CASE XIX.
A gentleman’s son in perfect health, between four and five years of age, on the third day after inoculation voided a long round worm alive, after having taken on the preceding night a dose of mercurial physick. No signs of worms had hitherto been observed in him; and he afterwards seemed to be quite well, till the symptoms which usually precede the small-pox came on.
After a very moderate illness, an eruption of about twenty pustules succeeded, and all complaints then ceased; so that on the 4th day after the eruption, I proposed, and was permitted, to discontinue my visits for the present. I called again however on the 6th day, and found him well as usual, and at play, the pustules being then nearly maturated.
I was informed, however, that in the night of the 4th day, he had been hot, feverish, and restless; was very well the day following, and hot again at night, but in a lesser degree; so that this slight illness did not then give the least alarm. But on the 7th day, early in the morning, I was called up to visit him as soon as possible, and was informed that in the beginning of the night he grew extremely hot and delirious, and soon became stupid, drowsy, and senseless; in which condition I found him, grating his teeth, with convulsive motions about the mouth.
The pustules were at this time quite ripe, and looked, as they always had done, extremely well. His pulse was very quick, though the heat was now moderate, and the respiration free and easy; but he was so comatose, as not to be roused, even so much as to open his eyes, by any disturbance that could be given.
In this alarming situation I desired the assistance of the physician, who on other occasions had usually attended the family. At our consultation, which soon followed, it was agreed, that as the small-pox were very few in number, had always looked well, and were now completely maturated, the present symptoms must be occasioned by worms, or some irritating cause in the bowels.
With this view a dose of rhubarb and calomel was immediately prescribed and exhibited, though we were obliged to open the mouth by force, and this not without some difficulty. The operation of this medicine was accelerated by a clyster, and a large fœtid slimy stool, followed by some smaller liquid ones, was procured that afternoon.
The child, however, seemed to be almost totally insensible during this time, nor did he yet appear to be in any respect relieved by these evacuations: blisters therefore were successively applied to the back, head, and legs, and sinapisms to the feet; leeches were likewise fixed to the temples, and rhubarb with calomel, after some little interval, again directed; tin medicines being given between whiles.
By these means, though not till a considerable quantity of slimy and extremely offensive fæces had been discharged, some signs of amendment appeared. But the child still remained in some degree comatose till the fifth day from this attack; after which the progress of amendment was very quick, and in two or three days he got quite well, and has so continued.