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INAUGURAL ESSAY 
 
 O N T H E 
 
 ANTHELMINTIC QIJ A L I T Y 
 
 O f'i the 
 
 Phafeolus Zuratenfis Siliqua hirfuta, 
 
 O R 
 
 COW-ITCH. 
 
 Submitted to the EXAMINATION of the 
 
 Rev. MYLES COOPER, L. L. D. President, 
 The GOVERNORS, 
 
 And MEDICAL PROFESSORS 
 
 O F 
 
 KING’S COLLEGE, in NEW-YORK, 
 
 For the Degree of D O C T O R In P H Y S I C, at the 
 ANNUAL COMME NCEMENT, May 21, 1771. 
 
 By SAMUEL KISSAM, M. B. 
 
 Phcsle fa^e, nevus ingreditur tua Templa Socerdos, 
 
 N E W - Y O R K : 
 
 Printed by S, I N S L E E, and A. C A R, at the New. 
 Printing-Office, on Beekmak’s-Slip. 
 
 M.DCC.LXXr. 
 
X 
 
 K \ ^ s. (X M 
 
T O 
 
 BENJAMIN KISSAM; Efqj 
 
 AND 
 
 JOHN BARDj SuRGEONj 
 
 At N E W - Y O R K I 
 
 This ESSAY is infcribed 
 
 With Respect and Gratitude, 
 
 By their moft obliged. 
 
 And moft devoted, 
 Humble Servant, 
 
 SAMUEL KISSAM- 
 
V ' 
 
 
 % 
 
 4 
 
 
 
 r'H) ' ■ 
 
y. 
 
 A N 
 
 INAUGURAL ESSAY 
 
 O N T H E 
 
 ANTHELMINTIC QJJALITY 
 
 OF THE 
 
 PHASEOLUS ZURATENSIS SILIQUA HIRSUTA, 
 
 O R 
 
 HE diforders of children afllime fuch 
 
 various appearances, that the moft minute 
 
 obfervers are frequently at a lofs to inveftigate 
 the caufes of their complaints. There are four 
 different fources from which they moft commonly 
 originate. The Meconium, the prevalence of 
 acidity in the primse via?, cutting of their teeth, 
 and worms. The latter of thefe ihall be the 
 fubjedt of the following essay. 
 
 COW-ITCH. 
 
 
C 2 ] 
 
 Worms which commonly infcdt the humani 
 body, are divided into three fpeciesj the Lum- 
 bricus or fraooth round worm j the Afcarides or 
 fnort pointed worm ; and the Tinea or jointed 
 tape vv^orm. The two former moft frequently 
 produce diforders in children ; the latter, though 
 children are fometimes affiidled with them, 
 feems more peculiar to adults, and is not unfre- 
 quently the fource of complaint in them. 
 
 Various opinions have been conceived con- 
 cerning the generation of v/orms : it appears how- 
 ever unqueftionabie, that they are produced from 
 the ova of infefls living in the air, and depofited 
 in fome part of the aliment, by which they are 
 conveyed into the ftom^ach; where, if the digeffcive 
 powers are not fjfficiently flrong for their deftruc- 
 tion, they grow to maturity: and hence are rnofl 
 peculiar to children, and perfons of languid , 
 imperfed digeftions, being fcarce ever difcovered 
 In vigorous healthy adults. Some kinds of diet 
 are more particularly favourable to the produdion 
 of worms, efpecially that which confifts of raw- 
 vegetables : Hence there is no country in whiclv 
 
 they 
 
Lhey are more prevalent than in Surinam, where 
 the fiaves are almoft wholly fed upon Plantens and 
 Bananoes, which are frequently eaten raw, both 
 by adults and children: and the verminous ova 
 contained in them left undeilroyed in the ftomachs 
 of the latter 5 and thofe of the former, whofs 
 digefdve organs are weak and languid. 
 
 Worms prove pernicious by obilru6ling the 
 inteftines, and compreffing the neigbouring parts j 
 by confuming the chyle intended for the nourilhi- 
 ment of the patient, and by irritating and inflam- 
 ing the internal coat of the guts j and fometimes*' 
 perforating them. Hence the fymptoms which 
 ufually attend children afflidted with worms, are 
 an offenfive breath, frequent, fudden and tranfient 
 pains in different parts of the belly, an unufual 
 fiov/ of fpittle from the mouth, efpecially when 
 the ftomach is empty, an itching of the nofe, 
 which they frequently rub, an irregular appetite, 
 fometimes voracious, at others entirely wanting 
 difpofition to puke, and frequent ftools of crude 
 indigefted matter, an unhealthy countenance vary- 
 
 * TilTot on Health, p. 38S. 
 
