DEP/DUA/1/45/07 (Normalised version)

Kitty Ord

(1788-1789)

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N^o26. Kitty Ord at 10.

With regard to case of this patient somewhat at loss.

Her affections however constitute at least principally if not entirely in fits.

And these either of hysterical or epileptic kind.

In appearance of fits themselves several circumstances favour rather former supposition.

Particularly sense of suffocation [referred] to affection of Trachea.

And inordinate action of alimentary canal, as indicated by contraction of umbilical to spine.

While at same time, little agitation of muscles of extremities, & no foaming at mouth.

Circumstances at least very common in Epilepsy.

But notwithstanding these particulars still inclined to latter supposition.

Particularly from total abolition of sense with fits accompanied.

For this more than any other circumstance considered, as constituting & demonstrating essential difference between the diseases.

This opinion also corroborated by fatuity remaining after fits.

For in hysteria recovery after paroxysm more immediate & complete.

Age also of patient in favour of Epilepsy.

For more a disease in early periods of life than Hysteria.

Indeed latter affection very rarely occurs previous to menstrual.

In so much that has derived its name from uterus from supposed [dependency] on that organ

And well known that uterus very commonly little influence on system till menstrual commences.

Is in common to both diseases, that fits excited by passions of mind.

But Epilepsy not unfrequently observed to be produced by worms, which never perhaps a cause of hysteria.

And of these some presumption in present instance.

For were at least discharged when patient at a former period subjected to fits.

And at present frequently observed to grind teeth & pick nose at least common symptoms of worms.

From all these circumstances then consider supposition of Epilepsy as most probable.

At same time not altogether without doubt.

And this it must be allowed should in some degree affect both, prognosis & practice.

But whether one or other well known that are in general obstinate diseases.

At same time on supposition of either several circumstances here favourable.

Particularly age of patient, short duration of affection, & spontaneous cessation on former occasions.

Hence inclined to hope that may either be able to induce artificial or at least to aid natural termination.

With this intent here proposed to make trial of Zinc.

And that not in form of Calx, but of praecipitate.

Shall wish to give this fair trial before have recourse to any other medicine.

May however on supposition of worms particularly of ascarides, have recourse to injection of lime water.

And if any appearance of these to other anthelmintic medicine.

But of practice reserve observations till afterwards