Capelle. Transactions of the college at Philadelphia, v. i.
Now as the dilute state of the bile depends on the deficiency of the absorption of its thinner parts, it appears, that the tumid belly, and bloated countenance, and swelled upper lip, are a concomitant circ.u.mstance attending the general inactivity of the absorbent system; which is therefore to be esteemed the remote cause of the generation of worms.
The simplicity of the structure of worms probably enables them to exist in more various temperatures of heat; and their being endued with life prevents them from being destroyed by digestion in the stomach, probably in the same manner as the powers of life prevent the fermentation and putrefaction of the stomach itself. Hence I conclude, that worms are originally taken into our alimentary ca.n.a.l from without; as I believe similar worms of all kinds are to be found out of the body.
M. M. The round worm is destroyed by a cathartic with four or six grains of calomel; and afterwards by giving six or eight grains of filings of iron twice a day for a fortnight. See Hepatis tumor, Cla.s.s I. 2. 3. 9. As worms are liable to come away in fevers, whether of the hectic or putrid kind, could they be removed by purulent matter, or rotten egg, or putrid flesh, since in those fevers from the enfeebled action of the intestines the faeces become highly putrid?
11. _Taenia._ Tape-worm consists of a chain of animals extending from the stomach to the a.n.u.s. See Sect. x.x.xIX. 2. 3. It frequently exists in cats, rats, and geese, and probably in many other animals.
The worms of this genus possess a wonderful power of retaining life. Two of them, which were voided by a pointer dog in consequence of violent purgatives, each of which were several feet in length, had boiling water poured on them in a bason; which seemed not much to inconvenience them.
When the water was cool, they were taken out and put into gin or whiskey of the strongest kind, in which their life and activity continued unimpaired; and they were at length killed by adding to the spirit a quant.i.ty of corrosive sublimate. Medic. Comment. for 1791, p. 370.
The tape-worm is cured by an amalgama of tin and quicksilver, such as is used on the back of looking-gla.s.ses; an ounce should be taken every two hours, till a pound is taken; and then a brisk cathartic of Glauber"s salt two ounces, and common salts one ounce, dissolved in two wine pints of water, half a pint to be taken every hour till it purges. The worm extends from the stomach to the a.n.u.s, and the amalgama tears it from the intestine by mechanical pressure, acting upon it the whole way. Electric shocks through the duodenum greatly a.s.sists the operation. Large doses of tin in powder. Iron filings in large doses. The powder of fern-root seems to be of no use, as recommended by M. Noufflier.
12. _Ascarides._ Thread-worms. These worms are said to be more frequent in some parts of this kingdom than in others, as near the fens of Lincolnshire. Do they escape from the body and become flies, like the bott-worm in horses? Do they crawl from one child to another in the same bed? Are they acquired from flies or worms, which are seen in putrid necessary houses, as these worms as well as the tapeworms, are probably acquired from without? this may account for their re-appearance a few weeks or months after they have been destroyed; or can this happen from the eggs or parts of them remaining?
Ascarides appear to be of two kinds, the common small ones like a thread; which has a very sharp head, as appears in the microscope; and which is so tender, that the cold air soon renders it motionless; and a larger kind above an inch long, and nearly as thick as a very small crow-quill, and which is very hard in respect to its texture, and very tenacious of life.
One of these last was brought to me, and was immediately immersed in a strong solution of sugar of lead, and lived in it a very long time without apparent inconvenience.
M. M. Ascarides are said to be weakened by twenty grains of cinnabar and five of rhubarb taken every night, but not to be cured by this process. As these worms are found only in the r.e.c.t.u.m, variety of clysters have been recommended. I was informed of a case, where solutions of mercurial ointment were used as a clyster every night for a month without success.
Clysters of Harrowgate water are recomended, either of the natural, or of the fact.i.tious, as described below, which might have a greater proportion of liver of sulphur in it. As the cold air soon destroys them, after they are voided, could clysters of iced water be used with advantage? or of spirit of wine and water? or of ether and water? Might not a piece of candle, about an inch long, or two such pieces, smeared with mercurial ointment, and introduced into the a.n.u.s at night, or twice a day, be effectual by compressing their nidus, as well as by the poison of the mercury.
The clysters should be large in quant.i.ty, that they may pa.s.s high in the r.e.c.t.u.m, as two drams of tobacco boiled a minute in a pint of water. Or perhaps what might be still more efficacious and less inconvenient, the smoke of tobacco injected by a proper apparatus every night, or alternate nights, for six or eight weeks. This was long since recommended, I think by Mr. Turner of Liverpool; and the reason it has not succeeded, I believe to have been owing to the imperfections of the joints of the common apparatus for injecting the smoke of tobacco, so that it did not pa.s.s into the intestine, though it was supposed to do so, as I once observed. The smoke should be received from the apparatus into a large bladder; and it may then be certainly injected like the common clyster with sufficient force; otherwise oiled leathers should be nicely put round the joints of the machine; and a wet cloth round the injecting pipe to prevent the return of the smoke by the sides of it. Clysters of carbonated hydrogen gas, or of other fact.i.tious airs, might be tried.
