DEP/DUA/1/42/49 (Transcript version)

Binny Craw

(1787-1788)

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Binny Craw at 21. N^o12.

Formerly obs. that no hesit in assert. all sympt in this patients case to be conseq of worm in alim.

And then assignd reason for cons it as ex of Taenia Solium or Cucurb.

What in English known by name of Gourd worm.

Without resum any observ. then off. [may] only obs. that of all spec of Taenia intest worm is most diff. to remove.

Accord to acct. given us much more so than Taen. lata or Tape worm.

In so much that resists modes of cure said to be effect for exp. of that species.

Partic those of Dr Herrenschward Phys to King of Poland & of Mad Nouffer of Morat in Switzerland.

And although cure sometimes effected in such cases both by these & other means, yet not to be dep. on.

And gener. admitted that no cert & safe remed yet discov.

Hence then could not here enter any sang. hopes of success.

Now however after disch of many consid fragm. patient has seen no app of worm for consid time.

While sympt induced in conseq pres. have also entirely ceased.

Some reason then to flatter oursel that compl. cure has been obt.

Have not indeed had that testim of cure which is afforded by disch of filum or [head] the upper extrem of animal.

And must also be allowed that even this no certaint.

For now app. that worm is not as once imagined strictly entit to app of solit.

But that diff chains may exist each having prop. filum.

While prop. to obs. that in some inst long disap. but again returned.

One case nine months free from any app of worm & every sympt of exist.

Hence then still express doubt as to prognos.

But if not radic cure at least very consid tempor relief.

And that too without hesitat to be ascribd to med here empl.

Of these then come now to offer some remarks.

Began by prescrib for patient the root of powder of Male Fern

The Filix Mas. of Pharmacop. the Polypod. Fil. Mas. of Linn.

This artic app. to have been empl. as an anthelm from very earliest per. of med.

And as early as days of Dioscorid partic recomm against Taenia.

But after that had fallen very much into disuse

And that too although Taenia obstin resist. most modes of cure.

Not many years ago a pract in Switzerland Mr Nouffer at Morat became celeb. for success in cure.

And after his death simil cures performd by his wife to whom he had comm his pract.

Her success attracted even notice of French Governm.

And after effic ascert by trial at Paris, secrete purch & publ. by author

Mad Nouffers specif as he calls it the Fern powder.

But besides this empl. also soon after it is taken a very strong purg.

Purgat consist of Calomel & Resin of [Scamm] or Jallap each to extent of gr X with six or 7 of Gamb.

For partic acct of mode of admin may referr you to treat on subj.

May only obs. that after very light supper. The specif or Fern powder to extent of 1. 2 or 3 dr. taken early in morn.

And at distin of two of three hour purgat empl.

Many suppose that on purgat whole efficac of med depends

But to this suffic answ. that in some inst worm brought away befre purgat taken.

An evid proof that Fern powder deliter to it.

But prop. of subj purgat suff. [manif]

For by this means force tend to exp. of worm is encr.

And although that totally inadeq for expuls. while worm enjoys health & vigour, yet may be suff. when much sickned by Fern powder.

While at same time even in this state would retain situat notw. ordin action of system.

Thus though each insuff. by itself may do when conj.

This meth. said to afford very cert. cure for Taenia lata or Tape Worm

But not for Taenia Cucurb or Gourd W.

Difficul in both cases arises from each joint have tenacul by which capab of attach itself.

While at same time each may be consid as possess as it were separ life.

Hence when consid usual length of anim. an alm infin num of [worms] as it were to be expl.

And even a very few capab of retaining whole though reduced to such state of sickness & weakn. that otherwise easily expl.

While however power of retent in syst. thus in comm to both, yet same artic may oper. much more powerful as poison to one than other.

And is thus I imag. that from Fern powder Taenia lata most certainly expl.

This remed. since publ of Mad Nouffers [receipts] have had occas to empl. in good many inst.

Prin however against Taenia Cucurb. much more comm than Taenia lata

In some cases use attended with most compl. success.

In others after even fairest trial has faild.

And in these inst. not always without inconv.

For sometimes both purging & vomiting to very distress. degree.

This I have thought in part to be ascribd to quant of Fern powder.

