DEP/DUA/1/46/42 (Transcript version)

Alexander Napier

(1789)

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Alexr Napier at 20. N^o14

Formerly observd that as to [case] of this patient no room for doubt.

Had no hesit in ascrib all comp to which he was subj. to pres of Taenia in alim canal.

And offered at some length my opin respect affect prod by this [anim] as well as causes giving rise to diff of remov.

This in pres case concl. would be more so, as [illegible] app an ex of Taenia Cucurb.

Or at least if no real diff in species of that variety the joints of which are least firmly attachd to each other.

And in which of course some small portion a greatr chance of remaining.

Here the rather reason to appr diffic as in [on] former inst occas disap. of cure

For when some months before under our care a large fragm brough away by means of Tin powdr.

But after consid interv without any app of worm joints again obs as formerly.

From this therefore seemd necss that on pres occas something [which] should be done.

As however formerly so far attend with good effect, seemd prop to rep it.

And indeed must acknowl. that notwith late introd of other modes of cure think it infer to none of them

Here however to Tin powder given to extent of half an ounce for a dose in usual manner subj also the remed of [Herrenchward].

That is Gamboge united to fixed veget alk.

From the Tin powder had no obv. operat to look for.

But the Gamb. a drastic purgat well known in gener to oper powerfuly even in small doses.

Here however taken to extent of nine gr without any obv operat.

An evid proof of divers in this respect from diff states of alim canal at time.

For during pres course have seen with anoth pat even a small quant prod very viol effects.

And that too a much stouter man than pres pat.

If in that case, then had vent on large dose of [Herrensw], but just had to say what would have been conseq.

And although with this patien might perhaps have been born to somewhat greater extent, yet what we have seen a suff lesson for empl of such active remd rather in [prises] than in large doses at a time.

Although no obv operat from either med yet followed by disch of large fragm of Taenia.

For although happend only the day after his med taken yet no doubt in attrib to this cause

But whethr was conseq of Tin of Gamb. or of conj inf of both cannot pretend to say.

Fragm now disch of more consid length than what formerly came away.

Still however no more reason than before from mere app to concl. compl. cure.

For in part at least brought to us no app of filum.

Now therfore seemd necess notwith removal still to employ what might have some inf in killing any rem. joint.

And accord with this intent have had recourse to Camph

An artic which need hardly observe very delit both to insect & worm tribe.

And from which have on former occas observd very large fragm even of Taenia brought [away].

Here the rather empl it, as could without inconv be regul [contin] for some time.

But with this thought it also necess to do something with view of expelling flatul & strength [bowels]

Accord have directed an arom mixt with a proport of Vitriol acid.

To which the rather had recourse as while well known to be astring & tonic is also reputed to be delit to the Taenia.

In so much indeed, that some consid the min acids as most effec means of cure.

Since these med begun cannot say that patient altog free from uneasy sympt.

And some of these as pain of bowels, sense of heat & like, are sympt, which although may arise from diff causes, yet not unfreq are prod of Taenia.

But since large fragm brought away no joints seen either spont disch or as conseq of med.

And of late sympt upon [whole] easier.

Shall not therefore prob think of directing his attend here much longer.

But before be dismissd shall be desirous of repeating former med Tin powder & Gamb

And if any portion of Taenia remaind, may expect that that leas some joints will now app.

If this not the case, will have strongr reason to presume, that compl animal before disch, though filum not obs.

If any left will give another & perhaps more fair chance than before of compl. removal.

For no doubt that this effected at one time even by the very med failing at another