Ant Helm in Tics

7/31/2019 Ant Helm in Tics

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GROUP X

Agent s Act ingUpon Micro-organism s an d Paras i t es

CHAPTER II.

Agen t s Act in g upon In t es t in a l Paras i tes

An t h elm in t ics .

SANTONICA

S PIGELIA

AS PIDIUM

CHENOPODIUM

CONVOLVULUS

MA LLOT US

KOUSSO

POMEGRANATE

SANTONICA. A r t e m i s i a p a u c i f lo ra .

Synonym Levan t Worms eed.

CONSTITUENTS

Sa n tonin , volat ile oil, gu m , res in .

PREPARATIONSSantonin is a crystalline neutral principle, derived from

Santonica. i t occurs in the form of shining, colorless, or slightly

yellowish, f lattened, prismatic crystals, odorless, and at f irst tasteless,

but subsequently bitterish. Nearly soluble in cold water, soluble in 250

parts of boiling water, and in forty parts of alcohol. Slightly soluble inchloroform an d ether .

T r oc h e s c i S a n t o n i n e , Troches of Sa n tonine. Dose, from one t o six

troches . San tonin. Dose, from on e-fou rth to two gra in s.

Ph ysio logica l Act ion Five grains of santonine given to a child causedpain in the stomach, convulsions, insensibi l i ty and death. Various

phenomena are produced by even smaller doses, as everything

appearing yellow or red throughout the field of vision; urine stained

deep yel low; a punct iform rash or an erupt ion l ike that in measles;

amaurosis, f lushed face, hot head, twitching of the eyeballs, dilatation

of the pupils, foaming at the mouth, clenching of the teeth, jerking ofEllingwood s - Agents that act as Anth elmin tics - Chap er 2 - Page 1


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th e arm s, s ter torous breath in g. Two grains cau sed th e death of a feeble

child.

Generally, recovery takes place after these symptoms, but occasionally

dea th follows.

Spe ci fic Sym pt om a t o logyThe following indications, seldom all

presen t a t th e sa m e t im e, poin t to the p resen ce of lu m bricoid worms in

the al imentary canal . They may also be present in par t , induced by

various other causes of intestinal irr i tation. There may be intense

itching of the nose in children, the child rubbing or boring the nostri ls,

with bloated abdomen, restless sleep, crying out in affright, grinding of

the teeth at night, groaning in sleep, complete loss of appetite, tongue

deep red without coating, deficient saliva, nausea, vomiting, fetidbreath depraved, erratic appetite with longings, great thirst , aversion to

food, abdomen enlarged and hard, diarrhea with whit ish, s l imy stools ,or bowels constipated followed by looseness, colicky pains in the

bowels, vomiting and purging after meals, worms discharged with the

stools , cram ps in th e bowels a t n igh t , itching at th e arm s, lim bs wasted,

face pale, skin sal low and unheal thy looking, constant urging to

ur inate, wet t ing the bed, ur ine whit ish and cloudy, scalding, dry,

hacking, constant cough, t ickl ing in the larynx and t rachea,

convulsive movements of the hands and arms, sensi t iveness to the

touch over the whole body, twitching of the muscles, lividity of the face,

arrested breath, severe choking sensat ions, convulsive contract ion of the fingers, general convulsions with violent agitation of the limbs,

chorea, haziness of s ight , loss of consciousness, rest lessness, not

satisfied with anything, will not sleep, fever occurring daily, usually in

th e afternoon.

T h e r a p y The generally accepted influence of santonine is in the l ine

of i ts anthelmintic properties. I t is an excellent remedy for the long

wormas caris lum bricoid es . It is given in doses of from one-half to one

grain, twice or three t imes daily. In the above symptomatology,

however, I have named a long list of symptoms, which are due toi n t e s t i n a l or g a s t ro -i n t e s t i n a l ir r i t a t i on . In a few cases they may bedue to other reflex influences. Many of these symptoms should be

treated with sa n tonin , with out regard to the presen ce of worm s. In fact ,

if we properly study this remedy, we must put aside entirely the idea of

i ts anthelmint ic proper t ies, and consider i t as a nerve sedat ive, as an

ant ispasmodic and as a posi t ive and rel iable agent with which to

Ellingwood s - Agents that act as Anth elmin tics - Chap er 2 - Page 2


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relieve, nerve i r r i ta t ions , es pecially th ose of a reflex character .

