DEP/DUA/1/30/28 (Transcript version)

Jean Armourer

(1782-1783)

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Jean Armourer.

Case of this patient as introd into our register consisted of compl. of affect.

At least lab. under sympt indic very diff diseases.

Some of these as cough & viscid [which] expect. evid catarrhal.

Others again as pains of abdomen picking of nose, grinding of teeth & start during sleep such at least as are common sympt of worms in alim canal.

And of these may also be consid as a farther indic that belly rather loose

Has nothing indeed of voracious appe with which worms often attended

But in augm thirst & in pecul desire for cold water, have somewhat at least of those whimsical cravings often attend on worms.

But besides what already mentiond, patient affected with a train of sympt. still more alarm perhaps more danger. than either

Those fits viz with which she is freq. affected & in which there occurs total loss both of sense & motion.

In these indeed have not every char of Epilep.

But from total abolit of sense strong presumpt at least afforded that were of that nature.

Epilep well known to arise from diff causes

And partic so in early period of life

Then still more than with adults in general admitted that may proceed from worms.

And here must acknowl. that on these diff grounds was at first inclind to suspect that worms might be great part of cause of compl.

Prest. case however among othr useful lessons which affords serves to shew that in cases where many symp. of worms, they may yet be absent.

For when consid that sympt now entirely gone, without any disch of worms can have no doubt that never existed here as cause of disease.

Proves then that neither picking of nose, grinding of teeth, start in sleep, pains in abdom nor loose glairy stools even when comb. with epilep access. can be consid as cert. evid of pres of worms.

Has been but too common error with pract. to attrib much more than ought to be done to worms as cause of disease.

Certain that often [susp.] to exist when entirely absent.

And no less so that even when pres. many sympt attrib to them which proceed from other causes.

And thus both time lost, & not unfreq, even constit impaird by following out, improp plan of cure.

But while point out this error in pract. must also remark that there may also be error on opp. extreme.

For not uncom among some mod path of great emmin. to deny that worms can in any case be cause of disease.

This doctr. supported by observ. that sympt supp. to indic worms freq arise when these absent.

And that worms on other hand often pres when no sympt whatever takes place.

But although worms, may at times remain inactive in alim canal, & although sympt simil to those [illegible] to them may be induced by other causes yet very erron conclus from thence to inferr that never prod of any sympt.

Cannot I think be a doubt that as supported in human stom & intest, [must] consume part at least of alim matter intended for syst itself.

And hence prob. that great waste & emaciat, that inordin appet. which is often their attendant.

But besides [consum] alim matters have been found even to erode intest themselves.

And thus, have made way even during life from intest canal into cavit of abdom.

May therefore reasonab. concl. that whence erosion not so great, yet prod all conseq of irritat & injury to intest in infer. degree.

Must be admittd then that are a cause adequate to prod of many sympt.

And as far as are capab. in any degree of judging of connex between cause & effect can be no doubt that do induce such.

Hence then equal error in suppos. that worms never cause of disease as in imag. that are always cause [when] any of sympt indic them appear.

Here though a combin of many of these [sympt] no doubt, that had no share in prod the affect.

Must then view affect of alim canal as here proceeding from some other source

Probab. from weak & irritab state

For when this the case effects of pecul. irritat prod even by very slight causes.

Thus same conseq from prevail acid in stomach, from ordin fecul matter &e as from worms.

And from many phenom good reasn to believe that picking of nose, grind of teeth &e effect of any pecul irrit in intest & not merely of worms.

Suppose however that affect of alim canal from this cause still quest whethr from irritat to intest epilep access. do not here arise.

Can be no doubt that by pecul irrit at any part of body, symptom Epilep sometimes induced.

Fits then here taking place may have been prod by irritat in alim canal.

At same time period for which these had already contin rathr again this suppos.

For although only in 4^th year of age yet had at diff. times been attackd with them for space of 2 years.

And no reason to believe that for such a length of time affect of alim canal now describd had contin.

Here therefore most prob. that this also a separate & distinct affect unconnected with two others.

When case of patient introd into register then may be viewd as labour under these diseases.

Catarrhal affect. Disorder of alim cana & Epilep fits.

Notwith these formidab. app. however was in very short time dismissd free from affect.

A circum by which any conject as to event of disease rend superf.

But here necess to consid how far this recov in any degree the effect of remed employd.

And must own that with regard to this am very doubtful.

When began treatm of case you will observe put this patient on use of Peruv Bark.

And that remed was I may say the only one which she employd during time she was under our care.

This remed need hardly observe prin intended with view to affect of alim canal.

Though epilept access. most alarm affection, yet in these at time at least nothing urgent.

Imag. that even on suppos of its being totally indep of affect in alim canal might yet be treated with more advant after that overcome.

And as some suspicion that epilep. might origin from this source had thus at least some chance of curing also that part of affect.

With regard to catarh again was an affect but of recent date.

Had begun in ordin state of [acute] catarrh, & had already passd through what may be calld inflam stage.

Hoped therefore that would soon even of itself have natural termin.

And imagind even that Bark might have some influ in prev. it from running into chron state

Which however a very rare occurr in infancy.

But still thought that might have some effect at least in short [decln]

Was also in some degree with view to Catarrh, that here empl. bark as conj with a Mucil. mixt.

Which while had effect of keeping bark susp. in watr hoped might also in some degree oper as a demul.

With both these intent indeed [extract] of liquor. dissolvd in water might have been employd perhaps with greater adv.

While at same time has effect of covering to a very great degree the taste of Bark.

This however requires consid time in preparat. while mucil always ready in shop.

And view to exped service was I own the only circum which led me to direct it.

Otherwise should undoubtedly have given prefer. to Liquorice.

How far these diff intent here answered by med employd will not take upon me to say.

Is however I think probab. that speedy termin of Catarrh which took place was prin if not entirely effect of natural progr of the disease

But may reason conject that Bark had some influ in allev affect of alim canal as indic by want of app pains in abdom & loosness.

Perhaps may also add by picking of nose & grinding of teeth

From time that she began bark this affect which till then had been grad encr. began evid to decline

And while appet encreased gaind both flesh & strength.

During all this time had no return or even threatn of fits.

Might seem therefore that by effect [strength] alim canal had removed [this] also.

But of this, can speak with much less confid, when consid that had often before been absent, for much longer interval.

Sometimes even for space of month together

Should not therfore be surprizd if again returns

And I own hardly consid her as cured of this part of affect.

But as at pres at least free from every affect. in which state reason to hope that may continue for long time farther attendance became unness & was therefore dismissd.