But still more to strong cathart partic to Jallap Gamboge which cont.

Hence corrected by exper. have at least reduced strength.

And have empl it with as much success as before.

Seldom using Fern powder to quant of more than one or two dr.

And in gener. throwing out both Gamboge & Merc. from purgat.

These circum will suff. expl. reason of pract here empl.

Directed Fern powder to extent only of ℥ i.

And at distinc of four hours to begin purgat. elect. consist of ℥p of Crem of Tart & ℥p of Jallap with simple syrup.

This to be taken in small doses till catharis induced.

And thus hoped that would have full effect both of specif as killing killing or expelling sickening worm & of cathart as expell.

In these however expect not answ.

From Fern powder no great uneasn at stom or at least no vomiting.

Hence full chance of action in intest canal.

While length of time before use of purgat. four hours, suff. to give opp for action

Cathartc taken after purgat oper. briskly.

But from this no large portion of Taenia.

Here most prob. supp. that want of success, conseq of species of worm.

But not imposs. that may have arisen from qualit of Fern powder.

For to be obs. that this artic. very apt to suffer from keeping.

And have found at least in one inst that after what for some time kept in shop had faild, cure performd by powder prep from root recently [gath]

This then might have been reason why should have orderd it a second time & as imm proc from fields.

But as season unfav. wishd first for trial of some other artic.

And after failure with one celeb. specif had recourse to anoth. - Gambog

This need hardly obs. long ranked among most acrid & drast of Resin cathart.

And this effect prod even in small quantit.

Of late as well as Fern celeb. for expuls of Taenia.

For introd with this intent indebt to Dr Herrenschward, Phys. to K of Pol.

Has never howevr pub. any acct of pract.

And supp. to [have] kept his pract secret.

In so much that stigm as an illust. empyr. by Van [Sweiten] & some other authors.

This however without just found.

For am well assured that freely com his pract to any Phys. who applied to him.

Was some years ago fav with very partic acct of it, by a Gentlem who had it from Herrensch. himself.

Directus Gamb. to extent of gr X or XV united with equal quant of [S]. Ab.

This dose given early in morn. In two hours repeated.

And by this in gener. worm disch.

But if fails given to third even to fourth time.

And not once in 100 inst. that is not accord to Herrens. effect cure for Taenia lata.

Does not howevr repres it as equal effect in T. Cucurb.

Though there also often succeeds.

Repres it as in operat perfectly safe.

And although sometime excit sevr purging yet never with gripes.

This acct of Herrensw. however must own have not found conf. by my own exper.

Have not indeed had opp. of trying it in many cases.

And never against Taenia lata. which as already obs. much more rare in this country than T. cucurb.

Must also add that have nevr given it to near extent which Herren. directs.

But even in much smaller dose have found it very rough in oper.

Inducing not only severe [hyper] cathar. but excess vomiting.

As far therefore as reason to bel. that expuls. effect of encr. action, may rather be susp of this than of Fern powder.

Indeed from what have seen of Gamboge am convin that unless anim either killd or sickened, encr. action alone by no means suff. for expuls.

And in all cases, partic where where not most essent. necess.  both viol vomiting & purg. to be caref. avoid.

This then will expl. to you reason why when directed Gamb. here empl. it in what when comp with those of Herrenschward but small doses.

In place of ten or even fifteen directed only iii gr.

And this to be repeated only to 3^d time at dist of two hours between each dose.

From this reason to presume that influ of one dose, on stom at least fully exerted before anoth taken

And thus hoped that vomiting which prob. in no degree coop with cure would be avoided.

In this however disapp.

For even from second dose some degree of vomiting induced.

But this did not deterr pat from taking third.

Conseq. of this however was we were told very severe vomiting of long contin.

And prob. is from this, that to acct for our being entirely disapp of expected catharsis.

Prob. even that compl. rejected without making way into intest.

If this the case not wonderful that neither compl. disch of worm, nor even large fragm.

Seems indeed to have had no effect upon it whatever.

For at succeeding report found that still cont to disch single joints as before.

In this situat consid it as imprud. to have immed recourse to any very active med.

Resolvd therefore to give respite to patient for space of week.