I have made some very conclusive observations in the past f if teen yearsthat convince me that this remedy is the best remedy we have with

which to relieve reflex irritation, when the cause of the irritation

cannot be at once determined. This is an entirely new field forsantonin. I was once treating a child who suffered from all the

symptoms of nerve irr i tation which are present with worms. I gave

santonin to remove the worms. Santonin relieved the nervous irr i tation

in a most s a t is fac tory man ner , bu t s u bsequen t observat ion proved th a t

there were no worms present , but that the i r r i tat ion was due to faul ty

digestion and decomposition of food. I was at once impressed that the

agent had relieved the irr i tation by its influence upon the nervous

system , in depen den t of an y act ion i t migh t h ave h ad u pon th e worms .

From this observation, I began at once to administer i t in all caseswhere there was re f lex i r r i t a t ion . I was consulted concerning a child

seven months old, who had a p e r s is t e n t h a c k in g c o u gh from its b irth ,

which resisted all treatment. I allayed the cough in twenty-four hours

with ha lf gra in doses of sa ntonin , an d th e cure was perma nen t .

I was consul ted concerning an i r r i table hear t in an old lady, who was

so enfeebled from the violent and irregular action of the organ that she

h ad n ot been a ble to do an ything wh at ever for over two years . Th e hea rt

disorder did not seem to be suff icient to cause the extreme weakness,and I treated it with santonin, as a case of reflex irr i tation. The results

were indeed most surpr is ing . The pat ien t was around the house and

as sist in g with th e work with in less th an a week.

A physician reported a case to me that was suffering from persistent

protra cted fever, with n ervou s p h en omen a, th at sh owed it to be of reflex

origin, as all other causes were excluded in the examination. After all

known methods had fai led, three doses of santonine, one grain each,

reduced the tempera ture a lmost to normal , and tha t agent a lone

cau sed th e perman ent a ba temen t of th e fever .

I advise with full assurance of satisfactory results, that this remedy be

used freely in the treatment of reflex irritations. I do not think it will be

found necessary to give i t in large doses. From one-half a grain to a

gra in an d a h alf in an extreme cas e, will, I th in k, b e su fficient .



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I would suggest that i t be carefully used in the reflex irr i tations of

pregnancy, especial ly when there is scanty ur ine, or when there is

deficiency of renal action, with much local irritation. Also in thebeginning stages of the album inu ria ofp r e g n a n c y . I am confident that

it will do much towards preventing p u e rp e ra l c o n v u l s i o n s if given

ear ly. I think there are some cases of the vomit ing of p r e g n a n c y t h a twill be quickly allayed by it. I advise that it be given in h y s t e r i c a l

conditions, and in those difficulties where there is i rr i ta t ion of theovaries and ir r i tat ion at the menstrual epoch, especial ly i f

accomp an ied with some pa in .

Lydston advised the use of this remedy in large doses in the t reatment

ofe p i l e p s y . Its a n t isp as m odic proper t ies wou ld s u ggest th at i t be u sed

in cases where the spasms are due to ref lex i r r i tat ion; whether i tpossesses suff icient ant ispasmodic proper t ies to control spasm, as

gelsem iu m , chloral an d other a gents of th at ch ara cter do, remains to beproven.

Santonine at t imes is a positive remedy with which to i nc rease th e

secretion of ur ine in children. I t gently stimulates the functional

action of the organs, promotes normal secretion and relieves irr i tation.

It is without doubt, our best remedy with which to restore the secretion

in post sca r l a t ina l or p o s t d i p h t h e r it i c n e p h r it i s . In th ese cases it ma y

be alternated with positive doses ofbelladonna . In conjunction with a

pers ist en t a pp lication of h eat, it will be fou n d u sefu l in p o s t p u e r p e r a lnephri t is , of an acute character , and probably in other cases, where

su dden s u ppress ion h as resu l ted from profou n d sepsis .

Where we find colic with loose, slimy stools, it points to intestinal

disorders, while convulsive movements are reflex symptoms,

consequent upon the intest inal disease. These are benef i ted by this

agent .

Santonine inf luences these condit ions by st imulat ing the great

sympathetic and giving tone to the functions of digestion andnut r i t ion .

It has been employed with advantage in nervous fa i lu re of sight ,

nervous vomit ing and nervous diarrhea; but i t is doubtful whether i t

has ever improved the sight in amaurosis or cataract , as has been

claimed.



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Santonine causes yellow vision and yellow urine, Where worms are

demonstrated to exist in the bowels, i t is a common practice to givesantonine with a cathartic of podophyllin, or follow it with castor oil.

