DEP/DUA/1/12/22 (Transcript version)

Nelly Cameron

(1776-1777)

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Nelly Cameron.

Case of this patient may be supposed to give rise to many doubtful questions.

But no question hesitat. howevr in affirming that affection from consequences already induced of very dang nature

In this case many of sympt as picking of nose grinding of teeth, & swelling of lip &e [univ.] consid as indicat of worms.

And that proceed from such cause in pres. case can hardly admit of doubt when consid that worms disch.

Yet question even if be sole cause of all of these

And here partic room for doubt respectin swelling of upper lip & alae narium.

For pres. case by no means without suspicion of scrophul sympt.

And of these operating as producing a still more dangerous affect.

For I appreh. great reason to suspect that pres. patient affected with Phthisis.

Of this indeed no certain indications in history at first given us.

There only presumpt afforded from pain of side & dry tickling cough.

At same time accomp with some degree of quickness of pulse.

To this indeed may add as farthr corroborating circum the app. of patient.

Had evid wasted & [extin] look.

But all these put together far from certain or even probab. evid.

And I own had I been to judge of case without seeing farther progr. in subseq. report should have rejected suppos of Phthis.

Pain of [siden] neither const nor fixd to any partic part.

Cough a sympt often occurring from worms

Quickness of pulse at that time by no means consid or alarming.

And appear of countenance, bad colour as it is calld, a very common sympt with worms

Was therefore I own disposed to considr compl. of this patien as a pure worm case.

And as an inst of that species of worm known by title of ascarides.

These indeed less apt to prod affection of system than other kinds.

And from Lumbrici still more from Taenia or Cucurbit an almost endless diversit of sympt

But even from ascarides could easily conceive all sympt of pres case to arise.

Soon however led to form diff. opin of nature of partic already mentiond.

And that even from single circum.

Disch. of blood viz which soon after [appr]

This we are told in way of vomiting.

And that accomp. with what to appear purul. matter.

How far latter suppos true perhaps a mattr of doubt.

But with regard to former disch of blood could hardly be any deception.

Disch of this by vomiting might give suppos that came from stomach.

But when consider circum of cough & pain of breast more probab that from lungs.

And on this ground must own that am now disp. to consider our patient as Phthisi

This suppos. corrob. by state of which pulse very generally found.

Never under 100 – often 120.

In this situat then cannot help consid pres. patient as in very great danger.

And in place of consid looking on worm as only compl. now consider view it to be by much the most insignif.

Would not however from appear of tenes case worms in intest having ceased conclude that these entirely gone.

For means destroying all worms alive will not prev generat of future ones from ova

But before this happens patient may very probab. be cut off by other affect.

Of which must own am disposed to consider looseness with which has been lately affected as in some meas a forerunner.

Would not howevr after all venture to be very posit in this opin of case.

And shall be very happy afterwards to find that am mistaken.

But with pres. idea of case will readily imagine that from practice here have very little expectat.

In conducting mode of cure since patient came under care have in some meas. altered plan.

Began treatment on idea of worms.

And may I think assert that in this partic the meas employd were attended with good affect.

In case of worms [great] object [unqes] is total expuls from body whether dead or alive.

This may sometimes be affectd by encrease action of alim canal for expuls.

While worms alive however unquest exert effort to retain place.

And by living princip preservd against those change to which in common with other contents of alim canal would necess. be [sub]

Becomes therefore means of facilit cure to kill worms in situat which occupy.

Or at least to use such applic to them as will dimin activ of vital powers.

When this affected even action of system itself sufficient for expuls.

Was on this last principle then that here thought of employing means for attempting cure.

No doubt that various subst in nature which on proper applic act as pois. to worms

Mode in which these to be applied must be varied according to situat of worms

When high in alim canal can be introd only by mouth.

But when situated about rectum many med even of active nature rendered effete before can reach worms.

And by this means affect entirely lost.

Much more sure of success then in conseq. of inject by anus.

And as rectum partic the situat of ascarides these I appreh prin to be [curd] in this way.

Such therefore the grounds of practice in pres. case.

Following these general princip howevr might have employd many diff. med.

As great variety of subst in [nature] which on applic to worms known to kill or to sicken them.

And which at same time may with safety be injected into intest.

In this way in partic have I own high opin of effic of oil.

In pres. inst however made choice of diff. article. viz Lime water.

With powers of this an as anthelm till pres. winter was not acquainted.

Nor do I know how far has been found effic against any othr species of worm.

But for practice here followd am indebtd to the informat of a Gent. who at commen. of winter honoured me with attend.

By him informd that inject of Lime water against ascarid had very [wonderf] affect

And that had often succeeded after many other modes of cure tried in vain

And instance before us affords I think proof of effic of practice.

Although from another case which have had occas to treat that viz of [Chas. Mitch] would not pron. infallib.

And even there seemd to have good affect

But neithr in that nor pres. inst found to kill worms.

In both cases cont. to be disch. alive

Could hardly however from Lime water suppose any greater effort to expuls.

Must conclude therfore that although does not kill worms rendrs them less able to keep place.

Or that renders situat disagreeable to them

While has these affects is unquest a mode of cure both simple & safe.

And must own am disposed to consider it as one of best yet in practice.

Good affect in pres. case very manif

And was repeated only for few times when every sympt of worms totally ceased.

With these however as have already observed compl. have by no means termin.

Since that as have already observd sympt of much more danger nature have appeard

Would naturally conclude therefore that although worms still remaind attend should be princip [turnd] to Phthisic affection.

But with regard to this will observe that have hitherto done very little.

And must again repeat that very little expectat of doing any service.

Patient from condit to which already reduc by no means an object of experim.

Imagine disease affect of scrophul. tubercule in breast connected with swelling of lip & [nose]

And take it for granted that best if not only chance of recov. from natural healing

All hitherto attempted therfore merely to allev sympt.

And to take off tickling cough by gentle mucilag. mixture.

Can neither here think of trial by Merc Mezer or any other subj. which have [suggs]

And patient even unfit subj. for drain. by way of issue.

Have howevr some thoughts of putting her on use of a decoct of Tussilago.

And am informed by a Phys in England in whose judgemt & accurate observat have the highest confid that thinks he has on some occas found it of use in Phthis from [Scroph].

For my own part disp. to imagine that if not active is at least innocent.

And on this ground if patient any longer able to attend us may think of trial.