DEP/DUA/1/34/40 (Normalised version)

Christian Stuart

(1783-1784)

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Christian Stuart. April. 24.

In this case principal symptoms indicate affection of alimentary canal.

And even reason to presume that to this cause all to be attributed.

For none of them which affection of alimentary canal may not produce.

Often instances of affection here, occasion cough in different forms.

And particularly apt to induce it with uncommon appearance, such as took place in present instance.

Often gives rise also to changes in appearance of countenance, & to affection of [Spirits]

While at same time here farther indicated by swelling of belly.

But what in this case chiefly led to suspect affection of alimentary canal was what formerly happened to patient

For when formerly subjected to [same] complaint, all these had disappeared on discharge of worms.

And is I think an undoubted [fashion] that from irritation given to intestinal canal by worms, a great diversity of symptoms may arise.

To this cause then, was I own inclined to conjecture, that all symptoms were here to be attributed.

Is indeed true that by some [names] of eminence has been denied that worms, or at least lumbricus in intestines, ever cause of disease.

In support of this doctrine contend, that all symptoms said to arise from worms, often proceed from other causes where no worms in intestines.

And on other hand that worms frequently present where no symptoms produced.

But from same mode of reason might with equal justice be contended that calculus never cause of any symptoms.

For certain that often present in bladder where product of no inconvenience.

And as certain that often symptoms giving strong suspicion of calculus where does not exist.

Yet any one who would deny that is capable of producing most excruciating pain would contradict undeniable facts.

And his reasoning incontestably refuted by complete relief of symptoms obtained from removing it.

Circumstances of analogous nature afford evidence of power of worms as a cause of disease.

For symptoms of most distressing nature completely removed by evacuation of these from intestines.

What had formerly happened in this way then, led me to suspect worms in present case.

And accordingly practice begun on that idea.

Now however must acknowledge that suspicion of worms not a little diminished.

For from use of Semen Santonica, succeeded by cathartic, had reason to expect that if any existed in alimentary canal, would have been discharged.

And undeniable that same symptoms which proceed from worms, may arise from irritation, produced by any other cause.

Although these medicines however not attended with desired effect, had yet apparent influence on her disease.

For after use swelling of belly diminished, with relief also from cough & other symptoms.

Hence then reason to believe that although purgative had not expelled worms, might yet have removed cause of disease from intestinal canal.

And in this situation thought nothing more advisable than gently to strengthen tone by bitter infusion.

Which, if notwithstanding failure of Semen Santonica, there should be any worms in intestines, had good chance of removing them.

For this purpose employed Infusion Amarum with proportion of Tincture Aromatic.

And hopeful that under use, patient may soon be dismissed free from complaint.