Th e agen t is toxic , as s ta ted, an d s h ould not be given in m ater ial doses

for the special purpose of destroying worms, when the child iscons tipa ted or su ffering from fever.

SPIGELIA. S p i g e li a m a r il a n d i ca .

SynonymMar ylan d Pin k .

CONSTITUENTS

Spigeline (bitter principle), fixed oil, volatile oil, resin, wax,

tan nin , sa lt s .

PREPARATIONS

Ext ra c t um Sp ige l iae F lu idum . Fluid Extract of Spigelia. Dose,

from one-half to two drams.

T h e r a p y Spigelia is specific in the removal of intestinal worms. It

need not be given in large doses, and if used with proper care, is most

effectu a l. An excellen t form u la is the followin g, which con ta in s u n itedaction of th e two agen ts : Flu id extra ct ofspigelia, two drams ; san tonine

pulverized fifteen grains; simple elixir, a sufficient quantity to maketwo ou n ces. A teas poonfu l is given on r is in g an d ret ir in g.

If this agent is followed, on the third day, by an efficient non-irritating

laxative, it seldom fails to remove lum brico ids . The worms are not

always entire when removed, but the evidences of their presence are

gone, a slimy or heavy mucous discharge occurring from the action of

th e ph ysic.

Spigelia is sa id to h ave a m ild influ ence u pon th e h ear t . Webster s ays i t

is b en eficial in en docard it is , esp ecial ly in th e rh eu m at ic form, a n d th atit will protect the heart from rheumatic attacks. I t is stated that i t is

beneficial in angina, in all neuralgic heart affections, and in

functional palpitations. The S pigelia An the lm intica is th ought to be more

act ive in i ts inf luence upon the hear t than the Spigelia Marilandica ;

oth erwise th ere is b u t lit t le differen ce in th e two s pecies.



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CHENOPODIUM. Ch en opod iu m a m bros io ides .

SynonymAmerican Wormseed.

The oil of the herb and of the seed is the only preparation ofchenopo-

dium used. It is a thin, colorless, or slightly yellow liquid having apene. t ra t ing camph oraceou s odor an d a pu ngent . an d somewhat b i t te r

taste .

This is str ictly an American product, large quantit ies of the oil being

produced in this country though the foreign demand should establ ish

foreign sources of supply.

T h e r a p y This agent has long been used as a remedy for worms bu t

because of an early objection made to i ts use on the grounds of certain

subtle , dangerous proper t ies, i t has not come into general use. In

sufficient doses of from ten to twenty minims of this oil, it was

recommended to expel the round worm. Our own authori t ies seldom

recommended above five minims which was not always sufficient

thou gh sa fer .

A recen t report pu ts th is a gent in i ts exact place as an an th elm in t ic . In

the Orient , especial ly in Singapore and in Sumatra, the oil of

chenopodium is extensively employed against hookworm and o the r

intest inal parasi tes. More than 100,000 cases of hookworm of both theOld and New World types have been treated with practically nountoward effects , and with greater success than with any remedy

h eretofore em ployed.

In Sumatra, i t is used also with equal confidence, in the t reatment of

roundworm , t apeworm , an d whipworm . Weiss of Kisaran treated 5,000

cas es of h ookworm with h i ghly sa tisfactory resu lts . Th ere was one cas e

of nephrit is which he thought might have followed it , but the case was

quickly control led. Schuffner and Baermann in Sumatra have t reated

over 40,000 cases without after effects, and with results superior tothose obtained from thymol. They Conclude that the efficiency of this

rem edy over th ym ol is a s 9 1 to 83.

Adminis t ra t ionThe method of the above observers is to give the

patient a l iquid diet for an evening meal, no breakfast on the followingmorning. From ten to sixteen minims of the oil is placed on sugar



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brea kfas t. Oils s h ou ld n ot be given a fter th is a gen t, as th ey facilita te th e

absorption of i ts toxic principle which exercises a profound influence

upon the nervous system. Saline laxatives or vegetable laxatives maybe administered. The usual preparat ion of the pat ient is essent ial and

it is necessary to follow the removal of the worm with mild tonics and

restorat ives. Unlike those of ten used, this agent does not produceunpleasant results, being in every way a safe remedy if taken in proper

doses.

It does n ot im pa ir th e app et ite or redu ce the st ren gth .

CONVOLVULUS. Con volvu lu s s ca m m on ia .

