DEP/DUA/1/39/28 (Transcript version)

Mary McFarlane

1786

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Mary McFarlane 1^st April 86

Resp. disease of this patient no room for doubt.

When came under our care, there took place, daily disch of worms from alim canal.

And each of these, distint joint of Taenia.

Could therefore be no doubt of exist of this animal, in alim canal.

And as little, in referr. to it, most if not all sympt to which pat. subj

Partic pains in bowels, & sensat of motion in these, immed effects of action of animal

And prob also to referr to same source, severe headach.

At least well known, that this often affect of diff irrit. in alim canal

While again, sense of weakness, prob. affect, of want of due nutrit, from alim exhaust by worm.

May indeed, be some doubt wheth to pres of animal, can attrib disten of stom, espec after food.

The acid eruct, & flatul with which affected.

Need not obs. that these often occurr where no Taenia.

And could by no means be consid as extr. conj, that Taenia & Dyspep. should occurr in same patient.

But yet to be obs, that such dysp. ailm, not uncomm. with pat. lab. under Taenia.

And on expuls of Taenia, have entirely left them.

From which may at least with consid prob. concl, that dep on Taenia as cause.

And Would therefore view all sympt as here arising from pres. in alim canal.

Having thus then stated opin, as to name, & nature of disease, next prognos.

And here may obs, that of all common kinds of worms at least, Taenia most diffic to expell from alim canal.

For which prob. sever diff. reason may, with some degree of just be assignd.

In first place, in an animal freq of prodig length, & extend through whole tract of intest.

In not a few inst, disch to extent of twenty, or even thirty yards.

Nay if there, be not an error in press, are told by Boerhave in [illegible] Acad that saw one disch 300 yards.

But whether there some suspic trecentarium, their [illegible] for tricenarum Whether this case or not, cannot be denied that in gener of great length.

And that from this circum great diffic in expuls.

But diffic from this source much less than from second to be ment.

Struct viz of animal as consist of separ joints.

Each of these joints possess tenac by which can be attachd.

And that too when necess with very consid degree of force.

Hence, unless vital power dest., hardly to be imag, that removal to be affected, by any mechan action, which intest capab of exert.

But in circum of vital power, still third partic giving diffic in expuls.

To be obs. of this worm that though all joints connected as whole, yet each enj. sep power of exist.

Each not only capab. of living by itself when detachd from others but even of gener.

Hence smallest potion remaining may again prod very long animal.

Has indeed been alledged, notwith author of Linnaeus to contr. that animal at upper part, termin by head in common to all joints.

Certain, that termin in filum, or small thread.

And said, that by aid of powerful microscope, extrem of this, termin in small bulb with four horns.

This at least descript given by [Lassone] [Magur] & others, app by French King to try M. Nouffer [remed].

But whethr strictly true or not, is at least cert, that rarely, if ever radic cure, till filum brought away.

And indeed may perhaps say, till compl, & entire disch, of anim.

For certain that each joint possess, power of life by itself.

And from what know of other anim, not impossib, that from a single joint, left by itself, head as well as other parts may be regen.

On these diff grounds then, suffic causes for diff of remov.

But besides this, still anoth part to be taken notice of.

Taenia of diff species.

And of these some, more diff exp than others.

Thus artic said to prod entire expuls of Taenia lata or tape worm

Yet ineffect with Taenia Cucurb. or Gourd worms

These two spec. not readily disting by marks given by Linnaeus.

But if comp. togeth repres. given in Lassones public evid diff.

Here accord, have exhib specim of each, which these who incl., may comp. with plates.

May only in gener. obs, that in Taenia lata, joints shorter.

That of unif breadth, through whole length.

That therefore worm, of unif breadth.

And that accord resemb. to bit of Tape with cross stripes.

In Taenia Cucurb. Again, joints worm as whole not of unif breadth margin in right line

That joints not of unif breadth but taper a little to both extrem.

And hence in separ state each very much resemb. seed of melon or gourd.

Joints in this worm less intim conn

Hence less readily disch compl & entire.

And prob. on this greater diffic in cure as fragm. more apt to remain.

But whether from this or other circum univ, admitted that cure less easy.

Of this spec however, very evid was worm of our patient.

As indeed abund app from single joints

Hence then both as being inst of Taenia, & still more of Taenia Cucurb. had reason to think cure diffic.

But here also as prev. having sanguine expect of cure, still 3^d [circum] to be ment.

What viz had hap. to this patient, when formerly under care.

Was as already ment. undr care in 1784.

And at that time by means of Fern powder, when obt of good qualit very large portion of Taenia 7 yards brought away.

Without however disch of filum, or in other words of compl. animal.

Accord. find that regener. has again taken place.

And this also, notwith large part now brought away & even smallness of its extrem, reason to fear may be case on pres. occas.

At same time, will not be denied that pract. here empl., at least so far success.

And worm disch, to very near its upper extrem. as may concl. from small of portion, pasted on side of phial.

Not impossib, that still smaller portion, may have escaped notice, of pat.

And therefore not altog without hope that even radic cure now obt.

But whether this case or not, after what said of prognos. next to speak of practice.

Need hardly obs. that use of Fern powder for cure of Taenia as empl. by ancients, lately [revivd] in France.

And for most full acct of it may referr you to treatise, translated from French of Lasson & [Magnus] &e, by Dr Simmons.

Though chiefly trusted to, only in Taenia lata, yet said also to succeed in Cucurbit.

And from affect which formerly had, in exp. very large fragm, had again recourse to use.

But from repeated dose to ℥ip followed by very brisk cathart. only few joints of worm brought away.

From this concluded, that had lost its activ from keeping.

A circum which had formerly occas to obs. with same patient.

This therefore determ me to delay using it again, till from frost leav ground, could obt it as fresh dug.

And in mean time, to try some other med.

Perv. however to use of these, seemd necess to do something, with view of strength bowels.

And was with this intent, that had recourse to mixt with Tinct Peruv. Bark.

After, under this, somewhat [recruited] from viol operat of formr med, had recourse to pills of opium & camph.

From which, in one inst, brought away a large prop of Taenia of same species.

Under use of these however, for sever weeks, only single joints still contin to be disch.

And these of such breadth as evid to shew that not near top of animal.

Then resolvd to make trial of Pulv. Stanni.

A remedy long empl & often [illegible] against this compl.

For most partic acct referr you to paper by Dr Alston, 5^th Vol. Med Ess.

By him repres. as very success.

But directs exhib to extent even of ℥i for dose.

And to ℥ii for cure.

Here prescr. only to ℥ii

And after third dose disch. portion to extent of 5 yards.

No propr filum indeed to be seen in it.

But smallness of one of portions shews at least that not far from head of animal.

And as already hinted filum may be disch.

But as this might not be case directed, after disch that Pulv Stan should again be repeated.

And that even after empl, strong cathart should be given.

But no more joints of Taenia have since been seen.

In this situat, then farther cont of anthelm seemd unnecss.

Acord have put her on use of Peruv Bark, with view of strength bow

And shall wish that contin attend for some time, that may immed have recourse to med, if again any app. of worm.

When dismiss her, shall recom it to her to return, as soon as slight app.

But if none for space of month may concl. that either with some prob. that entire disch or at least remain of very small