Harrowgate water taken into the stomach, so as to induce six or seven stools every morning, for four or six weeks, is perhaps the most efficacious method in common use. A fact.i.tious Harrowgate water may be made probably of greater efficacy than the natural, by dissolving one ounce of marine salt, (called bay salt) and half an ounce of magnesia Glauber"s salt, (called Epsom salt, or bitter purging salt) in twenty-eight ounces of water. A quarter or half a pint of this is to be taken every hour, or two hours in the morning, till it operates, with a tea-spoonful of a solution of liver of sulphur, which is to be made by putting an ounce of hepar sulphuris into half a pint of water. See Cla.s.s IV. 1. 2. 9.
13. _Dracunculus._ A thin worm brought from the coast of Guinea. It is found in the interstices of the muscles, and is many yards long; it makes a small ulcer; which is cured by extracting an inch of the worm a day, and wrapping the extracted part slowly round a bit of tobacco pipe till next day, so as not to break it. I have twice seen long worms, like a thick horse-hair, in water in July in this country, which appeared hard and jointed.
14. _Morpiones._ Crab-lice. The excrement of this animal stains the linen, and appears like diluted blood.
M. M. Spirit of wine. Mercurial ointment, shaving the part. Oil destroys other insects, if they be quite covered with it, as the ticks on dogs, and would probably therefore destroy these. Its manner of operation is by stopping up or filling their spiracula, or breathing pores; a few drops of oil poured on a wasp, so as to cover it, destroys it in a few seconds.
15. _Pediculi._ Lice. There is said to be a disease, in which these animals are propagated in indestructible numbers, so as to destroy the patient.
M. M. Cleanliness, mercurial ointment, stavis acria in powder, or the tincture of it in spirit of wine. Spirit of wine alone? Bath of oil?
ORDO I.
_Increased Irritation._
GENUS V.
_With Increased Actions of the Organs of Sense._
SPECIES.
1. _Visus acrior._ Acuter sight. There have been instances of people, who could see better in the gloom of the evening, than in the stronger light of the day; like owls, and bats, and many quadrupeds, and flying insects. When the eye is inflamed, great light becomes eminently painful, owing to the increased irritative motions of the retina, and the consequent increased sensation. Thus when the eye is dazzled with sudden light, the pain is not owing to the motion of the iris; for it is the contraction of the iris, which relieves the pain from sudden light; but to the too violent contractions of the moving fibres, which const.i.tute the extremities of the optic nerve.
2. _Auditus acrior._ The irritative ideas of hearing are so increased in energy as to excite our attention. This happens in some diseases of the epileptic kind, and in some fevers. Hence the whispering of the currents of air in a room, the respiration of the company, and noises before unperceived, become troublesome; and sounds louder than usual, or unexpected, produce starting, and convulsions.
M. M. Put oil of almonds into the ears. Stop the meatus auditorius with cotton wool. Set the feet of the patient"s bed on cushions, or suspend it by cords from the ceiling.
3. _Olfactus acrior._ The irritative ideas of smell from the increased action of the olfactive nerve excite our attention. Hence common odours are disagreeable; and are perceived from variety of objects, which were before thought inodorous. These are commonly believed to be hallucinations of the sense.
M. M. Snuff starch up the nostrils.
4. _Gustus acrior._ The irritative ideas of taste, as of our own saliva, and even of the atmospheric air, excite our attention; and common tastes are disagreeably strong.
M. M. Water. Mucilage. Vegetable acids. Sc.r.a.pe the tongue clean. Rub it with a sage-leaf and vinegar.
5. _Tactus acrior._ The irritative ideas of the nerves of touch excite our attention: hence our own pressure on the parts, we rest upon, becomes uneasy with universal soreness.
M. M. Soft feather-bed. Combed wool put under the patients, which rolls under them, as they turn, and thus prevents their friction against the sheets. Drawers of soft leather. Plasters of cerate with calamy.
6. _Sensus caloris acrior._ Acuter sense of heat occurs in some diseases, and that even when the perceptible heat does not appear greater than natural to the hand of another person. See Cla.s.s I. 1. 2. See Sect. XIV. 8.
All the above increased actions of our organs of sense separately or jointly accompany some fevers, and some epileptic diseases; the patients complaining of the perception of the least light, noises in their ears, bad smells in the room, and bad tastes in their mouths, with soreness, numbness, and other uneasy feels, and with disagreeable sensations of general or partial heat.