[ 4 1 
 
 ing often in a day: The belly is larger than in 
 health, whilfl; the other parts of the body are 
 meagre; an unufual laflitude, and a melancholy 
 afpeft. The eyes are furrounded with a 
 livid circle, their fieep mofl: commonly interrupted 
 with ftarting and terrifying dreams, a frequent 
 grinding of the teeth, a pale coloured urine, an 
 irregular pulfe, and fometimes a profound drowfi- 
 nefs : They are often afflicted with fwooning, con- 
 vulfions, cold fweats, and fevers, both with inflama- 
 tory and malignant appearances, attended with an 
 unquenchable thirft. They have a fmall dry 
 cough, a difficulty of breathing, with one hand 
 frequently applied to the throat. They have 
 paifies of the extremities, with a lofs of fight and 
 fpeech, their gums appear to be corroded, and 
 the head is fometimes irrefiftably thrown back as 
 in a Tetanus. 
 
 These fymptoms however, are fo far from 
 being peculiar to complaints arifing folely from 
 worms, that many of them conftitute diforders 
 wholly independent of fuch vermin. There is 
 neverthelefs great reafon p believ^, that all the 
 
 above 
 
r 5 ] 
 
 above cnurrierated fymptoms have often had their 
 origin from that fource aiene. Hence arifes the 
 difficulty of forming an invariable diagnoftic of 
 the exiflence of worms as the fource of complaints 
 in children; there are fuch variety of fymptoms 
 in different cafes, that no one can be affigned as 
 an invariable rule for fuch a determination. This 
 difficulty however ffiould not difeourage the 
 exhibition of remedies for their deftrudion ; pro* 
 vided fuch remedies do not interfere with the indi- 
 cations of cure under the prevailing fymptoms; 
 nor ffiould a blind enthufiaftic opinion that all 
 inflammatory appearances in the diforders of 
 children denote the prevalence of worms, prevent 
 the timely ufe of antiphlogyftics ; this would be 
 as abfurd as to fuppofe that children could not be 
 pbnoxious to inflammatory complaints. Such 
 opinions prevail at the prefent day; but they arc 
 dangerous in a profeffion where reafon as well as 
 experience ought to have fome influence in our 
 determinations. 
 
 Various are the effeds produced by worms in 
 different conftitutions; in fome children who have 
 
 but 
 
[ ^ ] 
 
 but few, they produce many alarming fymptoms: 
 others in whom they encrmoufly abound, find, 
 little inconvenience from them ; whether this 
 difference refults from any peculiar dirpofition 
 in one patient to be more accutely fenfible of 
 impreflions conveyed by fuch animals, or whether 
 fuppofing the conftitution of each to pofTefs 
 an equal degree of fenfibility, the adivity of 
 tlie animals proves injurious to the one, and 
 their inadtivity harmlefs to the other : or whe- 
 ther it refults from their fituation in the ali- 
 mentary paifage, is not yet fully determined. 
 It appears however indifputable, that the latter 
 has fome fhare in conftituting this difference ; 
 there can be no other rational method of 
 accounting for many of the fymptoms which 
 occur. Thofe in whom worms prevail could 
 not be deprived of the benefit of their food 
 was not the fituation of fuch animals above 
 the cscum ; The chyle v/ould purfue its wont- 
 ed courfe into the ladleals, and the nourifh* 
 ment of the patient could meet with no in- 
 terruption ; nor is it unreafonable to fuppofe 
 that an infatiabk appetite denotes the flomach 
 
 to 
 
[ 7 ] 
 
 to be the place of their exiusnee : becaufc in- 
 no other fituation could they eltect fo imme- 
 diate a confumpticn of the food as to produce 
 that quick fiiceeffive hunger of v>^hich children 
 often complain. Hence I would infer that 
 VtTorms may prove much more injurious, by 
 being fituate in the ftomach and fmall intef- 
 tines, than in the large •, in the former they 
 not only irritate and pbilru(51: them, but deprive 
 the patient of his nouriihment. In the latter, 
 the irritation and obilruclicn, is the only injury 
 to which he would be liable. 
 
 To enter into minute detail of the ratio 
 fymptomatum pr.t need by worms, would be 
 a tailc to which I confefs myfrrlf unequal ; nor 
 does there feem to‘-*be much neceffity for fuch 
 an undertaking, iince the efficacy of remedies 
 offered for their defrruflion, cannot by that 
 means be increa-'ed. 
 
 The moft pov/erful vermifuges with which 
 we have hitherto been acquainted, are prepa- 
 rations of M<^cury, Aloes, Rhubarb, Jallap, 
 s { Steel, 
 
Steel, Tin, Sulphur, and a variety of otliers, 
 too tedious to meotion. The aftive properties 
 of which many of thefe are compofed, render 
 them unfafe when given in large dofes, and 
 when exhibited in the ufual dofc, they prove 
 infufScient for the deftrudion of worms. There 
 is one other remedy however, which is I believe 
 unknown, as a vermifuge in the northern parts 
 of America. — The Pbafedus Zuratenfis filiqua 
 hirfuta^ or Cow-itch. Its efficacy is indifpute- 
 able ; nor will it be attended with the fame 
 objedions to which the c hers ^.c liable. The 
 part of this plant which is iiiac; ufe of, is the hairy 
 fubftance growing on the or Tide of the pod. It 
 is compofed of an affemblage of exquifitely fine 
 fpicula, fo accutely pointed, as when applied to 
 the fkin, to excite an intv^erable itching and 
 inflammation of the part. Hence when fuggelled 
 to me as a vermifuge, I apprehended danger- 
 ous confequences from its con* .ct with the coats 
 of the ftomach and intefl’-.cs ; nor could I be 
 prevailed upon to retr ;t my opinion, until 
 experience had convinced me o* its fafecy. 
 
