PATHOLOGY. 
m 
worm ; and Dr. Lifter, apparently without knowing that 
the fubjedl had been touched on before, defcribes the cafe 
of a patient, who, after having “ had about his ftomach 
and right fide a molt exquifite and tormenting pain for 
at leaft four months, which many times threw him into 
horrors and chillr.efs, ague-like, and was the fickeft man,” 
continues he, “ I ever faw not to die,” vomited up a 
worm of a dark-green colour, like a horfe-leech, and 
/ported. From the pundiure of the animal, or the vio¬ 
lence of the retching, he brought up at the fame time 
two pounds of coagulated blood: and had occafionally 
dilcharged blood downwards. The man imagined he 
drank it in pond-water during the preceding fummer. 
The worm was dead when rejected, or at leaft when Dr. 
Lifter faw it: four inches long, and three in its largeft 
circumference; and is ftill farther defcribed and drawn 
as having three fmall fins on each fide near the head, with 
a forky, finny, tranf'parent, and extenfile, tail. Phil. Tranf. 
1681-2. No. 6. 
- One of the moft extraordinary cafes, among thofe en¬ 
titled to attention, is related by Mr. Paifley in the Edin¬ 
burgh Medical Eftays, ii. art. 26. In this cafe there were 
two worms, whole heads he compares to that of the 
horfe-leech, and which appear to have been tolerably 
quiefcent in their growth, till the general fyftem was 
diiturbed by a wound on the breaft, received by the pa¬ 
tient in confequence of a duel, with the fmall lword. 
The general fymptoms of this fpecies of Helminthia 
appeared about the third day afterwards, and continued 
with many variations for feveral weeks, when the pa¬ 
tient difcharged inferiorly one of thefe worms, meafuring 
a foot and a half in length, and an inch and a half in 
diameter, dead,, but full of blood, and accompanied by 
a large dejedlion of grumous blood, “ to appearance fome 
pounds;” and not many weeks afterwards the other, ftill 
larger.—A worm, apparently fimilar, is ftated by Dr. 
Bond of Philadelphia, 1754, to have been difcharged 
downwards by a female patient of his, who had been 
long fubjedl to an hepatic difeafe, which gradually 
changed to violent helminthic fymptoms in the ftomach. 
Thele, at length, fuddenly vanifhed ; and within twenty- 
four hours the worm was dejefted, dead, and in two 
parts, the whole making twenty inches in length. The 
patient died foon after; and, on opening her, this worm 
appears to have worked its way, when fmall, into the 
liver by the courfe of the common dudl, to have com¬ 
mitted great depredation here, and afterwards, with con- 
iiderable difficulty and dilation o€-the duff, to have tra¬ 
velled back again. Dr. Bond ventures to call it an hepa¬ 
tic leech; though he calculates its courfe as now ftated. 
London Med. (Jbj'erv. and Inq. i. 68.—Maroja, phyfician to 
Philip IV. of Spain, in his treatife De Morhis Internist, 
lib. iv. cap. 16, mentions the cafe of a patient who dif¬ 
charged a ftill larger dead round worm of the fame mon- 
ilrous kind, and died in the aft of difeharging it: its 
length was twenty fingers breadth ; its rotundity equal 
to the fize of a ftout man’s hand ; full of blood, and had 
more than a pound and a half of blood taken from its 
infide. 
y. H. Mufcas cibariae ; larvae of the pantry-fly. Thefe 
feem chiefly to produce mifehief while in the ftomach, 
into which they may be taken with decayed cheefe, as 
the eggs are fometimes depofited in it. See Dr. White’s 
cafe, Mem. Med. Soc. Lond. vol. ii. The patient, aged 
thirty, was emaciated, of a fallow complexion ; had gri- 
pings and tendernefs of the abdomen; coftivenefs, ri¬ 
gors, and cold extremities. Took columbo-root, and oc¬ 
cafionally calomel and other purgatives. In a month 
was better, and the appetite good. The next purgative 
brought away an immenfe number of pupes, or chryfalid 
worms; fome of which, being preferved, were tranf- 
formc-d into four-winged infedls, the Mufca cibaria. 
