DEP/DUA/1/46/01 (Normalised version)

David Sheriff

(1789)

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N^o1

David Sheriff at 29 a [Sailor]

Of the disease of this patient no room for doubt.

That there exists a worm in intestinal canal, & that this worm of Taenia kind, cannot be denied

This incontrovertibly proved by joints which daily, nay we may say almost every hour, discharged by anus.

And although at present hardly affected with any other symptoms yet can neither venture to pronounce it a slight disease, nor even free from danger.

In particular remarked for [obstinacy] in so much, that by some held even to be incurable.

And although often continues for many years, without any great inconvenience, yet sometimes & that suddenly too, product of great inconvenience, in different ways.

Particularly giving rise to wasting of habit, loss of strength, severe pains of bowels, & even fatal convulsions.

But in estimating danger, as well as obstinacy, has been thought necessary to ascertain, not only genus of worm, but also species of Taenia present.

For by at least greatest part of natural, contended that different species of Taenia, at times to be met with in human intestinal canal.

Particularly two distinguished by names of Taenia Cucurbitina or gourd worm, & Taenia lata or Tape worm.

Of these two, former considered as by much most obstinate, & dangerous.

In so much, that Dr Herrenschwand Madame Nouffer, & others, contend that their remedies a certain cure for one, but not for other.

And particularly in account of Madame Nouffers medicine, published by authority of French Government¹, have drawing of both species.

Must own, that was never able to discover different species of Taenia, according to description of Linnaeus.

For with him, distinguishing mark taken from position of mouths.

And while describes Taenia lata to be osculis lateralibus his mark of Taenia Solum or Curcurbitinas is osculis marginalibus.

But in all I have ever seen, only openings which could be considered as mouths, entirely marginal.

Judging however from resemblance to plates, in Treatise mentioned, imagine that had seen both.

And have often exhibited those contained in phials on table, one as species of Taenia lata or tape worm, the Taenia articulis longioribus.

The other again as specimen of Taenia Cucurbitina the Gourd worm or Taenia artic brevioribus.

Must however own that what some time ago happened in case of patient before us has with me created doubts with respect to this distinction.

For now convinced that same worm may have different appearance at different parts of length

+ And that such instances do occur may I think with confidence be inferred

At one part exact resemblance to Taenia artic longiorib

At another to Taenia articulis brevioribus.

This I think proved by Taenia discharged by David Sheriff when last under our care.

And this therefore have also put upon table for examination.

But although such instances may occur would not deny that these may be cases where worm entirely of one or other appearance.

At same time such instances as present at least serve to render prognosis from examination of mere fragments a more doubtful matter.

As far however as prognosis here to be drawn from fragments, would lead us rather to give unfavourable opinion.

For resemblance of single joints to seeds of Cucumber would be led to conclusion that his an instance of Taenia Cucurbitina the most difficult to remove.

And to same conclusion also led from attendance to what has already happened with this patient.

For when formerly under care, was I own somewhat disappointed in expectation of obtaining complete cure.

At that time, upon use of Pulveris Stanni a very large fragment brought away.

And that fragment terminated in what had at least some appearance of filum.

A circumstance always considered as [demonstrating] complete removal of animal.

Is indeed true that filum very short, at least when compared to figure alluded to.

But imagined that a longer filum might also have been discharged & neglected, or not observed by our patient.

After this part discharged, patient for space of several months did not observe even single joint

A circumstance tending somewhat at least to corroborate idea of complete removal.

Yet must acknowledge that in former instances have seen discharge again [commence] after nothing of it has been discovered for space of three months.

And how long interval necessary before can venture to affirm that cure complete must own, cannot pretend to say.

In present instance evident appearance that some portion of worm still remained.

And probable that smallest, even single joint sufficient again to generate worm of any length

What has already happened therefore serves at least to render hopes of radical cure less sanguine.

At the same time patient a vigorous man, anxious to get rid of disease.

And may therefore afford us at least opportunity of making trial of different active medicines.

After case taken directed for him mixture of bitter & aromatic tincture.

From this no other view, but that of [recruiting] & strengthening alimentary canal after Tin & Purgative before employed.

With view to radical cure, is intention here in first place to give fair trial to remedy of Herrenschwand, Gamboge & vegetable alkaline.

And if this fails next to have recourse to Madame Nouffers specific the Fern powder.

If disappointed in both a variety of other practices to which according to circumstances recourse may be had.

Particularly Electuary Camphor Aether & Corrosive Sublimate.

And hope that by some one may be able if not to affect complete discharge at least to bring off another large fragment.

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Explanatory notes:

1) Joseph-Marie-François de Lassone, Traitement contre le ténia ou ver solitaire, pratique, à Morat en Suisse [by Mme Nouffer], examiné & éprouvé à Paris (1775).