36 
Hookworm  Disease. 
f  Am.  Jour.  Pharm. 
\    Jannary,  1915. 
Medicus  revealed  but  12  published  cases  of  poisoning  by  wormseed 
011  in  something  over  50  years,  the  first  having  been  published  in  1852 
and  the  last  in  1903.  Of  these  cases  8  were  fatal.  The  report  of  one 
of  the  fatal  cases  is  cited  by  Wood,  with  the  added  comment:  "  It  is 
plain  that  the  wormseed  was  not  the  direct  immediate  cause  of  all 
these  symptoms  or  of  the  fatal  result."  All  of  the  reported  cases, 
however,  show  a  certain  general  similarity,  indicating  that  the  toxic 
action  is  exerted  particularly  upon  the  central  nervous  system.  Salant, 
in  a  preliminary  report  of  his  studies  on  the  pharmacology  of  this 
oil,  notes  the  possibility  of  cumulative  action,  indicated  by  the  fact 
that  non-toxic  doses,  when  repeated  in  a  day  or  two,  were  fatal  in 
the  rabbit.  In  the  reported  cases  of  poisoning  the  dose  appears  to 
have  been  excessive  and,  in  some  cases,  repeated.  B riming  asserts 
that  when  properly  used  this  remedy  does  not  cause  any  unpleasant 
secondary  actions,  an  experience  confirmed  by  that  of  subsequent 
workers. 
It  is  to  be  noted  that  oil  of  chenopodium  is  a  paralyzant,  rather 
than  a  parasiticide.  It  narcotizes  the  parasite,  which  must  then  be 
got  rid  of  by  free  purgation.  Moreover — and  here  it  differs  radically 
from  aspidium  and  thymol — it  is  probably  best  administered  with 
castor  oil.  In  the  case  of  aspidium  and  thymol  the  coincident  or 
subsequent  use  of  any  oil  is  to  be  avoided,  because,  their  constituents 
being  soluble  in  oils,  they  are  thereby  rendered  more  toxic  to  the 
human  subject.  With  reference  to  chenopodium,  which  in  itself 
appears  to  be  constipating,  the  castor  oil  does  not  add  to  its  toxicity, 
but  offers  a  ready  method  of  ridding  the  host  both  of  the  parasites 
and  the  drug. 
Schiiffner  and  Vervoort  administered  16  drops  of  oil  of  chenopo- 
dium with  sugar  every  two  hours  for  three  doses.  Two  hours  there- 
after they  gave  a  tablespoonful  of  castor  oil  with  a  teaspoonful  of 
chloroform.  Gockel  gives  the  single  dose  as  8  to  16  drops,  according 
to  age — 6  to  8  years,  8  drops ;  9  to  10  years,  10  drops;  11  to  16  years, 
12  drops ;  over  16  years,  12  to  16  drops.  Should  untoward  symptoms 
arise,  particularly  inordinate  sleepiness  or  depression,  the  chenopo- 
dium should  be  withdrawn  at  once,  active  purgation  induced,  and 
stimulation  begun  with  strong  hot  coffee  by  the  mouth  or  by  the 
rectum. 
Owing  to  its  increased  vogue  in  continental  medicine,  the  demand 
for  this  product  has  increased  in  the  past  few  years.  Schimmel  re- 
ports that  the  acreage  put  to  wormseed  increased  from  about  oo  acres 
