58 



tremors, convulsions, and finally death. Two grains are said 

 to have proved fatal to a child of five. 



Rectal Treatment. 



A great and varied number of agents have been administered 

 by the rectum 1 in the attempt to destroy, or drive out, thread- 

 worms, some of which have already been mentioned. The 

 most popular are ice-cold water (as used by Van Swieten), 

 lime-water, salt-and-water, infusion of quassia, turpentine, 

 and solution of perchloride of iron, as vermicides, and warm 

 water, soap-and-water, sugar-and-water, Epsom salts, oil, 

 and glycerine, as vermifuges. 



Among the less common remedies, mention may be made 

 of tobacco smoke ; and also of ether, naphthaline and corrosive 

 sublimate. 



Every kind of rectal treatment is open to serious objection. 

 It is more than doubtful if substances injected in enemas ever 

 reach as high as the ccecum, and, if given in suppositories, they 

 certainly do not ; while their administration is apt to cause 

 pain, griping, tenesmus, and, frequently, diarrhoea. But, 

 apart from these immediate effects, due to the drugs used, the 

 repeated use of enemas of any kind must have a tendency to 

 relax the rectal walls, and so cause piles, and to weaken and 

 distend the sphincter muscle, thus leading to prolapsus ani, 

 which occurs on very slight provocation in weakly children. 

 Moreover, there is always a risk, when powerful drugs are 

 used in this way, of absorption taking place, and producing 

 symptoms of constitutional poisoning. 



Expectant, or Hygienic, Treatment. 



Of all orthodox methods of treatment the expectant, or 



1 KUECHENMEISTER admits that sigmoidea hinauf eingefiihrt werden. 



only drastic enemata, which reach Auf diese Weise gelangt der Strom 



beyond the sigmoid flexure can be des Lavements, was eine Haupt- 



trusted : " Heilung kann man nur sache ist, auch zu den iiber der 



durch lange f ortgestzte allabend- Flexura sigmoidea befmdlichen Oxy- 



liche Lavements erreichen, und in uren. Leider entgeht der Ein- 



einigermaassen hartnackigen Fallen wirkung des Klystieres auch immer 



auch dann nur, wenn man sich noch eine grosse Anzahl jener 



hierbei der neuerdings, besonders Wurmexemplare, die sich hinter den 



von Griesinger empfohlenen elas- Mastdarmfalten verbergen und ver- 



tischen Ansatzrohre oder Katheter halten." (KUECHENMEISTER, G. F. 



bedient, die bis iiber die Flexura A., op. cit., vol. i., p. 289.) 



