such cases, such as caries of the bone, the formation of fungus under the nail, &c. that it will always be advisable to apply to an experienced surgeon, whose timely assistance will prevent much serious mischief.

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OF WORMS. The species of worms that are most prevalent in the human body are three, viz. ascarides, or small round and short worms, which chiefly occupy the lower intestine; the teres, or round and long worms*, which are generally seated in the small intestines and stomach; and the tænia or tape-worm, which, for the most part, occupy the whole tract of the intestinal canal.

SYMPTOMS. The symptoms denoting the existence of worms are common to the different species, viz. indigestion, with a variable appetite; foul tongue; offensive breath; hard, full, and tense belly, with occasional gripings and pains about the navel; heat and itching sensation in the rectum and about the anus; the eyes heavy and dull; itching of the nose; short dry cough; grinding of the teeth; and starting during sleep, attended often with a slow fever.

The round long worm being generally considered to be of the same nature as the earth-worm, I shall briefly notice in what their difference consists. On examining their outward appearance with attention, the human worm will be found more pointed at both extremities than the common earth-worm. The mouth of the human worm consists of three rounded projections, with an intermediate cavity; whereas the mouth of the earth-worm consists of a longitudinal fissure, situated on the under surface of a small round head. Upon the under surface too of the human worm there is a large semilunar fold of skin, into which the head retreats, and out of which it is elongated, which is entirely wanted in the teres. The anus of the human worm is situated on the under surface, a little way from its posterior extremity, and appears like a transverse curved fissure. The anus of the earth-worm is an oval aperture at the very extremity of the worm. The outward covering or skin of the human worm is less fleshy, and not so strongly marked by transverse rugæ as the earthworm. In the latter there is often to be seen a broad white band surrounding the body of the worm; but in the teres this is entirely wanting. On each side of the human worm there is a longitudinal line well marked; in the other worm there are three such lines upon the upper half of its surface, but very faintly marked, so as to be hardly discernible. The human worm has nothing resembling feet, whereas the earth-worm has on its under-surface, and towards its posterior extremity, a double row of processes on each side, very evident to the eye and finger, which manifestly serve the purpose of feet on the locomotion of the animal. The internal structure of both animals is also extremely different; in the human worm there is an intestinal canal, nearly uniform and smooth in its appearance, which passes from one extremity of the worm to the other. In the earth-worm there is a larger and complex stomach, consisting of three cavities, and the intestinal canal is likewise larger and more formed into sacculi than the former; the parts subservient to generation are very different in both; there being in the human worm a distinction of sex, the parts being different in the male and female, whereas the common earth-worm is an hermaphrodite. The human worm depending upon the body it inhabits for a supply of heat, dies almost immediately after it is expelled.

CAUSES. As worms are generally found only in persons of a leucophlegmatic habit, and of weak digestive organs, indigestion may be noticed, if not as the principal cause, at least as favouring the generation. There is nothing, however, in the economy of animals more involved in mystery than the generation of parasitical animals. Were they found to exist in situations out of the bodies of living animals, one might readily suppose that their eggs are taken into the stomach with the food or drink, and there gradually evolved into animals: this, however, is not the case, for they are evidently incapable of exist ing for any length of time in any situation, except within a living animal body, which appears to be the proper place for their growth and residence. We might, therefore, be led to another supposition, viz. that they are really formed from the matter contained in the intestines, which previously had no regular organization; but this idea is widely different to all analogy in the production of animals. The origin, therefore, of such animals is a subject of much obscurity. That they are not produced by ovula of animals taken with the food, is not only obvious from - their being found in the liver, cellular substance of the extremi ties, and brain, but from the frequency of another kind of animal, generated in the kidneys, brain, and liver, named Hydatids.*

TREATMENT. The indications of cure are, first to clear the stomach and intestines of redundant slime, and afterwards to strengthen the stomach and bowels, so as to destroy the disposition to their generation.

The first object is best accomplished by a brisk cathartic medicine, as the basilic powder, a dose of which should be taken every second or third morning, for at least a fortnight, and if the patient has arrived to the age of puberty or advanced beyond it, the Tonic Mixture (B), p. 115, in the intermediate time. Lime

There is not a doubt of hydatids and tubercles being animals: they have been seen to move when taken out of the liver, and they retain their power of motion for some time when put into warm water. The origin of such animals is extremely mysterious; and when the whole evidence of one and the other opinion is compared together, the grounds for believing that in some orders of animals equivocal generation takes place appears stronger than those for a contrary opinion. Persons who wish to consider those animals more minutely, will find an excellent account of them, published by Dr. John Hunter, in the Medical and Chirurgical Transactions.

At the request of several friends of this work, the author has ordered the Basilic Powder to be kept at the Chemical and Medical Hall, 170, Piccadilly, well blended with gingerbread, and carefully divided into nuts, containing twenty grains cach, which, in consequence of being well mixed, may be divided into doses proportioned to the age of the patient. In this form it is readily administered to children, and the ginger in the composition corrects its griping quality;-- - while the most active part of the medicine, being very ponder ous, is frequently lost by being administered in a thin vehicle.

water, being capable of dissolving the mucus in which the worms are involved, may be given to children, in the quantity of three table-spoonsful, two or three times a day.

