DEP/DUA/1/19/13 (Transcript version)

Helen McLearen

(1778-1779)

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Helen McLearen.

This patient also as well as former so short time under our care that reckon it unnecss to say much with regard to her.

Yet in some respects case in very oppos circum. from last

For if formr distinctly markd, pres very obscure.

This obscur indeed would in some respects have been removed had pat contin longer under care

For then if could not have been able to say what had not acquird knowledge disease was, should at least perhaps have know been able to say what it was not.

Obscurity of pres. case did not arise from great diversit of sympt.

For these by no means numer.

But while of such nature that could not fail to give consid distress. might also arise from diff causes.

May farther be remarked that patient at that period of life when worms [most] freq.

At least in this country more common during child.hood than either during infan or manhood.

And here princip diff was whether disease did or did not arise from pres. of worms in alim canal.

No sympt mentiond in history of case before us, which does not freq proceed from these.

While at same time sever appear here occurring more freq. from these than from any other cause.

Of this kind are freq picking of nose while awake & grind. of teeth dur sleep.

As a sympt also if not pecul to worms, at least freq from that cause, may ment. our pat moaning much in sleep.

With these, almost only other sympt which occurr are acid eruct. & vomiting.

Both of which are sympt partic markd by every histor as being often attendants of worms

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From all these partic then taken togeth may at least assign it as a suppos not improbab. that worms cause of the disease to which patient subjected.

This however the utmost that can with any degree of confid assert with respect to it.

And if from partic already mentiond some counten given to this suppos. must be allowed that other circum making rather against it.

Here several partic wanting which while worms occurr but seldom absent.

Do not indeed know any sympt at least if except actual disch which can be reckond a pathognom or infall sign of their pres.

And even consider all those repres as such as being without foundat.

Such for example as swelling of upper lip, septum narium &e.

Had such swelling here occurd would by no means have consid it as estab pres of worms

Nor on other hand would I from want of this mark inferr contrary.

But although no univ or certain sympt, yet severr which at least very commonly occurr.

Thus seldom that not attended with some degree of gripes.

In general also appetite for food more keen than natural &, at same time, that keeness for pecul matters.

But rarely also that state of disch by the belly is not affected.

Where no worms disch stools for most part of greasy or glairy appear.

None of these sympt howevr have to any degree occurrd in pres. case

And hence while pres would corrob suppos. absence would must tend to create doubt.

To this farther to be added that sympt with which patient princip distressd are acidity at stomach & vomiting.

And although these freq. from worms, yet still more freq. from other causes.

Tendency to superab. acid a very common condit, at period of life at which patient has arrivd

And from this alone all sympt of pres case may perhaps origin.

Lastly although affect has now subsisted for three weeks yet no worms observd

And although sometimes sympt from these before disch yet rarely for any length of time.

Upon whole then disp to think that presumpt. rather against worms as otherwise

Yet no ground for posit or decis judgm

From knowledge however of nature of affect alone, could either give probab. judgem respecting event or instit prop. plan of cure.

For sympt here if arising from prev. of acid would require very diff treat from what suited for removal of worms

Was therefore first object in this case to ascert. nature of disease.

And with this view meant to have carefully attended to any [occur.] which could throw light on nature of affect.

Hoped also that knowledge might in some degree be forwarded by meas which would not tend to aggrav either disease

Was rather however more with view of waiting for occur of new sympt which might determ judgem than with any other intent that orderd for pat powder of Cham flowr

Yet must observe that am far from consid this as being an artic void of activ.

Hold it to be justly entit to place both among class of stom & of anthelm

If not a pleasant is unquest a strong bitter.

In this way then, as ascert by late experim must be allowed to have powr as destroying acids.

But besides this probab. may presume also that as well as most other bitters has consid influ as encreas. tone.

Is prob on this footing that are to explain influ in cure of interm.

For although powers infer to Peruv Bark that are very consid cannot be denied.

On these diff consid then viewd it as being an artic at least not [adver] to stomach compl.

And that too on suppos that these did not proceed from worms.

Will here indeed naturally occurr. that Cham flowers an artic in daily use as excit vomiting.

And therfore might seem ill adapted for sympt by which patient most distrssd.

When exhib howevr as means of prom vomiting univ given in form of infus.

And then effect solely to be ascribd to action on organs of taste joind to influ of warm water.

By these means [illegible] excited to which must be allowed that the [pec] bitter taste of cham contrib to consid degr

This however if not altog. at least in great meas avoided from its being taken in solid state

And thus most effect obt. full influ as bitter & tonic in stom.

While however has this effect is at same time at least very gener [receivd] opin that this as well as others of class of veget bitters has operat as anthelmint.

That they possess this power [indeed] to any very high degree not [confirmd] by experim made with earth worms out of body

Some even who contend that in place of destroying their powr of life seemd to encrease it

Yet from experim of Dr Fowler which of all that hitherto made I hold to be most accur. appear. that are really [inj.] to worms

And probab. in living body have still more power, from influ which exert on alim canal as thus encreas. force for expuls

Whichever of opin then as to nature of affect best founded consid trial of this promising some advant.

While at same time during course of it hoped that occurr might take place by which should be better able to judge as to nature of compl.

During use however for space of a week [with] was not the case.

While at same time neither allev stom compl. nor gave disch of worms.

For this then determ to trial of anothr & more strong anthelm.

And if from this no evid of worms was intent to have treated it as a stom affect arising from superab. acid.

As an anthelm here had recourse to Cal succeeded by a purgat.

But as since that patient has never appeard here can say nothing of effects with which attended.