They are considered in the article Alkalies (ante).
2902. Anthelmintics are agents which destroy, or cause the expulsion of, intestinal worms. They are sometimes called Vermifuges. They may be divided into four classes: - 1. Specific. 2. Mechanical. 3. Purgative. 4. Corroborant or Preventive.
1. Specific Anthelmintics are those which, by some poisonous property which they contain, destroy the worm whilst in the intestines. In this division may be classed Turpentine, the Male Fern, Pomegranate, Sabadilla, Kousso, Wormseed, Santonin, Rottlera, and Spigelia. The evidence of their specific action is that the worm is expelled lifeless. Most of this class require a brisk purgative to assist and complete their action.
2. Mechanical Anthelmintics operate by irritating and wounding the worms, and thus oblige them to leave their hold on the mucous coat of the intestine. Of this class, two only are at present employed, and even these rarely: viz., Tin-filings, and the setAe or hairs of the pod of the Mucuna Pruriens or Cowhage. That they do not act poisonously on the worm is evident from the fact that, under their use, it is generally voided alive. A brisk purgative is required to evacuate the worm after it has been obliged to quit its hold on the mucous membrane.
3. Purgative Anthelmintics are those which cause the expulsion of the worm, by their action on the intestinal canal. This they effect, partly by increasing the peristaltic action of the bowels to such a degree that the worm is unable to retain its hold, and partly by clearing away the accumulations of mucus with which the worms are so often found surrounded. The
worms thus become detached, and are expelled generally alive. All the more powerful purgatives, particularly Scammony and Jalap, are included in this class. In every case their operation is increased by a combination with Calomel; indeed this last medicine may itself lay some claim to the character of a specific anthelmintic, as worms are sometimes expelled dead after a full Calomel purge. Purgative anthelmintics are peculiarly adapted for children; the Pulv. Scammon. Co., in full doses, is, perhaps, the most efficient of the class.
In order to ascertain the remedies to be classed in this division, it is necessary to ascertain, first, what condition of the intestines or system is most favourable to the development of these parasites; and having done this, it should be the object of the practitioner to apply those remedies which appear the most probable to remove that condition. Now, it appears that debility, and a vitiated, state of the secretions dependent upon unwholesome diet, are conditions the most favourable to their production; and to remove this state, wholesome, digestible food, ferruginous preparations, and vegetable bitters, are indicated, and will, in the majority of cases, prove successful. Common salt appears to be particularly effectual, and considerable quantities may be given, not only as an article of diet, but as a medicine. The absence of salt as an ordinary condiment appears, more than any other circumstance, to favour their production. The Sulphate of Iron I have found an excellent preventive. Dr. Paris states that, in his experience, Hydrochloric Acid with infusion of Quassia is the most efficacious remedy of this class.
2903. It should be remembered that certain anthelmintics are more effectual against one class of worms than against others: thus, Pomegranate, the Male Fern, Sabadilla, Rottlera, Turpentine, and Kousso are chiefly effectual against Tania Solium, or Tape- Worm; purgatives of Calomel and Scammony or Jalap, the Oil of Turpentine, Tin-filings, Cowhage, Spigelia, Santonin, Andira Inermis, &c, against Ascaris Lumbricoides, or Round Worm; and enemas containing Turpentine, T. Ferri Sesqui-chloridi, Quassia, Olive or Castor Oil, Assaftida, and common salt, against Ascaris Vermicularis, or Thread-Worm. It is only against the last class (thread-worm), and then only when situated in the rectum or lower intestines, that enemas, either simple or medicated, can be of any permanent benefit. (See Enemas.) The irritation caused by this worm is best relieved by enemas of Olive Oil. As a general rule, anthelmintics are less efficacious when given singly than when given combined with other medicines of the same class.
2904. Antidotes are remedies given to counteract the noxious
effects of poisonous substances. They are of two classes, Chemical and Mechanical. The first includes all those agents which, when taken internally, decompose the poison, and render it inert or less noxious; the second comprises those agents which act simply by sheathing the mucous surface of the intestines, enveloping the poisonous particles, and obstructing their absorption. Amongst these may be mentioned gelatinous, albuminous, oleaginous, and saccharine substances, demulcents, &c. The two classes of antidotes may often be advantageously combined.
2905. Antiphlogistic, a term applied to agents which are employed to diminish or subdue inflammatory action. Amongst the remedies chiefly classed under this denomination are, bloodletting, Calomel, Antimony, Digitalis, and Colchicum. They operate by lowering the action of the heart and arterial system, reducing vascular excitement, diminishing the quantity of fibrine in the blood, and increasing all the secretions, particularly those of the skin and bowels.
Antiphlogistic regimen is the system of diet and hygiene employed to co-operate with the above-named remedies. It consists of low diet, and bodily and mental rest. It includes abstinence from animal food, from all spirituous, vinous, and fermented liquors; the avoidance of all strong emotions and mental agitations, of muscular action, in fact of everything which may tend to quicken the circulation, or cause disturbance, either mentally or bodily. If a limb be inflamed, rest in the horizontal position should be maintained; if the brain or head, an erect position is preferable; if the lungs, all exercise of the vocal organs should be prohibited; if the eye, strong lights should be avoided; if the ear, silence should be enforced. The admission of pure air, by proper ventilation, into the patient's apartment, is a point never to be neglected. A temperature of about 62° F. should be maintained.
It is indicated, 1, in all acute inflammatory, and febrile Diseases, of a sthenic type, occurring in healthy subjects; 2, in plethora; 3, in Acute HAemorrhage; 4, in certain injuries, particularly in those of the Head and of the Eye.
2906. Antispasmodics are remedies which relieve existing spasm, and prevent its recurrence. They may be divided into four classes, as follows: -