7. _Sensus extensionis acrior._ Acuter sense of extension. The sense of extension was spoken of in Sect. XIV. 7. and x.x.xII. 4. The defect of distention in the arterial system is accompanied with faintness; and its excess with sensations of fulness, or weight, or pressure. This however refers only to the vascular muscles, which are distended by their appropriated fluids; but the longitudinal muscles are also affected by different quant.i.ties of extension, and become violently painful by the excess of it.
These pains of muscles and of membranes are generally divided into acute and dull pains. The former are generally owing to increase of extension, as in p.r.i.c.king the skin with a needle; and the latter generally to defect of extension, as in cold head-aches; but if the edge of a knife, or point of a pin, be gradually pressed against the fibres of muscles or membranes, there would seem to be three states or stages of this extension of the fibres; which have acquired names according to the degree or kind of sensation produced by the extension of them; these are 1. t.i.tillation or tickling. 2.
itching, and the 3. smarting; as described below. See Sect. XIV. 9.
8. _t.i.tillatio._ Tickling is a pleasureable pain of the sense of extension above mentioned, and therefore excites laughter; as described in Sect.
x.x.xIV. 1. 4. The tickling of the nostrils, which precedes the efforts of sneezing, is owing to the increased irritation occasioned by external stimulus; and is attended with a pleasureable sensation in consequence of the increased action of the part. When this action is exerted in a greater degree, the sensation becomes painful, and the convulsion of sneezing ensues; as the pain in tickling the soles of the feet of children is relieved by laughter.
A lady after a bruise on her nose by a fall was affected with incessant sneezing, and relieved by snuffing starch up her nostrils. Perpetual sneezings in the measles, and in catarrhs from cold, are owing to the stimulus of the saline part of the mucous effusion on the membrane of the nostrils. See Cla.s.s II. 1. 1. 3.
9. _Pruritus._ Itching seems to be a greater degree of t.i.tillation, and to be owing to the stimulus of some acrid material, as the matter of the itch; or of the herpes on the s.c.r.o.t.u.m, and about the a.n.u.s; or from those universal eruptions, which attend some elderly people, who have drank much vinous spirit. It occurs also, when inflammations are declining, as in the healing of blisters, or in the cure of ophthalmia, as the action of the vessels is yet so great as to produce sensation; which, like the t.i.tillations that occasion laughter, is perpetually changing from pleasure to pain.
When the natural efforts of scratching do not relieve the pain of itching, it sometimes increases so as to induce convulsions and madness. As in the furor uterinus, and satyriasis, and in the sphincter ani and s.c.r.o.t.u.m. See Cla.s.s II. 1. 4. 14. IV. 2. 2. 6.
M. M. Warm bath. Fomentation. Alcohol externally. Poultice. Oiled silk.
Mercurial ointments on small surfaces at once. See Cla.s.s II. 1. 4. 12.
Solutions of lead on small surfaces at once.
10. _Dolor urens._ Smarting follows the edge of a knife in making a wound, and seems to be owing to the distention of a part of a fibre, till it breaks. A smarting of the skin is liable to affect the scars left by herpes or shingles; and the callous parts of the bottoms of the feet; and around the bases of corns on the toes; and frequently extends after sciatica along the outside of the thigh, and of the leg, and part of the foot. All these may be owing to the stimulus of extension, by blood or serum being forced into vessels nearly coalesced.
M. M. Emplastrum de minio put like a bandage on the part. Warm fomentation.
Oil and camphor rubbed on the part. Oil-silk covering. A blister on the part. Ether, or alcohol, suffered to evaporate on the part.
11. _Consternatio._ Surprise. As our eyes acquaint us at the same time with less than half of the objects, which surround us, we have learned to confide much in the organ of hearing to warn us of approaching dangers.
Hence it happens, that if any sound strikes us, which we cannot immediately account for, our fears are instantly alarmed. Thus in great debility of body, the loud clapping of a door, or the fall of a fire-shovel, produces alarm, and sometimes even convulsions; the same occurs from unexpected sights, and in the dark from unexpected objects of touch.
In these cases the irritability is less than natural, though it is erroneously supposed to be greater; and the mind is busied in exciting a train of ideas inattentive to external objects; when this train of ideas is dissevered by any unexpected stimulus, surprise is excited; as explained in Sect. XVII. 3. 7. and XVIII. 17. then as the sensibility in these cases is greater, fear becomes superadded to the surprise; and convulsions in consequence of the pain of fear. See Sect. XIX. 2.
The proximate cause of surprise is the increased irritation induced by some violent stimulus, which dissevers our usual trains of ideas; but in diseases of inirritability the frequent starting or surprise from sounds not uncommon, but rather louder than usual, as the clapping of a door, shews, that the attention of the patient to a train of sensitive ideas was previously stronger than natural, and indicates an incipient delirium; which is therefore worth attending to in febrile diseases.