DEP/DUA/1/24/16 (Normalised version)

Katherine Reid

(1780-1781)

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Kath. Reid.

Disease of complicated nature.

Principal & most urgent symptom when came under care a cutaneous eruption.

But besides these affected also with Headache & Vertigo.

Since these symptoms have taken place another also has supervened.

viz Affection of discharge of urine.

Observed both scanty & discharged with difficulty

All these symptoms can hardly suppose connected.

At least such an assembly very rare occurrence.

But here that no connection particularly evident from period at which have appeared.

With headache & vertigo affected long prior to attack of other [symptoms].

These well known often occur by themselves without any complications.

And this may reasonably presume to have been case in instance before us.

Especially when consider that eruption which [supr] arose from obvious causes

For little reason to doubt, supposition of patient that was consequence of infection.

May conclude therefore that with head & vertigo was totally unconnected.

Same observation may also be made with regard to difficulty of discharge of urine.

And for this also am inclined to think that an obvious cause may be [assigned]

That is pregnant state of patient.

For will observe that has only commenced since in that condition.

And well known that with many women, at different periods of pregnancy with some even during whole course a very distressing symptom.

Here therefore consider it as solely proceeding from this cause

And if take this view of it must at same time observe that unless very urgent nothing in general to be done

Here therefore as not highly distressing to patient did not consider it as objective of treatment.

And in condition in which patient was had also same view of vertigo & headache

For though these objects of attention yet more proper to employ means of obviating after pregnancy at an end.

And indeed to several modes of cure promoting greatest success this state an objection.

Here therefore selected case chiefly with view to treatment of eruption.

With regard to nature some doubt.

How many different kinds of eruption may proceed from infection do not know.

And unquestionable if capable of making accurate distinction variety in cutaneous diseases very considerable.

But know few subjects where from description in particular greater difficulty.

And even when opportunity of examining appearance still very much in the dark.

This so much the case in present instance that at loss to determine whether eruption to which this patient subjected be not very common cutaneous disease viz Itch.

From appearance alone dare hardly venture to pronounce so.

But to be observed that natural appearance of pustules changed in consequence of scratch

And many circumstances support opinion that nothing else than Psora.

Is in favour of this that produced by Infection.

For of all cutaneous diseases psora most frequently & most readily communicated in that way

And if have not external appearance have at least common symptoms in peculiar itchy sensation & discharge of watery ichor.

With this opinion of nature of affection could not be disposed to give unfavourable prognosis

For upon whole disease very far from being obstinate one.

Possess many remedies principally external applications to which very generally yields.

In so much that unless in obstinate cases becomes very rarely object of treatment with regular practitioners.

Here however case could not be considered as very slight

For had, we are informed, resisted one of most common & not least successful applications viz Sulphur.

Selected therefore as object of treatment with view of trying other practices.

And from such hoped that in no long time should be able to obtain complete removal.

How far this has in reality been case cannot pretend to say.

For from irregularity in attendance of patient have seen very little of her.

Here however practice to which had recourse was, I own, one from which expectation of cure.

With regard to general principle of cure can be no doubt that in this disease symptoms consequence of foreign infected matter applied to body & multiplied there

Cure therefore on one of two Principles

By complete expulsion of this nature

Or by destruction of activity.

Former an end which can never expect to accomplish by general evacuation.

May sometimes indeed be totally removed by mechanical means.

This however can never expect to accomplish unless very circumstantial.

Hence on latter principle alone that cure in general attempted.

And as already observed many [substances] by which activity destroyed.

Was with this view that had here recourse to Vitriol acid.

Introduction of this active fluid as remedy for itch but a late practice.

First, as far as I know, employed, by Dr Cothenius first Physician to Army of Prussia.

By him however employed internally

And in form, of which in remarks on another case, shall afterwards have occasion to speak.

Must own have from beginning [illegible] this practice as promoting success.

And unquestionably strongly [supported] by analogy of Sulphur.

For can be no doubt that sulphur consists principally of Vitriol acid.

And indeed probable that combined with principle of inflammation serves only to [diminish] [activity]

Among other advantages of this mode of cure no inconsiderable one that not product of any [disagreeable] swelling

After having tried this practice [however] was inclined to think that same convenience when externally applied.

And that in this form, as well as sulphur, would be much more effective.

While at same time activity [might] to any degree be restrained in consequence of degree of diffusion in Hogs lard or any other unctuous substance.

These considerations then first led me, to use in this affection, of Unguent Vitriol

A formula which have also of late employed in several other affections & I think with advantage.

With present patient, directed to quantity of ℥i of Acid to ℥i of unctuous matter

In this state a purgative & active ointment

Often begin use weaker never strong.

But here as Sulphur had before failed thought that from active ointment aloe could expect much benefit.

From trial for space of week did not appear that derived any inconvenience from stimulating power.

At same time in appearance of eruption change rather favourable as otherwise.

Itchy sensation indeed still continues.

But during course of week no fresh eruption

And of what formerly out very little remained.

Besides this another favourable circumstance.

Discharge of watery ichor viz had ceased.

In this situation prospect of speedy cure

But now apprehensive that might be too expedient.

For from this also some danger.

And especially where eruption with discharge

Same inconvenience as from obstruction of habitual discharge

Particularly affection of breathing.

To be obviated by [compensating] discharge by some other evacuation.

But especially by increased discharge by surface

Was with this intention that had recourse to antimony in crude state.

An article from which have in such affections often I think seen considerable benefits.

And of which may hereafter probably have occasion to speak.

But here remarks unnecessary.

For since ordered have not seen patient

But when consider situation in which was at least with respect to eruption, at time when left us some probability at least that has discontinued attendance as no farther occasion for assistance.

And whether this case or not, her desertion renders it unnecessary to say anything of future plans of cure, if present should have proved unsuccessful.