DEP/DUA/1/26/12 (Normalised version)

William Hamilton

(1780)

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William Hamilton.

In history of this case symptoms not numerous.

While at same time are such as occur in many different affections.

Among other causes capable of producing these complaints may observe that such symptoms often effect of worms in intestines

Particularly of the lumbricus or those most resembling earth worm.

And although here no symptoms which could be considered as diagnostics of worms, yet presumption of this case from having formerly been product of similar symptoms.

And from removal of these in consequence of discharge of worms.

This reckoned sufficient reason at least, for trial of these medicines, by which worms in general expelled from intestines.

And to this the rather induced as even supposing mistaken as to cause nothing in circumstances of case [constrained].

Trial however has I think demonstrated truth of conjecture.

For in consequence of measures employed a considerable quantity of worms have been discharged.

And patient now free from all the symptoms to which subjected.

Am in hopes therefore that disease already to be considered as cured.

And therefore remarks on prognosis superseded.

Necessary also to say very little as to measures by which this effected.

For here while practice to which had recourse a very common one principal of operation also very obvious.

For removal of symptoms depending on worms two great objectives to be aimed.

1 The killing the worms in the intestines.

2. The expelling them from intestines whether dead or alive.

Where indeed latter objective can be immediately accomplished of itself sufficient.

But to be observed that till killed or at least till vigorously diminished expulsion difficult frequently impossible.

Hence then both objectives in general to be conjoined

Was with first of these intentions that had here first recourse to Calomel bolus.

In this, as in other mercurial well known that an active poison for worms.

Perhaps indeed less active than where mercury in saline form more soluble as in Corrosive sublimate.

And accordingly this often exhibited as anthelmintic even in form of pills after previous solution in water.

But Calomel as being less active mercury a safer medicine.

And at same time in general at [least] sufficiently powerful.

This found case in present instance.

For next day after use of purgative several worms discharged.

As purgative here had recourse to very effective one viz Compound powder of [ Sol]

An article in which activity of Jalap moderated & restrained by Cream of Tartar.

And when dose properly accommodated to constitution operates as giving powerful & free discharge of contents of intestines

From effect of first trial of these medicines was naturally to repetition for by first dose could hardly [expect] that whole would be discharged.

And even supposing that the case yet still from removal of [illegible] & ova that might remain

And on this account as worms discharged by second dose ordered two more during following week

From there being no more appearance however notwithstanding brisk operation of medicine concluded that intention completely answered.

Have ordered therefore mixture of vegetable bitter with view merely of strengthening bowels.

And if no farther appearance of worms or return of symptoms shall reckon farther attendance unnecessary.