For the secondary symptoms:—Venesection; antimonials; sarsaparilla; Dover's powder. Mercury increases the ravages of the disease, except when on the wane, when it may be given in alterative doses, with safety and advantage. For the pain in the head, a blister to the nape of the neck. If the eruption appear scaly, then mercury is likely to be useful. If the throat and skin are affected, muriate of mercury in solution, and decoction of sarsaparilla. If the ulcer in the throat be small, touch it with the oxymel æruginis, or solution of nitrate of silver, grs. v a x to an ounce of water; but if there exist extensive ulcerations, fumigations with red sulphuret of mercury ought to be employed.
Fourth, Scaly Venereal Disease, or Syphilis.—Primary ulcer of a circular form, excavated, without granulations, with matter adhering to the surface, and with a thickened edge and base. The hardening is very circumscribed, not diffusing itself gradually or imperceptibly into the surrounding parts, but terminating rather abruptly. Its progress is slow, sometimes assuming a tawny appearance.
Constitutional symptoms.—Sometimes the skin, at other times the throat, is first affected. There is headach, restlessness, and fever. The scaly eruption appears, but does not relieve the fever, as in the other diseases. This eruption commences with a small hard reddish protuberance; and as it advances, the sides are raised, and centre depressed or flat, and covered with thin white scales. It terminates in ulcerated blotches. This eruption appears on the forehead, breast, back of the neck, and groin; often in large copper coloured blotches, in parts near the hair. The ulcers of the throat mostly affect the tonsils, and come on without much previous pain or swelling; although there soon appears a considerable excavation of the tonsil, attended with evident loss of substance. The ulcer is foul, with thick white matter adherent to it, which cannot be washed away. The bones then become affected, those nearest the surface being most liable to attack; such as the tibia, sternum, clavicle, and cranium.
The remedies for syphilis are full courses of mercury, for both primary and secondary symptoms; except where a tendency to phthisis, or a delicate constitution forbids them. He thinks syphilis a rare disease now, compared with what it was formerly.
Article IX.—Remarks on some Means employed to destroy Tænia, and expel them from the Human Body.—By Louis Frank. M. D. Privy Counsellor of her Majesty, Maria Louisa, Duchess of Parma. [Lond. Med. Rep. April 1825.]
The symptoms produced by the presence of tape worm in the human body, are exceedingly distressing, and the sufferings of the patient are increased, by the obstinacy, with which these animals resist the operation of the most disgusting, and even painful and dangerous remedies. Improvements in the mode of attacking and expelling them, therefore, should be gladly received, and widely made known.
The numerous reports which we have received, concerning oil of turpentine as a remedy for tænia solium, have already given to that remedy the highest character; but many cases have been only partially relieved by it. The ol. tereb. seems to be capable of causing the separation and expulsion of portions of the animal; but while the head remains unexpelled, it is supposed to be capable of reproducing the joints, to a degree not yet ascertained. If we may believe medical writers, the tænia has been observed of the enormous length of 700 feet. It is probable that the reproduction, after the loss of large numbers of joints, is often very rapidly effected; as was the case in a patient treated at the Carey Street Dispensary, mentioned in their report for Aug. 1813,[18] This person always discharged very considerable quantities of joints or fragments, after the use of oil of turpentine; after which he remained free from the complaint for a few months, until the tænia recovered a troublesome magnitude; when it was again easily reduced to less uncomfortable dimensions.
We are not able to state positively, how long the oil of turpentine has been in use as a remedy for tænia. The Carey Street Report for Feb. 1810, informs us, that a mechanic in Durham, having been very successful in the treatment of tænia by means of this article, the circumstance was communicated by Dr. Southey, of that place, to Dr. Laird of London; and it was accordingly prescribed in doses of ℥ss. to [Symbol: ounce]ij. at several of the London charities. It had been found, says the report, that ol. tereb. might be thus given, as safely as so much gin, and frequently caused the expulsion in two hours: Dr. Knox says it has been in use in Germany for fifty years for the expulsion of tænia.
The experience of Dr. Knox, concerning tænia, at the Cape of Good Hope, is the most extraordinary that we are acquainted with. Dr. Sparman, the traveller, had observed, that worms were exceedingly common in the northern parts of the colony; but Dr. Knox, who was there in 1819, did not notice any special prevalence of verminous disorders, "previous to Oct. 1819, when the tape worm became so general among the troops, as to resemble an epidemic."[19]