[ 9 ] 
 
 The method in which it is ufually givena' 
 is in the the form of a thin elefluary, mixed 
 either with molafies dr comimon firup, until it 
 acquires that conuilence j a tea fpoon full of 
 which may be given to a child of two, three 
 6r four years old, and double that quantity 
 to an adult ; in this manner it is to be con- 
 tinued for three fucceeding mornings, after 
 which a dofe of rhubaib may be given to 
 advantag-e. 
 
 At iirfc I attributed the innocence of this 
 reiTiedy when taken into the ftomach, to the 
 manner of exhibiting it. Suppofing that by 
 the firup, the elafticity of its parts might in 
 fome meafure be impaired, and become lefs 
 active than in its dry and fimple (late : But 
 the following experiment proved my conjedute 
 to have no foundation in truth. 
 
 I applied to the back of one of my hands 
 a; fmall quantity of dry Cow-Itch, and to the 
 other at the fame time, nearly the fame quantity 
 intimately blended with firup, agreeable to the 
 
 B above' 
 
[ 10 ] 
 
 above prefcription, without being able to dif- 
 cover the leafb perceivable difference in its 
 operation, either in point of time or fevcrity ; 
 Hence I think it indifputable that the ftimu- 
 lating properties of the Cow-Itch are carried 
 into the ftomach with it. The ftomach is 
 doubtlels infenfible of its operation ; Willing 
 to believe that this infenhbiiity was owing to 
 fome affignable caufe, I imputed it to the mucus 
 with which the ftomach is lined j fuppofing it 
 to poffefs a power of flaeathing the points of 
 the fpicula, and by that means leffening their 
 adlivity. But there feems little neceffity for 
 fuch a fuppofition, fince the tongue and roof 
 of the mouth are equally infenfible of its 
 effedls, independent of any properties in the 
 faliva or mucus to prevent its operation. 
 This will be beft illuftrated by experiment. 
 
 I MIXED with Saliva a fmall quantity of 
 Cow-Itch, and applied it to the back of my 
 hand, then took the fame quantity of dry 
 Cow-Itch into my mouth ; that upon my hand 
 fpeedily produced a very fcnfible iritationj, 
 
 whilft 
 
[ II ] 
 
 whilil my tongue and the roof of my mouth 
 were entirely free from the kail perceivable 
 uneafinefs. 
 
 Altho’ the whole alimentary pafiage feems 
 to be infenfible of this ftimulus, yet I can- 
 not conceive any other quality on which its 
 efficacy as a vermifuge depends, efpecially after 
 having given it to worm patients, both in 
 tindlure and decodlion without the lead: fen- 
 fible advantage. This opinion however will 
 be ftill lefs liable to obje<flions, by attending 
 to the following experiment. 
 
 To feveral common earth worms, which 
 have fuch a fimilitude to one fpecies of worms 
 infeiling the human body, that Linnscus in his 
 defeription has made no diftin(ftion between 
 them, I applied when motionlefs and undif- 
 turbed, a quantity of dry Cow-Itch ; in every 
 inftance, the mornent it touched them, they 
 difeovered figns of pain, by immediate and 
 brifk agitation ; nor was the effedt lefs con- 
 fiderable upon the application of it when mixed 
 with firup or molalTes : If freely applied in either 
 way it produces a flow but inevitable death. 
 
[ ] 
 
 There is fomething in the corofn/e ftibllmate 
 particularly deliterious to worms. One lingle 
 drop from an ounce of water, wherein one 
 grain of well levigated fublirhatc is diffolved, 
 being dropped upon an earth worm inllanily 
 produces the molt violent convulfions; and if 
 condned in the fame folution for the fpace of 
 five minutes it is inevitable death. Lefs than- 
 half a grain of fublimatc being applied in fub- 
 fiance upon an earth worm effefts his de- 
 flruflion in two minutes. Whether enounh 
 
 O 
 
 of the folution might not be given to prove 
 dehruflive of worms, without being injurious 
 to the human botiy, wants the tell of exoe- 
 rience. There is no medicine in the whole 
 catalogue of vermifuges which proves deliteri- 
 cus to worms from its ftimulating quality, but 
 which likewife proves ftimulating to the nervous 
 coat of the ftomach and inteftines ; hence their 
 exhibition is attend"'d with danger : But the 
 
 Cow-Itch feems perfedlfy inoffenfive to the 
 human body, and yet contains all that is ne- 
 ceftary for the deftrudlion of worms. I recom- 
 mend its exhibition, I am conndent both of 
 its fafety and utility. 
 
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