DEP/DUA/1/11/06 (Normalised version)

Elizabeth Anderson

(1776-1777)

---

Elizabeth Anderson.

A case with regard to which have not received all information could have wished.

If relations however to be depended upon little difficulty respecting disease.

And all symptoms with which patient affected to be ascribed to worms in intestine.

Here also as little doubt respecting kind of worm.

Can be no question that are what generally known by name of ascarides.

These although troublesome perhaps of all others give least dangerous symptoms

And although resists some remedies, overcoming other kinds yet seldom so obstinate as lumbricus never so much so as Cucurbitina or Taenia.

Hence in present case should I own be disposed to entertain favourable expectations.

That is if patient shall think it worthwhile to submit to treatment.

But would seem that she herself considers complaint as not deserving much attention.

For although of three years standing has used no medicines.

Shall however briefly mention plan which would order were she disposed to follow directions.

In curing symptoms from worms in general two great objectives to be had in view.

viz killing the worms & expelling them from system.

May indeed seem that either one or other sufficient.

Could worms be effectively killed, symptoms before induced would cease.

And would then be subjected in bowels to same changes as other inanimate matter

Yet as not subjected to any previous [illegible] would afford putrid forms of more alkaline nature than usual aliment.

Hence quick expulsion from system is at least desirable

Not same objection indeed to expulsion without killing.

And could it be as easily affected perhaps preferable.

As by this means could avoid use of substances if not deleterious at least many of them nauseous to human stomach.

While worms however remain alive in system would seem that exert powerful efforts for retaining situation.

Hence even most violent purgative effectually evacuating other contents of intestine, unable to discharge them.

Upon whole then easiest & most desirable method first to employ means either killing them or diminishing vital power.

And then to have recourse to such remedies as have tendency to evacuate them from system.

With these views many different remedies employed against ascarides.

Of substances however having tendency to kill worms many whose nature entirely changed by action of alimentary canal.

Others in great measure taken up by absorbance through tract of intestines

And those passing through whole length of it, before reach extremity of rectum greatly diffused in other matters.

Hence in general medicine with this view taken by mouth can have little effects against ascarides.

As these seem to be principally if not totally lodged about extremity of rectum.

On this account may in most instances be more effectively done by injection into rectum

In this manner of exhibition indeed are precluded from use of many substances.

Others however may be employed with equal safety as if taken by mouth.

Such for example as injection of oil, of decoction of Semen santonica & the like.

Probably might also use in this manner celebrated anthelmintic lately purchased by French King from Madame Nouffer.

I mean powder of fern root.

Is intention first however to try present patient with oily injection alternating with brisk cathartic

And these I hope may answer purpose in view.