It was at one time imagined, and the idea is still popularly current, that worms were the occasion of a troublesome and lingering species of fever, which was therefore designated worm-fever. This notion is now entirely exploded; for if worms be present under such circumstances, it is a mere accidental complication; the fever referred to being generally of a remitting character, and neither caused by or causing the generation of worms. The symptoms of this fever, however, have led and continue to lead very many astray. This is not surprising, since they so closely resemble those which characterise the presence of worms, that an unprofessional person is almost sure to be misled by them. Amongst other symptoms, there is the picking of the nose and lips, offensive breath, occasional vomiting, deranged bowels, pain in the head and belly, with a tumid and swollen condition of the latter, a short dry cough, wasting of the flesh, etc.; symptoms continually attendant upon the disorder now under consideration. These cases have hitherto been perpetually looked upon by mothers as worm-cases, and after having been treated by them as such, by the use of the popular worm-powders of the day, have, as perpetually, presented themselves to the physician greatly and grievously aggravated by such injudicious treatment. It is folly, at any time, for an unprofessional person to prescribe for a case where worms are actually known to exist: surely where there is any doubt upon the latter point it must be greater folly still.
The infant at the breast is seldom, if ever, the subject of this disorder, whilst an artificial diet, or bringing up by hand, predisposes to it. Worms most frequently occur, however, during childhood; much more so at this epoch than in adult age. They do not invariably occasion indisposition, for they are now and then passed without pain or distress by children who are in the enjoyment of perfect health, and in whom previously there was not the slightest suspicion of their existence. The idea, formerly so prevalent, of their being attended with danger, is without foundation; for unless the case be mismanaged, they rarely give rise to serious consequences.
HOW PRODUCED, AND HOW BEST PREVENTED.—The causes of worms it is not very easy to explain; at the same time it is very certain that some known circumstances favour their production.
If the general health of a child be enfeebled, particularly if the child be strumous, such a condition will favour the generation of these animals. The protracted use of unwholesome and innutritious articles of food, or a deficient supply of salt (the most necessary stimulant to the digestive organs), or other condiments, predisposes to worms. This observation is strikingly illustrated by an occurrence which formerly took place in Holland, where an ancient law existed forbidding salt in the bread of certain criminals; they were in consequence horribly infested with worms, and quickly died. Sugar, too, whilst a necessary condiment for the food of children, if given in the form of sweetmeats, and their indulgence, long persisted in, may so enfeeble the organs of digestion as to cause worms. And, lastly, (though many other causes might be referred to) the injudicious means occasionally employed to effect the removal of these animals, by the debility produced in the intestinal canal, favours not only their re-appearance but their increase.
These, then, are so many causes which may occasion worms in the child, and of course the best and most effectual method to prevent their production is their avoidance. A mother, therefore, should at all times be careful in the regulation of the diet and general management of her child's habits and health, even if no stronger obligations existed than the dread of this disorder; and she must be more than ordinarily vigilant on this head, when the slightest disposition to such disorder is manifested. Again; she must not forget that the symptoms so commonly ascribed as characteristic of worms are much more frequently caused by other diseases; that at no time, therefore, is she justified in giving worm powders, or strong doses of medicine for such symptoms; for if they do exist, their use is always attended with risk, and if they do not, the debility which they occasion in the stomach and bowels may itself become the source of their production.
Sect. V. SCARLET FEVER.
There are several varieties of this disease; it will be more perspicuous, however, for our purpose to speak of it under the two following forms:—
Mild scarlet fever;
Scarlet fever, with sore throat.
MILD SCARLET FEVER.—In this form of the disease there is only the rash with fever.