There is not a more certain anthelmintic than Carolina pink-root[47]. But as there have been instances of death having followed excessive doses of it, imprudently administered, and as children are often affected by giddiness, stupor, and a redness and pain in the eyes after taking it, I acknowledge that I have generally preferred to it, less certain, but more safe medicines for destroying worms.
3. Of the medicines whose action is compounded of mechanical and chemical qualities, calomel, jalap, and the powder of steel, are the principal.
Calomel, in order to be effectual, must be given in large doses. It is a safe and powerful anthelmintic. Combined with jalap, it often brings away worms when given for other purposes.
Of all the medicines that I have administered, I know of none more safe and certain than the simple preparations of iron, whether they be given in the form of steel-filings or of the rust of iron. If ever they fail of success, it is because they are given in too small doses. I generally prescribe from five to thirty grains every morning, to children between one year, and ten years old; and I have been taught by an old sea-captain, who was cured of a tænia by this medicine, to give from two drachms to half an ounce of it, every morning, for three or four days, not only with safety, but with success.
I shall conclude this essay with the following remarks:
1. Where the action of medicines upon worms in the bowels does not agree exactly with their action upon the earth-worms in the experiments that have been related, it must be ascribed to the medicines being more or less altered by the action of the stomach upon them. I conceive that the superior anthelmintic qualities of pink-root, steel-filings, and calomel (all of which acted but slowly upon the earth-worms compared with many other substances) are in a great degree occasioned by their escaping the digestive powers unchanged, and acting in a concentrated state upon the worms.
2. In fevers attended with anomalous symptoms, which are supposed to arise from worms, I have constantly refused to yield to the solicitations of my patients, to abandon the indications of cure in the fever, and to pursue worms as the principal cause of the disease. While I have adhered steadily to the usual remedies for the different states of fever, in all their stages, I have at the same time blended those remedies occasionally with anthelmintic medicines. In this I have imitated the practice of physicians in many other diseases, in which troublesome and dangerous symptoms are pursued, without seducing the attention from the original disease. The anthelmintic medicines prescribed in these cases, should not be the rust of iron, and common salt, which are so very useful in chronic diseases from worms, but calomel and jalap, and such other medicines as aid in the cure of fevers.
Footnotes:
[40] See the Inquiry into the Diseases of the Indians, p. 19.
[41] Vol. II. of his Epidemics, p. 56.