DEP/DUA/1/20/04 (Transcript version)

William Bayne

(1779)

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Wm Bayne.

Of perusal Of case of this patient when came under our care was very doubtful.

One of chief inducem for select. it was uncertainty with respect to affect.

And among many suppos which might be entert respecting it imagind that might exhib examp. if not of uncommon disease at least of uncom. complic.

Hoped that from attent to progr of disease doubts at first enter. might in some degr at least be removed

This however has not been case.

But if have been unable to discov. [cause] & nature of affect, compl. at least since came under our care much dimin.

And from this at least may concl. that some causes which might [otherwise] have been suspected had no share as induc compl.

Of various sympt to which subj what seemd not least alarm was pect compl.

With cough & dyspn to consid degree there here occurd expect of yellow ill tasted matter.

This also to be observd comb. with quickness of pulse – near 130.

When to these add evening fever exacerbat attend with morning sweats had at least some ground for presum Phthisis.

And notwith relief which patient has already had am yet by no means [cert] that this not the case

While at same time must be allowd that besides relief, many other object also to suppos.

If Phthis must suppose matter expect to have been purul.

Of this however by no means suff evid in yellow colour & ill taste

If matter purul. must have proceedd from bursting of large vomica.

This however would naturally suppose to have been [proceed] by consid pain

Or at least without such very rarly happens in a case so recent.

By no means uncommon to find all same sympt attending a catarrh affect

And in inst before us while patient not arrived at age at which Phth. most common attrib to cold.

Upon whole then inclind to hope that in pect. compl of patient had merely catarrh.

But if doubt concern these still more with regard to other compl.

Compl of Affected with pain almost const about umbilic region.

Const. of this compl. gave some probab of local cause.

And this still farther augm from pain on pressure.

While at same time as no obvious disease, if local cause existed must have been in abdom viscer.

But whatever seat or cause of pain in course in which propag something pecul. singular

At irregul intervals are informd extended upwards to neck.

This I must own consid as somewhat pecul.

Could not indeed have been strange if propag in course of alim canal.

In this case however would have been propag both upwards & downwards.

And would not probab. have arise higher than stom.

Besides if had been propag to aesoph. would not have been said to affect neck.

Some allowance however probab [here] to be made for relat of compl. given by patient, little more than 10 years of age

And not improbab. that if his acct or that given by parents had been accurate acct explan of it would have been less diffic.

At same time while ignor of cause of pain, hard to say from what circum might origin or with what pecul. might be connected.

And here besides all circum [already] mentiond some others also claiming atten

Besides const pain of belly had also simil affect of head.

And if latter former at any time sufferd remiss was attended with proport aggrav of latter.

From this circum some reason to conclude that the two were connected.

And inclind also to view as concom of headach dilat of pupils here occurring.

From this some presumpt that [heada] might depend on water.

But from such a cause while [pupils] dilated, become insensib to impress.

With our patient however contin to have usual dispos to contract on stim.

From this then reckond it more probab. that compl. of intest head from [som] cause in head intest than contrary

And here from nature of these compl. exist of worms could not fail to pres. itself, as probab cause.

Well known that sympt from [illegible] often so simil to what attend [hydroceph] that distinct often impossib

Is farther also a common sympt from worms that sleep disturbd.

And that disturb here from this cause rend at least in some meas. probab. from pain of belly & head being [then] most severe.

Had not indeed which might have been expected of late passd any worms

But are informd in hist. of case that two years before such a cause of disease had existed.

And this although no proof of return on pres. occas. renderd it at least more probab.

Upon whole then sympt of case numer. & doubtful.

Yet when came under our care was inclind to view pect compl. as being of catarrh. nature & arising from cold.

While reckond it most probab. [that] other sympt might arise from worm in alim canal.

How far these conject true from progress of case, as far as have hitherto had opport of observ. have not been able to determ.

Yet now some presumpt at least for truth of former while probab. that latter without foundat.

Opin now therefore respect prognos. more favorb. than would have been at that time

And while reason to presume that pain of belly not from worms would now appear that has depend on cause still more easily remov.

For at last report, are informd that without disch of worms was entirely gone.

Cough also very consid relievd, which togeth with disapp of other sympt indic Phthis, gave presumpt was in fav of catarh.

To be observd however that all these by no means gone.

And while with contin of sweating, consid [illegible] nature of disease, ought not to [surp.] [us] if this part of patients affect should yet turn out to be fatal.

At same time now more than formerly at least reason to hope for fav conclus.

How far tenden to [illegible] recov. in any degree from pract here empl. is I must own with me matter of doubt.

And in treatm will readily [perceive] that have not through out whole proceeded upon one plan.

At first visit from circum already mentiond inclind to suppos. of exist of worms.

If this really case [had] every reason to concl. that means of cure directed with other intent would prove ineffect.

Reckon it therfore necess before take other meas to use some method of determ whether existed or not.

And this not better ascertaind in any way than by means tend to [expuls].

With this view might have had recourse to numer artic of extens tribe of [Anthelmin.]

But as here from former circum presumpt of Lumbrici than which knew no preven had recourse to Mercur [dulc] than which know no artic more powerful.

This combined with Magnes. prin with intent of giving form

Consid it however as not improbab. that compl. might in some meas dep. on acid in stomach.

And if this the case might expect from Magnes. some allev as destroy. it.

To calomel when employd as anthelm necess. that purgat should be subj.

As by this means worms either killd or having vital power dimin more readily expelld than by action of syst. itself.

As purgat had here recourse to Jallap than which perhaps possess few more [active] or which can be exhib [with] greater safely.

In subst operat most certain.

And in as far as [corrigen] necess none better than Crem of Tart.

Here as patient at early period of life directed it to be given with larger prop. than in comp. powder of Jallap.

And must own that for my part have been able to discov. no advant from two artic being pounded together.

By these med hoped that worms if any existed in alim canal might be expelld.

And if none that patient yet benef from bowels being emptied.

Evacuat not so consid as could have wishd.

Yet as no appear of worms was inclind to concl. against that cause.

And next consid. pect compl as cheifly claiming attent.

Was with view to these that has [rec] to repeated emet.

And that both with view of prom expector & of giving determ to surf.

Under emetics, pectoral as well as other sympt very greatly dimin.

And at last report so far free from compl. that some reason to think shall not again see him at this place.

If does [futur] treatm must entirely be regulated by condit in [wha] sympt then are.

And at pres. can say nothing with regard to it.