In domestic medicine, an infusion of Indian pink has been generally employed for the destruction of worms in children, and often with success. The giddiness, stupor, dimness of sight, redness and pain in the eyes, that sometimes affect the patient during the use of this medicine, prove that it should be administered with caution, and not till after safer vermifuges have been tried in vain. The decoction of quicksilver is also a popular remedy.

Powdered rust of iron is a very excellent vermifuge medicine, and where the complexion of the patient is pale, or the system weakly, is preferable to any other. The intestinal canal should be prepared for its exhibition by an active dose of the basilic powder, which should be repeated once a week for three weeks or a month. The powdered rust of iron is recommended by Dr. Rush to be given from five to thirty grains, in a little currant jelly or brown sugar, for children between one and ten years old. "Of all the worm-medicines that I have administered," observes this eminent physician, "I know none more safe and certain than this simple preparation of iron. If ever it fails of success, it is because it is given in too small a dose." Taught by an old sea-captain, who was cured of tape-worms by this medicine, Dr. Rush has given to adults from two drachms to half an ounce of it every morning for three or four days, not only with safety, but with uniform success: the addition of ten grains of granulated tin has been found to increase its vermifuge powers.

The hairy down which covers the pods of cowage, made into an electuary with treacle, is much recommended by Mr. Chamberlayne, a surgeon of London. The electuary, in the dose of a tea-spoonful, is said to be perfectly safe, and that two or three doses generally suffice.

The common male fern-root has been much extolled as a certain remedy for the tape-worm. The following directions. are given for its use: "Two or three drachms of the powdered root to be taken in the morning, no supper having been taken the night before. It generally sickens a little. A brisk purgative, with a little calomel, (as the Basilic Powder, No. 36,) is to be given a few hours after, which sometimes brings off the worm entire; if not, the same course must be followed at due intervals." For the success of this remedy, it is necessary the root should be recently gathered; as after being kept long in the shops, its activity is diminished or destroyed. It should be used recently dug, being brought to a state fit for powdering,

by drying in a gently-heated oven, or within the gentle heat of a fire.

Since the publication of the last edition of this work, the spirit of turpentine has been found to be very efficacious in expelling the tape-worm it is given in the quantity of a large tea-spoonful, mixed with a little honey, twice a day. In some instances the dose was increased to a large table-spoonful. It has been found most efficacious when administered with the croton oil as the anthelmintic draught, p. 106. The patient should take this medicine before breakfast, and continue in bed two hours after he has swallowed it, an horizontal position having been observed to prevent its affecting the head.

The ascarides, or round short worms, are principally lodged in the lower intestines, and, through being enveloped in mucus, are often very difficult to dislodge. With the use of the basilic powder, it will be proper to employ either of the vermifuge clysters, p. 104, as there directed.

In the 90th number of the Gazette of Health, a mode of removing these worms from the rectum by manual means is much recommended by a physician of Edinburgh.

PREVENTION. For the prevention of worms, it will only be necessary to attend to the state of the digestive organs, and to avoid such diet as is likely to disorder them, as acid or unripe fruit, fermented liquors, &c. If the pale or dark appearance of the fæces should indicate a deficiency of the secretion of bile, the patient should take a grain of prepared calomel at bedtime, for five or six nights; for nothing is more destructive to the life of worms than a proper secretion of bile. DIGESTION, p. 403, and ANTHELMINTICS, p. 9.)

(See INChildren are very subject to an irritative fever from having been indulged in too great quantities of fruit or acescent food, which is generally attended with the symptoms I have noticed as denoting the existence of worms. This fever was termed by Dr. Musgrave the Spurious Worm Fever; and by Dr. Butter, the Infantile Remittent Fever. Dr. Hunter states, that he dissected "a great number of children who had been supposed to die of fever arising from worms, in whom he did not discover the least appearance of worms." This fever is evidently symptomatic of a disordered state of the digestive organs, always attended, more or less, with some visceral obstruction or tumefaction of the mesenteric glands, and may be cured by a gentle emetic of ipecacuan powder, the occasional use of the basilic powder, and a little stomachic medicine, as camomile-tea, with the prepared natron, which will also prove of service should the fever arise from worms.

No disease offers such a field for the imposition of quacks as worms. Mercury is the basis of all the worm-specifics that have fallen under my examination. The articles with which mercury is mixed to form it into lozenges becoming acid by keeping, the mildest preparation of mercury is often converted into a powerful poison, nearly equal in violence to arsenic; besides, the mercury not being well blended with the other ingredients, from the quantity that is made at a time, it may, and I know it has happened, that one nut has contained an over-dose of mercury, while another in the same box has scarcely contained any. To these circumstances the many fatal effects that have followed the exhibition of advertised remedies for worms may be attributed.

In my late treatise on the means of regulating the stomach and bowels, and correcting the varieties of temperaments, &c. &c., I have given very copious directions for correcting the constitution which favours the production of worms, rickets, and mesenteric affections in children, under the head of the Leucophlegmatic or Verminous Temperament.