DEP/DUA/1/45/36 (Normalised version)

Kitty Ord

(1789)

---

N^o26 Kitty Ord. at 10^th

Formerly expressed doubts with regard to case of this patient.

But upon whole disposed to consider fits to which subjected as of epileptic kind.

To this led not so much from appearance of fits themselves as from other circumstances

Particularly from age at which here occurred.

From presumption that at first at least derived origin from worms.

But above all from total abolition of senses occurring during their course.

During time for which has been under care cannot indeed say that this opinion has been confirmed.

At same time nothing has occurred to invalidate it.

And now no less inclined to it than before.

Began treatment here by directing for this patient the use of Calx of Zinc combined with Valerian.

In former of these an articles of late much employed in epileptic cases.

Probably first employed in this affection by Ludemanni a Dutch empiric who used it under name of Luna Fixata Luddemanni.

Afterwards recommended by Gaub. who analysed the nostrum of Luddemanni

And still farther tests of successfulness by van Doeveren.

On these authorities extensively employed.

But found inadequate to cure of greater part of Epilepsy.

And failed so often that not a few disposed to consider it as of no efficacy.

For my own part am fully persuaded that a majority of epilepsies will be found incurable either by this or by any other remedy with which yet acquainted.

Yet from my own experience, am much [deceived], if have not often seen benefit from it.

Sometimes in cases of Epilepsy but still more frequently in Hysterical affections.

On what principle operates can hardly venture to say.

But not improbable that influence in part at least if not principally depends on tonic power.

For by this means diminishes morbid irritability giving tendency to inordinate action.

And without this well known that exciting causes often incapable of producing effect.

Here exhibited Zinc as combined with Valerian.

An article well known to have very considerable influence on whole nervous system.

And which although medicine [proposed] also matter of dispute with some is I think justly ranked among tribe of antispasmodic medicines.

Have often been inclined to think that from combining powers of both [increased].

With present patient however this did not seem to be case.

For from almost every dose of powder considerable sickness at stomach [induced].

And very frequently vomiting.

When this case however could not expect from them any material benefit.

And accordingly neither frequency nor severity of fits in any degree diminished.

Here thought it not improbable that sickness might be consequence of Valerian.

And before deserting Zinc thought it at least proper to try how far could be borne alone.

Wished also to give it in manner in which would act more slowly on stomach.

Hence directed it under form of pills made with crumb of bread.

In this form Zinc taken nearly to same extent as before.

And now at least no vomiting or even sickness from use.

Did not however show any influence in combating the disease.

For fits still as frequent & as severe as before

But here considerable benefit not at once to be expected.

And hoped that by persisting in use benefit might be obtained.

But besides this thought it advisable also to try another practice.

With other symptoms, had some of those, considered as indicating presence of worms in alimentary canal.

Particularly grinding of teeth, & picking of nose

And upon a former occasion with similar symptoms had discharged some worms from [describing] of ascarides kind.

Well known however, that from irritation of worms in intestines, Epilepsy [illegible] not unfrequently proceeds.

Hence then seemed advisable to try some anthelmintic medicine.

As by this, if any worms present, some of them at least, would be discharged.

Was with this intention that directed injection of Lime water.

Which in my opinion one of easiest, safest & most effective remedies against Ascarides.

Particularly if which generally case, they be entirely situated about rectum.

Here however, from repeated use, no worms observed to be discharged.

A circumstance, which I consider, as at least strong evidence, that none existed.

Now however under farther continuation of Zinc, fits still as frequent as before.

And at same time complained much of sickness at stomach.

This, perhaps however without good reason, she herself disposed to attribute to the pills.

Reckoned it therefore improper to persist in employment.

And accordingly in place of these resolved to make trial of Vitriol Aether.

An article which need hardly remark one of most powerful & immediate antispasmodics with which acquainted.

And although effect more sudden than permanent, yet often useful at least as anticipating fits.

Here directed it, in combination with a mucilaginous mixture

Which at once serves both to cover taste, & to prevent loss from volatile

This medicine, seems to have been attended with obvious benefit.

For very soon after began use, both frequency & severity of fits diminished.

And in short time entirely ceased.

Then complained only of sense of coldness with some headache.

In this situation seemed improper to continue medicine.

For well known that by habit articles of this kind lose influence.

Hence then in place of Aether directed merely mixture with vegetable bitters & aromatic.

This hoped might have some effect, as strengthening tone of alimentary canal & thus of system in general.

And by this means, diminishing tendency to fits.

In this expectation however disappointed For under use fits became as frequent as before.

Probably however not in any degree consequence of remedy employed, but of want of Aether.

Led therefore to direct repetition.

And in order to secure advantage [which] might obtain ordered that should at same time employ Cuprum Ammoniala, under form of pills.

An article which in different epileptic cases, have not unfrequently employed with advantage.

And which as [employed] with two other epileptics under care, Torrence & Watt, shall afterwards have occasion to mention.

Here may only observe that since these medicines begun, fits upon whole very few & slight.

And not without hopes that by persisting in employment cure may be accomplished

At same time, hardly to look for uninterrupted progress.

As upon slight accident recurrence to be expected.

Yet upon whole patient at present apparently benefited by medicine