DEP/DUA/1/23/04 (Normalised version)

Susan Tait

(1780)

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Susan Tait.

Affection of this infant of very distressing nature

At same time so far obvious that might be supposed no room for doubt as to name.

Can be little question that principal affection is that of eyes.

These so much affected with inflammation & intolerance of light, as to afford characteristic of ophthalmia.

Would naturally therefore look for it under this genus.

But at same time to be observed that subjected also to other symptoms.

Particularly ulceration on neck now of three months standing.

From continuation of sore, from appearance which has – from age at which has occurred, as well as from general habit of patient no doubt of being scrofulous

And this indeed corroborated also by other symptoms with which conjoined.

Such for example as swelling of upper lip & enlargement of abdomen.

These well known to be Scrofula symptoms.

Upon whole then no hesitation in pronouncing that scrofula here exists.

And when consider continuation of affection of eyes little room for doubt that disease also in these depends on Scrofula.

In reality therefore perhaps with more propriety referred to this than to any other genus.

For is unquestionable the complaint on ultimate removal of which, radical cure to be alone effected.

Yet in first instance at least Ophthalmia claims attention.

From this therefore practitioners in general would denominate the affection.

And according to nosology¹ of Mr Sauvages could have no hesitation in employing term Ophthalmia Scrofulosa.

Yet although give it this name must still consider it as an instance of Scrofula affecting the eyes.

Thus then in few words stated opinion as to name & nature of disease

Here however will naturally occur as question whether any other affection.

And may observe, that symptoms here occurring which commonly considered as diagnostic of presence of worms in alimentary canal.

This particularly the case with respect to grinding of teeth

That frequently a symptom of worms cannot be denied.

And wherever occurs some inclined to suspect presence.

If however there are practitioners who put much confidence on this mark others still greater reliance on another symptom here present.

That is swelling of upper lip.

Of late represented as infallible diagnostic of presence.

But notwithstanding concurrence of both am here inclined to think that have no share.

For to be observed that although affection has now continued near twelve months no worms observed.

Nor indeed any of other symptoms as glairy stools, gripes, voracious appetite etc with which commonly attended.

This however hardly possible if really present.

Were they even therefore to appear hereafter should still consider them as having had no share in giving present symptoms.

Upon whole therefore consider present case as affording proof that grinding of teeth & swelling of lip cannot be considered as diagnostics of worms.

Would by no means however [represent] as singular in instance before us.

For every day observed to accompany scrofula affections.

If however from these medicines disappointed, shall still have more expectation from trial of other articles of tribe of Nervous medicines, than any other class

And with this view may have recourse to Valerian or to Camphor.

As from both one & other have I think seen remarkable benefits obtained in such cases.

If all these trials without success must be directed to future measures by situation in which shall then find patient.

At present therefore any farther suggestions unnecessary.

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Explanatory notes:

1) Nosology is the branch of medical science dealing with the classification of diseases. Individuals referred to in the case notes as nosologists were commonly those who had published nosological, or classificatory, medical texts.