16. Of ?nthelmintics.
By anthelmintics, are meant those me dicines which, without endangering the life of the patient, are effectual in pro curing the removal of worms lodged in the human body. The direct effects aris ing from this class of medicines are in tended to be exerted only on the worms themselves ; but there are at the same time few, if any, medicines, which, when employed with this intention, do not also produce some effect on the animal body : to enter upon the consideration of these, however, would be foreign to this class. As anthelmintics they produce the follow ing effects. They kill worms to which they come to be applied in the body. They expel them from the body. They prevent their generation in the body. The only changes produced in the sys tem, that are here to be considered, are those which arise from their action upon the worms themselves. These are, the removal of an almost infinite variety of different symptoms which worms produce whilst lodged in the body. Anthelmin tics may be subdivided into the following tribes : poisonous, as quicksilver, tin, sul phur; lubricant, as oil of olives and oil of linseed ; tonic, as savin, tansy, santonicum; cathartic, as scammony, jalap, aloes, gam boge. Their indications are manifested from the following considerations : 1. From their action on the worms them selves ; whence they may be employed to kill worms lodged in different parts of the human body. 2. From their action on the system ; whence they may be used to promote the expulsion of worms from the body, whether dead or alive ; to pre vent the generation of worms in the bo dy. These indications may be illustrated and confirmed from practical observations concerning the use of anthelmintics in cases of atrophy, diarrhoea, and vomit ing.
The cautions to be observed in the em ployment of anthelmintics, as derived from their nature, chiefly respect the other effects they have upon the system, independent of their action as anthelmin tics. The conditions of the system which chiefly require attention in their employ ment are, infancy, delicacy of habit, and other similar affections. In the regimen, farinaceous food should be avoided ; and exercise should be encouraged.
There are, perhaps, no morbid condi lions of the system, during which the re moval of worms from the body may not with propriety be attempted by one mean or other. But although it may be doubt
ful whether there be morbid conditions con tra-indicating the whole class, yet it can not be questioned that there are many con tra-indicating particular orders. Among others may be mentioned: an abraded or inflamed state of the intestines, contra indicating the poisonous ; accumulations of feces in the first passages, contra-indi cating the lubricant ; a peculiar sensibili ty of the stomach, contra-indicating the tonic ; and topical inflammation of the in testines, previous looseness, or a high de gree of inanition, contra-indicating the ca thartic.
17. Absorbents.
This term is used differently by differ ent therapeutists. Generally speaking, it implies medicines which, possessing no acrimony in themselves, possess, notwith standing, a power of destroying acidities in the stomach and bowels : at other times, however, it is employed more large ly to indicate those substances, as well, which increase the general action of the absorbent system. They may hence be divided into two kinds: the calcareous, as burnt hartshorn, oyster shells, and chalk ; and stimulative, as burnt sponge, salt of hartshorn, and alkalies. They are hence indicated in peculiar acrimo nies, or peculiar torpidities of the sys tem generally, or particular organs of the system ; and may hence be employed be neficially in acidities of the stomach, heartburn, and excesses in a vinous po tation ; as well as in strumous and other leucophlegmatic affections of the glandu lar system ; especially in bronchocele, or the disease termed provincially Derby shire-neck, and scirrhosities of either ex tremity of the stomach. Their use may be collected from practical attention to these diseases, in which, notwithstanding, they commonly require to be connected with more active applications. On this last account they may generally be em ployed without apprehension : yet in cases of acidity of the stomach, they have often been used to an extent that has produced worse diseases than the malady they were intended to remedy, and have laid the foundation for calcareous concretions, that have resisted the application of almost every purgative, and formed indurations almost as troublesome as the calcareous concretions of the bladder : concretions which have only been removed by a long use of active lithontriptics.