Mr. Church, to whofe entomological fk.il 1 thefe worms 
were confided, a Herts that he once knew a child difeharge 
a larva of the caddy infedl (Phryganea grandis) ; and 
that the Phalsena pinguinalis lives and is nourifhed in the 
ftomach; and, after fuftaining feveral metamorphofes, is 
thrown out, and proves its proper genus. See alfo Mr. 
Calderwood’s cafe ; Edin. Med. Com. ix. 223. 
The fymptoms of worms are as various and complica¬ 
ted as we ftiould naturally expedt to find them, when we 
take into confideration the multiform efledl of nervous 
irritation on all parts of the body. When fpeaking of 
the functional difturbances of the alimentary canal, we 
have endeavoured to ftiow how the irritated extremities 
of the nervous expanfion of the ftomach and bowels will 
convey nervous irritation to every other organ, and after 
a time induce more important changes. The fame rea- 
foning will apply to the efredl of worms, which are to 
the nerves irritants of extreme power. To deferibe, 
therefore, all the fymptoms of worms, would be endlefs ; 
and it would moreover be ufelefs, lince they may be fimu- 
lated by every other nervous diforder. The only certain 
fign of their exiftence is their being feen in the ftools ; 
but in many this is not obferved till their prefence has 
produced much gaftric and inteftinal difturbance. Ac¬ 
cording to profeffor Brera, in perfons attacked by worms, 
the colour of the countenance is changed ; it is fome¬ 
times red, then pale, or leaden-coloured. A half circle 
of azure appears under the eyes ; they lofe their vivacity, 
and are fixed and motionlefs with regard to furrounding 
objedts ; they are fad and dejedled ; the lower eye-lids 
fwell, and the pupils are evidently dilated. At other 
times the eyelids are yellowifh, and the fame tint extends 
over the white of the eye. There are alfo infupportable 
itchings in the noftrils, with occafional haemorrhage 
from the fame parts ; headache is frequent, efpecially 
after taking food ; this is fometimes fo violent as to 
produce delirium and phrenitis. The mouth is full of 
laliva, and exhales a fetid and verminous odour; there 
is grinding of the teeth; uneafy and agitated fleep, and 
great thirft. Sometimes fomnambulifm renders the pa¬ 
tient timid. Fainting, vertigo, and tingling of the ears, 
augment the morbid ftate of the fufferer. The cough 
is dry and convulfive, fometimes ftertorous, and even 
fuffbeating ; refpiration is difficult, and fometimes at¬ 
tended with hiccough; fpeech is interrupted, and in 
fome inftances entirely fuppreffed. The mouth is frothy, 
and there is palpitation of the heart; the pulfe is hard, 
frequent, rapid, and intermittent. The belly is tumid, 
and troubled with borborygmi; there are eradiations, 
naufea, retching to vomit, and vomiting. At one time 
there is no appetite; at another it is fo great, that the 
patient is compelled to take more food than ordinary. 
The belly fwells, and is the feat of fevere pains; there is 
a fenfe of pricking and tearing, which is not fixed, but 
wanders over the whole abdominal cavity ; thefe fuffer- 
ings are aggravated wdien the ftomach is empty, and im=C 
mediately ceafe on taking food. The bowels are fome¬ 
times relaxed, fometimes coftive. The urine is crude 
and turbid ; the excrements fetid ; cardiaigia afflidts the 
patient, and fometimes deftroys him; the body is ema¬ 
ciated, though the patient eats much ; and violent itch¬ 
ing of the anus fometimes occafions fainting. At other 
times tenefmus aggravates the pains of thefe parts. 
Languor, anxiety, liftneifnefs, and extravagance in con- 
dudl, difeourfe, and the intelledlual fundlions, are ob¬ 
ferved in perfons harraffed with worms. 
The profeffor has alfo feen pains of the joints, refem- 
bling arthritic rheumatifm, resulting from worms. Wei- 
kard relates the cafe of a woman who was long harafled 
with headache, fpafmodic affedlion of the eyes, vertigo, 
fub-apopledtic attacks, and occafionally temporary blind- 
nefs. One day, feeling fomething in her nofe, flie ex- 
tradled, with a hook, a living lumbricoides, and then 
three more. Some anthelmintic remedies now preferibed 
brought away feven worms per anum, when the woman 
was perfedlly cured of her diftrefling complaints. Worms 
hav® 
