DEP/DUA/1/47/01 (Transcript version)

Alexander Napier

(1789)

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N^o14 Alexr Napier at 20.

Of disease to which this patient subj no room for doubt.

Evid disch points of a Taenia.

And may without hesit ascribe to its pres in alim canal all the other sympt to which he is subj.

Joints disch from their size & shape resemb seeds of Cucumb. evid belong to a Taenia Cucurbit.

Or Taenia artic longiorib.

If therefore any real diff in spec of Taenia, met with in human intest, may pron this an ex of the Gourd worm, in [contradist] to the Taenia lata or Tape worm.

But at same time from what have now seen, am conv. that a Taenia may have every app of Taenia artic longiorib, at one part of length & of Taenia artic brevioribus at another.

But whether in pres inst this the case or not may concl. it one of most diff to remove.

And in every case remov of Taenia more diffic than that of other comm species at least of intest worms.

Obstin also in pres inst may be inferrd from two other circum.

His having been affected viz with worm for seven years.

And its having already resisted some powerful remed without at least a complete cure.

Pecul obstin of Taenia is prob conseq. of each joint, being in some respect an entire animal.

Of each possess. tenacul, by which capab of fixing itself to intest, & thus at least aiding, in retaining place.

And of each being capab. of gener. others, till a taenia again formd of any length.

Hence if even a single joint retaind in living state, cure not perf. or radic.

And accord can only presume a compl. cure, when worm come away, termin in a thread, of consid length or filum as has been calld.

Of this abund evid from what has already happend in case of pres patient.

For after being affected with this worm for sever years, applied for assist at the Disp in Augt. last.

And after use of some pretty large doses of Tin powder, a large fragm came away.

What brought to us however evid without filum.

But thought it not impossib. that might have been disch, although unobs. by patient.

And for very consid interv, not even a single joint obs. nor had he any sympt whatever of disease.

But at end of three months, joints again began to app.

An evid proof, that complete disch had not before taken place

And to worm regener. are in all prob. to ascribe pains in belly sickness, vomiting & other sympt with which affected some time prior to app of any joints.

With this view of disease could have no doubt that obj to be aimd at was remov of Taenia.

This as in case of other worms might conceive effectd on one of two princip.

By destruct viz or expulsion.

Expuls however in case of this worm perhaps never to be effected by encr action of intest.

For while vigour remains from numer tenac enabl to keep place.

Aided prob indeed from encr of propelling power greater exert on part of animal.

Accord fewer joints obs. to be disch when brisk purgat taken than at other times.

Hence then is only by killing the animal or at least dimin vital power that expuls to be at all expectd.

For this purp. as powder of Tin seemd formerly to have consid effect, resolvd again to make trial of it.

Hoping that though formerly did not bring away filum might now have that effect.

This artic long in use as a cure for diff species of Taenia.

But partic recomm both against Tape & Gourd worm by late Dr [Alston]

For his acct of most success method of admin. may referr you to paper in medic essays.

Suff. to obs. that first led to use from an empyr. receipt which accid fell into his hands

In that directed to quant of an ounce & a half in three days.

Directed also however, to be begun on certain day before change of moon.

And even in this partic, Dr Alst. though putting no reliance on that circum, tells us he followd prescr.

In this however for my own part when imitated Dr Alst. pract have not followed him.

For apprch could give rise only to unnecess delay.

And whatever [prosp] there may be of lunar influ in cert diseases & in in some countr. yet may with confid assert that none here at least with respect to Taenia.

Have always been inclind to think that success of Dr Alst. method, the effect of quantit.

And here directed to same extent. viz ℥ iss in three days.

As however not compl. success formerly thought it now advis to superadd to it the use of Gamb.

This as mixed with fixd veget alk. the basis of remed. celebr for cure of Taenia as empl. by Dr [Herrensw] 1^st Phs. K of Pol.

By him howver Gamb. united to equal or larger quant of salt given from ten to 15 gr at once.

And this dose repeated at dist of two hours to 3^d or even 4^th time.

That is Gamboge to extent event of ℥i. in course of day.

Accord to Herrens, from even this quant. no inconv results.

And indeed looks on med as so gent that exhib it even to very young inf.

Must however obs that may own exper does not confirm his obs. on this subj.

For in much smaller doses have seen it prod of very great distress both in way of vomiting & [catharis.]

Am howevr conv that when divided by proper [illegible ] with any salt, is not that drast med which some imag.

And this indeed was suff evid from what happ in case before us.

Tin powder as might naturally have expected taken without any incon whatever.

And during use as is commonly the case, only single joints of Taen. came away as before.

For even in cases where most compl. success, is only, brought away upon use of purgat.

And may therefore conj. that worm powder, has merely effect of reducing it to state in which incap of retaining place on encr of expelling power.

Rarely at least of killing it entirly.

For in that case, would be expelled from intest, like foeces or any other inanim matter by mere action of intest canal itself.

A purgat therefore, in some degree encr force of expuls is requis.

And had little doubt that Gamb. would operate in this manner.

In this expect however disapp.

For took all these doses of Gamb. that is 9 gr. without any inconv. whatever or obv. operat whatever.

And during whole of that day no uncomm disch of Taenia took place.

But day a large mass of it came away at once, about nine or ten feet in length.

An evid proof of speedy regener of the anim.

For may reason concl. that on form exhib of tin powder greater part disch

As then some of what came away of very small size & appr to filum.

Now however a much longer fragm

That this discharge in conseq of remed empl. can not I think be matter of doubt.

But to which to be attrib not so certain.

For before any disch had not only taken both, but consid time from exhib of last.

Here however would seem, that disch conseq of actual death of worm.

For came away by mere natural action of intest canal.

And father came away after being collected in ball or mass at rectum.

From which may concl. that prev. to disch. had after death been grad prop. downwards.

For can hardly supp. that had this dispos in body.

Very generally comes away at full length.

And accord partic enj to patient not to break it, but to sit particularly upon stool till compl. disch.

Circum therefore of being disch without aid of purgat, & of coming away in ball, would consid, as giving some presumpt of compl. cure.

But at same time have not here that evid which disch of filum affords.

Or at least if disch not discov. & brought to us.

Hence partic after what formerly hap. must be very doubtful as to rad. cure.

But before exhib any very powerf med, thought it prop to give some resp.

And accord have ordered a stom mixt with Tinct Amar. with view of strength stom.

And have directed Camphor pills an artic poison to most animals and from what have seen am inclind to think to Taenia among others.

By this if any consid part of Taen remains trust that some joints will be brought away.

In that event, being satisf that cure incompl. must have recourse to some other med perhaps to Fern pow

But if no joints app. is intent after interv of week or two, to repeat Tin powder & Gamb. in same mann as before.

And if no joints from that, will at least give more pres of comp. cure.

But still, can hardly speak with confid till a period of six or eight months has elap. without any evid or even presumpt of Taenia.