SECTION VIII. ANTILITHICS.

By this term of ANTILITHICS, I mean those medicines which give relief in the disease of lithiasis, or calculus, and also in nephritis when this depends upon the same causes that induce calculus, such as a gouty diathesis, not to mention others. I prefer this term to the old one of LITHONTRIPTICS, which has so generally been employed to denote a set of medicines which produce the effects I have mentioned. Lithontriptics, in the rigid sense of this term, are, I think, unknown to us; though I do not deny, that the long-continued use of lime-water and other similar medicines, may on some occasions, have acted partially by dissolving, or otherwise altering, the surface of urinary and other calculi. Meanwhile, we are certain, that in many instances where Uva Ursi and other medicines have greatly relieved the distressing symptoms induced by calculus, the latter has remained undissolved, and its form, perhaps, not in the least, altered.

THE real mode of operation of the Antilithics is unknown to us. It seems highly probable, however, that many of thein produce their effects by virtue of an astringent quality. We, at least, find that not a few of the astringents, such as Uva Ursi*, some species of Geranium, &c., do give relief in many cases of nephritis and calculus t. Dr. Cullen imagines, that the astringents act, in this case, by absorbing an acid in the stomach. But this appears to be a frivolous theory,

* See page 3.

† J. H. Heucher.

↑ A Treatise of the Materia Medica. Vol. II. p. 13, &c.

unsupported by any respectable body of facts. The mode of operation of the astringents, is not completely understood; and in ascertaining the fact, that these medicines are antilithics, we have only advanced one step towards the discovery of truth. But whatever may be the precise manner of acting of the astringents in cases of nephritis and calculus, we are certain, that an antilithic property belongs to many articles which have little or no claim to the character of astringents. Such are some of the plants of the genus Allium, or Garlic, as the Leek (Allium Porrum), &c.: also carbonic acid, and carbonate of soda, not to mention several others.

IT is much to be regretted, that this most important subject should still be involved in so much uncertainty, notwithstanding the late laborious and ingenious inquiries of Fourcroy, Pearson, and other philosophers, who have favored us with the results of their experiments, relative to the analysis of human and other calculi. But on this subject much remains to be done; and although it is not probable, that we shall soon, if ever, discover a solvend for calculi in the body, it is highly likely, that a more extensive and correct acquaintance with the intimate nature of these concretions, will, in time, conduct us to a knowledge of the means of preventing their formation.

I HAVE but little to say on the subject of particular Antilithics. Indeed, it must be confessed, that our catalogue of articles that are deserving of this title is very small.

Of the Uva Ursi, I have already taken some notice*. I have also observed, that the Pyrola umbellata has been

* See Part First, p. 9, 10 See also page 3, of the present part.

employed with advantage in nephritic affections*. The good effects of the kernels of Corylus Americana have been noticed †, as have those of the Philadelphia Flea-bane, or Erigeron Philadelphicumt. I have not, however, employed any of these articles in the disease of nephritis, except the Uva Ursi, which is, unquestionably, a valuable antilithic. I have often prescribed this medicine, and have known it to be useful, even when it was ascertained that a calculus was present. It is certain that it does relieve the disagreeable symptoms which are the consequence of the irritation of a stone; and some facts which have come under my own observation, independently on those which I have met with in medical authors, have led me to believe, that the use of this astringent medicine facilitates the expulsion of calculous granules, through the urethra. In what manner this effect is accomplished, I am unable to say. I must add, however, that in some nephritic cases, Uva Ursi seems to increase the irritation which it so generally relieves.

I HAVE already observed, that the root of Convolvulus panduratus "has been much recommended in cases of "gravel§." Since the publication of the former part of the Collections, I have received some additional and more certain information on this subject. In particular, I have learned, that an infusion or decoction of the root has been often used by a physician ‡‡ of New-Jersey, who has found the medicine very useful in his own case. He is persuaded, that it has enabled him to pass the calculous granules, with much facility.

SECTION IX. ANTHELMINTICS.

IT has been asserted, that Worms, as constituting a disease, are more common in America than in Europe. I suspect that there is some foundation for this assertion, though I am sensible, that the assertion ought to be received with some hesitation. A larger body of facts should be collected, before the truth can be completely established.

I HAVE already observed, that the Indian children, in some parts of the United-States, are very “subject to worms, and to the larva of insects, introduced into the system, along with their crude, and often unwholesome, aliment*." It is, moreover, a fact that great numbers of these children fall victims to the diseases induced by worms. This is acknowledged by many of the Indians with whom I have conversed. The Oneidas preserve a very curious tradition concerning one of these epidemick worm-fevers, and inform us, that in consequence of the destruction which it occasioned among their children, the nation relinquished a station which it had long occupied, on the margin of the Oneida-Lake, and took possession of another, at some distance from the Lake. It has, however, been asserted by some ingenious writers, that diseases from worms are unknown among the Indians. My own observations and inquiries lead me

See Part First, p. 37, &c.

† Dr. Rush says, he "cannot find any accounts of diseases from worms, among "the Indians." "Nor does dentition (he observes) appear to be a disorder among "the Indians. The facility with which the healthy children of healthy parents "cut their teeth, among civilized nations, gives us reason to conclude, that the "Indian children never suffer from this quarter." See An Oration, &c., containing an Enquiry into the Natural History of Medicine among the Indians of NorthAmerica, &c. &c. p. 26. Philadelphia: 1774.

to adopt a very opposite opinion. Indeed, the children of the Indians seem to suffer not much less from worms, and from dentition, than the children of the Europo-Americans.

WHATEVER foundation there may be for the assertion, that worms are peculiarly common in North-America, it will not be denied, that the subject of Anthelmintic medicines is one well worthy of attention. On this account, I shall introduce into this place a few additional notices on the subject. I begin with those vegetables which are most obviously characterized by a tonic quality.

A STRONG decoction of the bark of the Prunus Virginiana has been employed, with a good effect, in some cases of worms. Whether this bark operates by any other than by a tonic quality, I am unable to say. It will not be denied, that many of the bitter tonic medicines are, on many occasions, excellent anthelmintics. But I am very far from believing, with some ingenious writers †, that the tonic medicines are always the best anthelmintics. In the epidemic verminose fevers, which often prevail in the marshy tracts of country, and are evidently owing to the same causes that induce common intermittents and remittents, the Peruvian bark and other similar medicines may be used with peculiar advantage. Moreover, tonics are at all times properly exhibited, with a view to prevent worms from increasing in the system. But many articles that are not at all, or at least very inconsiderably, tonic, are among the most valuable anthelmintics. with which we are acquainted.

* See p. 21, 22.

Mr. James Moore. "Bark (says this author) is perhaps the best of all worm'powders." An Essay on the Materia Medica, &c. p. 148. London: 1792.