Ascarides, as we formerly mentioned, are a kind of intestinal worms resembling earth-worms, being formed about the extremity of the rectum and the beginning of the sphincter ani, and occasioning a great itching of the parts. This species is formed by bad diet, cold, and indigestion of the food. Wherefore they are to be discharged, in children, by suppositories of honey with a moderate quantity of salts or natron; but in adults by acrid brine, or a decoction of centaury with natron and honey, or of colocynth, or of wormwood, or of chamæleon, or of alkanet, or of bastard saffron, or of hyssop, or of pennyroyal, or of calamint, or of lupines. After the injections we may anoint the rectum with these simples: Acacia, or hypocistis with natron, or Syriac sumach with liquid alum; and in those which are bound, with Lemnian earth in wine, and with these compound medicines, the trochisk of Andron and the like. And we may give them an injection of cedar-rosin with a syringe having many perforations, such as those used for the uterus; or salted flesh is to be adapted to the part and secured with a bandage, as long as it can be allowed to remain, and changed often. In general all those infested with worms derive benefit from fumigations with the hairs of ichneumon. The food should contain wholesome juices, and such as are easily distributed over the system, neither increasing the cause which engenders the worms, nor allowing the strength to sink; and on that account we may give some diluted wine. And we must give food frequently on that account, and in order that the worms may not bite the intestines for want of their food. The best time for taking food is when the worms are full. If there be a defluxion of the belly you may be sure that the worms are on the increase, the food not being properly distributed, and we are to give soups with a mixture of astringents, such as pears, apples, and pomegranates, more especially such as are acid; and we may apply to the belly, externally, astringent remedies as mentioned above.
Commentary. On this curious subject consult Hippocrates (Aphor. iii, 26; De Morbis, iv, 27); Aristotle (H. A. v, 9); Celsus (iv, 17); Cælius Aurelianus (Pass. Tard. iv, 8); Scribonius Largus (36); Serenus Samonicus; Marcellus (31); Octavius Horatianus (ii, 30); Dioscorides (pluries); Galen (Meth. Med. xiv; Isagoge;) Aëtius (ix, 39); Oribasius (Morb. Curat. iv, 90); Actuarius (Meth. Med. i, 21); Nonnus (172); Myrepsus (8); Avicenna (iii, 16, 5); Serapion (iii, 30); Averrhoes (Collig. vii, 37); Avenzoar (ii, 7, 22); Haly Abbas (Theor. viii, 28; Pract. vii, 29); Alsaharavius (Pract. xvii, 2, 9); Rhases (Divis. 169; Contin. xxvi); Alexandri Tralliani Epistola ap. Alb. Fabricii Bibl. Græc. xii, 602, and ed. Ideler, 1842.
Hippocrates states that the round and broad lumbrici are often passed with the first discharges from the bowels of children. This is a fact very difficult to account for. When, and how did the seed of the worm get access to the belly of the child? He rejects the opinion that the rings of the broad lumbricus (tænia) which are passed from the bowels are its offspring. He says it does not occasion death, but continues to live as long as the man lives.
Aristotle divides intestinal worms into the lumbrici teretes, the l. lati, and ascarides. He remarks that the broad produce something resembling the seeds of the gourd. He believed in spontaneous generation.
The pomegranate seems to have been a popular remedy for intestinal worms. Cato the Censor gives directions for medicating wine by the addition of pomegranate and fennel, of which, he says, “Id vinum tinias perpurgat et lumbricos, si sic concinnes.” (De re rust. 127.)
Celsus treats of the lumbrici lati and teretes. For the cure of the former he recommends a draught containing lupine and the bark of mulberry, with the addition of hyssop, pepper, or scammony. He also recommends emetics with garlic, or pomegranate rind with some nitre. For the teretes he recommends the same, and also the seed of nettle, or of cabbage, or mint, or wormwood, or hyssop with mead, or the seed of cresses with vinegar. He advises, likewise, to eat garlic, and use clysters of oil.
Scribonius Largus directs first garlic and old soft cheese to be eaten, and then Macedonian fern to be taken with honey. After four hours a mixture of aloes and scammony with honied water is to be given, and a clyster of warm water administered. He also recommends wormseed and the shavings of hart’s horn. Marcellus mentions the same remedies.
Serenus Samonicus recommends hartshorn, calamint, garlic, southernwood, coriander, pennyroyal, horehound, &c.
The beginning of the chapter of Cælius Aurelianus on lumbici unfortunately is lost. He mentions the usual symptoms which accompany them, namely, occasional deliquium, agitation, grinding of the teeth, change of colour, convulsions, &c. Worms are discharged by the mouth or anus, sometimes single, and at other times in great numbers rolled up in a ball; sometimes dead, and at other times alive; and they are of various colours. For ascarides he recommends when there is inflammation of the rectum an injection of oil, to which may sometimes be joined a decoction of wormwood and centaury. But if bloody scrapings of the bowels are discharged, he directs us to give a decoction of pomegranate-rind, and, if the complaint continue, equal parts of burnt paper and of arsenic, to the amount of six drs., with the infusion of plantain. Surely there must be some mistake as to the amount of the dose, for so great a quantity could not be injected with safety. When there is putrefaction he recommends an injection of salt water, with other suitable remedies. When complicated with any other disorder he properly directs us to pay attention to it; after which the animals may readily be discharged by drinking oil, or a decoction of sebesten plums (myxæ), or of liquorice: these things, he says, will obviate constriction and swelling, while by lubricating the bowels they will promote the discharge of the worms. When complicated with relaxation he recommends astringents externally and internally, such as vinegar with honey, lupine, the shavings of hart’s horn, &c. Sometimes, he says, in order to expel them we must have recourse to acrid substances, such as onions, garlic, mustard, cresses, cardamus, assafœtida dissolved in vinegar, wormwood, &c. In stating the detail of the treatment he mentions various other anthelmintics, such as the hiera of aloes, gentian, mulberries, squills, spurge, alkanet, colocynth, and scammony. All these things may be given by the mouth or in injections, with a considerable admixture of oil. For the lumbricus latus he directs, first, an emetic of oil, and next day a clyster with nitre or salt. Saltish things are also to be given in drink, with liquorice, or scammony, or polypody, &c. When the animals are discharged, to prevent a renewal of the complaint, he recommends friction, vomiting, acrid food, calefacient plasters, sinapisms, paroptesis, and the like.