SynonymScammony.

CONSTITUENTS

Resin (scammonin, identical with jalapin), gum, fibre, starch.

PREPARATIONS

Regina Sca m m on iae , Resin of Scammony. Dose, from three to

eigh t grains .

T h e r a p y Scammony is a vermifuge and is useful in combinat ion withother vermifuges to increase their action. I t also acts as a cathartic for

their removal, as i ts cathartic influence is of considerable importance.It is hydragogue and irr i tating in large doses and more or less

depressing. I t has a certain eliminative influence, and like

podophyllum, has been given in conjunc. t ion with alteratives. I t is

greatly superseded in this l ine of action, by many other of our agents

bet ter known .

MALLOTUS. Ma l lot u s p h i l ip p in en s is .

Syn onyms Kam ala, Kam eela.

CONSTITUENTS

Resin 80 per cent, citr ic, oxalic and tannin acids, rott lerin,

malotoxin, paraoxybenzoic acid.

PREPARATIONS

Sp ec ific Kam ala . Dose, from th irty to sixty m in im s.



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T h e r a p y Kamala is an efficient remedy for t apeworm , ranking next to

male fern . No preparation for i ts administration is necessary. Tocounteract gr iping i t should be taken in cinn am on w ater or combined

with hyoscyamus . If the first does does not act, i t should be repeated in

fou r h ou rs or followed with a d ose ofcas tor oil.

Kamala may be employed as an external application in herpetic r ing.

worm, scabies an d o ther sk in d iseas es .

BRAYERA. B ra y e r a a n t h e lm i n t i c a .

SynonymKousso.

CONSTITUENTS

Bra yerin (a bit ter , a crid res in ), vola ti le oil, ta n n in .

PREPARATIONS

E x t ra c t u m Kou s s o F lu i d u m , Fluid Extracts of Kousso. Dose, from

one to six dram s.

T h e r a p y Kousso is given for the removal of the tapeworm. An infusion

of h alf an oun ce in a p in t of water sh ould be ma de an d dru n k on r is in gin the morning. The pat ient should take but l i t t le food during the day,

and if the bowels do not move freely, a physic should be taken at night.An extractive is obtained from the plant, known as Koosin, which is

given in doses of twenty grains. The fluid extract in two dram doses is

also given. The, agent is said to possess abortive properties. All

in tes t in a l ir r itan ts s h ould be given with care in p regn an cy.

GRANATUM. Pu n i ca g r a n a t u m .

Synonym-Pomegranate .

CONSTITUENTS

Pelletierine, a colorless liquid, soluble in twenty parts of cold

water, freely solu ble in alcoh ol. Acted u pon by s u lph u ric, h ydrochloric,

or hydrobromic acids, a crystall ine salt is formed in each case. With

tannic acid, the tannate of pelletierine is formed, a yellowish powder,

odor less , pu n gent , a s t r ingen t .



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Dose of th e a lka lo id , from on e-tent h to on e-ha lf grain.

Dose of th e sa l t s o f th e a lka lo id , from on e to five grain s.E x t r a c t u m Gra n a t u m F lu i d u m . Flu id E xtract of Gran atu m . Dose,

from fifteen to th irty m in im s .

Ph ysio logica l Act ionPomegranate has an astr ingent inf luence qui te

marked, at the same t ime in ful l doses i t produces evacuat ion of the

bowel , and in some cases i r r i tat ion and emesis may be induced. A

decoction of the fresh bark of the root will produce the best results,

when th e an th elm in t ic in flu ence of th e agent i s des ired .

T h e r a p y It is a specific for the destruction of the t apeworm . Two

ounces of the fresh bark is macerated in two pints of water for twenty-four hours, when it is then boiled down to one pint. After fasting one

day, the p at ien t m ay tak e a win e-glas s of th is every h our , u n t il th e pin tis taken. I t may induce vomiting and purging, but if the bowels do not

move freely, a physic should be given near the end of the treatment, or

sometimes a glycerine enema will be sufficient. If not at first

successful , the t reatment should be repeated within. a few days. When

the f resh bark cannot be obtained, the alkaloid or i ts sal ts may be

resor ted to . This agent has been used in diarrhea and in col l iqua t ive

n i gh t s we a t s . In bronchorrhea and as a gargle in var ious forms of s o r t

th roa t , i t has produced good resul ts . I t has been used both internal ly

an d as a dou che in l euco r rhea .

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Ant Helm in Tics