growth of animals and vegetables, na¬
ture has taken fufficient care that their feeds ffiould
find the way thither. Worms are faid to have been
found in the intedines of dill-born infants. Purges,
by leffening this dime, never fail to relieve the pa¬
tient : and it is not unlikely, that the worms which
are not forced away by this quickened motion of the
intedines, may, for want of a proper quantity of it,
lahguiffi, and at lad die j for if the afcarides are taken
out of their mucus, and expofed to the open air, they
become motionlefs, and apparently die in a very fhort
time. Dr Heberden fuppoles that the kind of purge
made ufe of is of fome confequence in the cure of all
other worms as w'ell as afcarides ; the animals being
always defended by the mucus from the immediate
adlien of medicines; and that therefore thofe purges
are the bed which aft brilkly, and of which a repe¬
tition can be mod eafily borne. Purging waters are
of this fort, and jalap efpecially for children ; two or
more grains of which, mixed with fugar, are mod eafi¬
ly taken, and may be repeated daily.
From Dr Heberden’s obfervations, tve may eafily fee
why it is fo difficult to dedroy thefe animals; and wdiy
anthelmintics, greatly celebrated for fome kinds, are
yet fo far from being fpecifics in the difeafe. As the
worms which refide in the cavities of the human body
are never expofed to the air, by which all living crea¬
tures are invigorated, it is evident, that in themfelves
they mud be the mod tender and eafily dedruftible
creatures imaginable, and much lefs will be requifite to
kill them than any of our common infefts. The
mod pernicious fubdances to any of the common in¬
fefts are oil, caudic fixed alkali, lime, and lime-water.
The oil operates upon them by fhutting up the pores
of their bodies 5 the lime-water, lime, and caudie al¬
kali, by diffolving their very fubdance. In the cafe
of intedinal worms, however, the oil can have very
little effeft upon them, as they are defended from it
by the moidure and mucus of the intedines j the like
happens with lime-water : and therefore it is neceffary
that the medicine diould be of fuch a nature as to
dedroy both mucus and infefts together ; for which
purpofe the caudic fixed alkali is at once fafe and ef¬
ficacious ; nor is it probable that any cafe of worms
whatever could refid the proper ufe of this medicine.
A very large dofe of any fait indeed will alfo dedroy
the mucus and dedroy the worms 5 but it is apt to
inflame and excoriate the domach and intedines, and
thus to produce worfe didempers than that which it
w'as intended to cure. Dr Heberden gives the fol¬
lowing remarkable cafe of a patient cured of worms
by enormous dofes of common fait, after trying many
other remedies in vain. In February 1757, the pa¬
tient was feized with uncommon pains in his domach,
attended with naufea, vomiting, and eondipation of
bowels, and an almod total lofs of fleep and appetite a
H®