DEP/DUA/1/45/13 (Transcript version)

David Sheriff

(1788-1789)

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N^o32. David Sheriff. at 29.

Respect disease, to which this patient subj when came under care, in sever respects no room for doubt.

But must at same time add, that in other partic, has puzzled me very much.

And has led me, if not to alter an opin which have had for many years past, at least to be very uncert with respect to it.

Chief mark of disease in this patient when he came under our care, consist in disch of worms by anus.

And from slightest exam of those brought us, could have no hesit in pron them to be joints of Taenia.

A worm well known freq. to exist in alim canal both of human species & also of other anim. partic some domest anim as dogs, cats or the like.

All writers in natur hist however, have agreed, that there are diff species of this worm.

And Sir Chas Linnaeus, in partic, has pointed out four diff spec.

Of these, two admitted as very freq. cause of disease, with human species, by almost every pract writer.

And the rather to be disting. as diff remed said to be effect cure for one, by no means so for other.

This partic the case both with respect to remed, of Mad Nouffer of Switzerland, & of Dr [Herrenschwand] of Poland.

And accord, in treatise respect remed of former, pub. By author of French King, have an [engrav]. both of that species of Taenia which is capab of remov, & that which is not.

These species by Linnaeus, Pallas, Bonnet, & other Zoolog. disting by titles of Taenia Cucurbit or Taenia artic longior, and Taenia lata or Taenia artic brevior.

In English, as will obs. from paper of Dr Alston, in Ednr med essays, & likewise of some other writers, known by names of Tape worm, & Gourd Worm.

One denom from resemb. to bit of Tape, the other from each separ joint being somewhat like seed of Gourd or Cucumber.

This opin however though gener. yet not univ receivd.

And some who contend that among all alleged species of Taenia, though slight diff in appear or colour, yet no matterial or essent diff.

For my own part however have hitherto always held, the contrary & what I may say the common opin.

And in this partic my opin not only swayd by author of most emin & most accur natur. but also from what I thought I had myself distin seen.

Accord, among Taenia disch by consid numb of patient, whom have had occas to treat, have pres two in Spirits, one as specimen of Taenia lata. the other of Taenia Cucurb.

And on repeated occas, in lectures on subj of Taenia, have pres them in this room.

These indeed I allow not to be disting by marks mentiond by Linnaeus.

One viz Taenia osculis margin. the other T. osculis lateralib.

But markd at least by charact of Bonnet one artic brev, other artic longior.

Markd also by resemb of one to bit of Tape, of other to a numb. of Gourd or Cucum seeds connect togeth.

And final, markd by strict resemb. to copper plates of these worms in French treatise, to which I have alluded.

But notwith all this evid, must now own, that what has occurd in case of pres pat has created consid doubts.

And now very uncert whether diff spec or not.

Or at least, some ground for believing that same worm, may at one part corresp to descript & app. of T. Cucur, & at anoth of T. lata.

For in pres patient, in form judgem from single joints, should have had no hesit in assert that Taenia Cucurb.

But in judging from large fragm since disch as little in pron it Taen. Lata.

While at same time, even in large fragm, resemb. to Taenia lata, chiefly at upper part, towards filum.

For at infer & broadest extrem, artic longer & less intim connected.

Reason therfore to believe that from this extrem, the separ joints, or Cucurb came off.

Two circum however here occur, to creat at least some doubt with resp. to this.

1 Separ joints appar very diff. even from broadest extrem of worm.

Not only appar of diff colour but also much longer.

2^d. In mass of worm brought us one fragm found still less corresp. with large one.

For consist of joints consid narrower than broadest extrem, & consid broader than narrowest.

With regard to separ joints, may indeed be supp, that changed both figure & colour after detached from [illegible].

For no doubt, that each joint capab of living both in conn, & separ state.

But much more diff to give any explan of latter circum.

And at least most easily expl. from suppos it part of separ chain of joints.

Is indeed true that very gener one chain only in body at time.

And this indeed so much the case that with some has got name of Solit worm.

But from observ of French Physic, incontest proof, that in some inst two or more at once.

Not impossib then that to acct both for differ in app of single joints, from large fragm, & likewise for this small fragm, from being parts of diff worm.

And while worm disch the Taenea lata, there may yet remain anoth the T. Cucurbit.

But this suppos it must be allowd not without diff.

For in that case should have exp. that after disch of large fragm, separ. joints would still have come away.

This however at least for some days, & even under use of a brisk purgat, did not happen.

And if does not soon occur, need not exp. it.

Opin however as to these diff & doubt points, to be determ by future & more accur obs.

In mean while however, patient has at least derivd some benef from pract here directed.

For has got rid of a very large fragm of worm.

And if suppos of another chain not well founded, may even be means of radic cure.

But must at same time allow, that if that even should be case no other chain still radic cure here doubtful.

For well known, that every spec of Taenia very diff to remove

Each joint not only possess tenac by which cap of fixing itself, but can also enjoy life, in separ state.

And in all prob. capab also of gener other joints.

Hence then, as long as any port rem almost certain of return.

Not however so readily regener. that after disch of very large fragm, other joints soon come away.

And have known inst, where even sever months interv, before again indic by any obv. disch.

Hence then even disch of large fragm, & want of app or sympt for consid time no certain indicat of radic cure

At least till very consid period has interv without reappear.

As far however as judgem of cure can be formd at time, is to be determ from exam small extrem of fragm disch.

If termin in filum or thread, this consid as evid of compl. disch, & conseq of radic cure.

And in plates of Taenia lata will obs. that this filum repres as of corr length.

But in case of our pres. patient from this circum also, left in state of doubt.

For filum here, neither very fine nor very long.

And have before met with cases where though both finer & longer filum disch, yet return of worm.

But notwith this, in pres case, what brought us may be entire upper extrem of animal.

Or, a longer & smaller filum, though disch may have escaped exam of pat

Before therefore any post judgem can be formd, must at least be observ for some time.

And with this intent may not be improp to employ some med, with view of engag attent of patient.

Is with this view, & in some degree with intent of strength bowels, that have directed, vegetab bitters & arom

And shall prob in no long time, repeat another large dose of powder of Tin.

As from this if any worms then exist, a disch of some may be expected.

But observat on pract referr till shall again speak of case in order of list.