And at same time to empl. what might in some degree have effect of strength & bracing alim canal.

For by operat of violent emet & cathart. tone necess much weak.

Was then with this intent. not with view or expect of having any influ in remov. of worm that directd mixt with aromat. Tinct.

This as may readily suppose sat easily on stom

And prob. had some effect in [illegible] that viscus.

But sympt. result from worm cont as before.

For still single joints obs. at time to come away.

And still cont. to be much distressed with pains in abdom.

In this situat thought of giving fair trial to anoth celeb. cure for Taen.

And one [too] equally extolld for exp. both of Taenia lata & T. Cucur.

That is the Pulv. or Limat. Stanni.

Which however neither prop. powder nor filling of [tinc], but Tin reduced to state of small granul.

This need hardly remark a remedy long in repute against diff species of worms.

But partic against Lumbrici

Then however in general empl only in [small] doses

But for introd in large doses, & as cure for Taenia, chiefly indebted to Dr Alst. lately Prof of Botan at this place.

For most partic acct of it referr you to papr of his in Edr Med. Essays.

Though mode of exhib there ment. has some circum rather ridic than otherwise, such for ex. as giving it on cert. days before change of moon, yet no doubt that often efficac.

And that may be given in very large doses without inconv.

Quant directed by Dr Alst. from ℥ ip to ℥ii.

And this made into elect. with Treacle taken in space of three days.

Here ordered to our patient to largest extent viz ℥ii.

Half an ounce to be taken every day for four days.

In Dr Alst. directions nothing partic said of purgat to be given after.

Merely recomm. that purgat be subj.

As one of most efficac & easiest of brisk cathart here ordered comp powd of Jallap.

And directed that should be thrown in by repeated small doses to extent of ℥ ip.

That is ℥ p of Jallap & ℥i. of Cr. T.

From elect. no uneas. & inconv.

While purgat operated as briskly & freely as could have wishd

During operat a consid numb. of fragm of Taenia brought away.

But none of them very large.

And among these no app of any thing like filum of animal.

Hence at that time was very far from looking upon this as radic cure.

Have since however learnt that at that time many more fragm than brought to us were disch.

And not imposs. that among them head filum of animal term in head [may] have been.

For as already obs is disch of this alone that gives pres. of cure.

But whether compl. disch or not now reason to hope that has at least done more than then imag.

For a whole month has now elapsed without even single joint being disch

This however I may obs. no security.

For have heard of cases, where reapp. after much longer interv.

And not imposs. that may be case here

Yet total disapp of joints for period already ment. at least so far fav.

And espe. as during that period med have been empl. from which if any remains of worm some joints at least might have been exp. to be disch.

For after use of Tin had recourse you will obs. to anoth active remed Camph.

Do not indeed known that any writer has partic celeb. this for cure of Taenia.

But well known to be very active poison to many smaller anim.

Partic those belonging to tubes of insecta & vermes.

And accord. used every day in preparat of anim subst. as defence against insects & worms.

In former inst have had recourse to it in cases of T. Cucurb.

And have seen at least very large fragm disch under empl.

Here however cont. to consid ext for space of forthn. without small. app.

Concl. therefore that either incap of [brining] them away or that none to be disch.

Still indeed patient affected with some sympt.

Partic pain & uneasin. at stom

This however now susp. might be as much mere conseq of state of stom ind. by worm.

Or perhaps of med empl. for ex.

Hence therefore thought of attempt allev. by means of stom bitters & aromat.

And as such had here recourse to mixt of Aromat Tinct. with T. Abs.

Chose this latter rather than T. Amar. from idea comm at least entert that worm wood inimic to all anim of worm tribe.

And therefore that if any exist migh prod disch of some joints

While at any rate, though not most agreeab. certainly one of most powerful of veget bitters.

This mixt. now contin for space of several weeks

And during that period while no app of worms, pain at stomach has of late in partic been a good deal allev.

Am in hopes therfore that may grad get rid of it.

This however more perhaps to be affected by time than by contin of med.

Unless therfore some change in circum shall consid farther attend as at pres unnecss.

And may at least venture to assert that patient has reapt ben. under treatm here directed.

At same time must still conf. appreh. that recov. rather temp. & partial than complete & radic.