DEP/DUA/1/12/14 (Transcript version)

Isabel Crookshanks

(1776-1777)

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Isabel Crookshanks.

Case as introd into our regist. would seem somewhat of anomal. nature.

Compl most severe & of longest [durat.] there mentiond the headach.

This however well known more freq sym of other affect than an idiopath disease.

That rather of formr kind however some presumpt from pain of ears.

Especially as at same time conj. with freq. sneezing.

These sympt with quickness of pulse some evid of inflam in mucous memb.

And suppos. corrob. by tickling cough.

All these well known to be first symp even of slight catarrh. affect.

And as such was I own disp to consid pres. case cheifly to be.

Some circum however giving rise to other suspicions.

Are told that besides sympt already mentiond patient freq. picking at nose.

This it is true a circum taking place from various causes.

But well known to be one of most [freq] appear from worms in alim canal.

Are farther informed that patient a few months before affected with same sympt.

And that then left her on disch of two or three large worms of lumbric kind.

Ground for presum therfore that a simil cause might again occurr.

And well know that worms productive of great variety of diff. symptom.

Was led therfore to imagine that might have some [share] in pres. case

Yet I own could not consid as prod of all symptoms above enumer.

And was more doubtful with regard to [excret] of worms than of catarrhal affection.

At same time consid it as by no means improbab. that these might have been conjoind.

This the opin which was disp. to form of disease from history given us.

But at first visit inclind to take still diff. view.

Are told in case that patient belly rather loose

And when come to inquire about this partic found that had so far encreased as to be at that time most uneasy sympt.

From all partic therfore somewhat [uneas] both regarding prognos. & practice.

Yet on whole saw nothing in this case which seemd to threaten fatal termin.

And was even in hopes that might soon be brought to fav. conclus.

If suppos. of worms well founded had chance of being most tedious part of compl.

But even admitting it presumpt at least that was that kind of worm most easily [removed.]

And respecting existence some room for doubt.

Two other parts of compl. not in common at least of ted nature.

And no reason here to suspect that would be partic so.

For here disp. to consider looseness as in some meas. connected with catar. affect

And as probab. proceeding from same occas cause cold.

What however termin of this case have not learnd.

As for some time past patient has not visited

From this circum howevr should [rather] presume that compl. have left her as otherwise

Especially as have had no private message with regard to her.

This however give merely as conject.

Of treatment while under our care very little to be said.

Evid that practice as far as went hardly conducted on any suppos now mentiond.

Cheifly calcul. for obv. most urgent part of patients compl. viz looseness.

With this view first though necess to try what could be done by evac. primae viae.

As imagind that from stimul or encreased secretion there the disease might be augm.

Had first recourse to an Emet.

From which lookd for sever good conseq.

Hoped not only to evac stomach but to prod determ to surface.

And thus imagind that besides allev. looseness might dimin both cough [headc] & other affections.

Was far from imagin howevr that would be of itself suff. for cure.

And imagind that in partic farther [evac] of alim canal would be necess.

At same visit with vomit therfore ordered two doses of salts at prop intervals

These imagind might be of use on all three suppos

In obviating looseness would have influ as removing stimul. causes from intest.

As counteracting catarh of some use as [detr] from parts princip affected.

And had even expectat that if worms realy lodged in alim canal might be means of disch. these.

Did not howevr appear that in any of these respects success equal to wish.

And patient contin affected nearly by same sympt as formerly.

Not only no worms disch. but of these less indicat.

For could not now learn that cont. to be affected by same uneasy senst. at nose as before

While cough if any thing rather mitigated.

And by much most urgent part of her compl was the looseness.

After thorough evac of intest hoped that might be removed by gentle means for restoring tone.

And with this view, directed which in sever cases reckon best of all astring the Inf. Jap.

But affects have not been able to learn