DEP/DUA/1/25/17 (Normalised version)

Ann Kinnaird

(1780-1781)

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Ann Kinneird.

Of case of this patient, who has hardly been subject of treatment here, very little to be said.

In disease to which she was subjected an evident example of Tinea capitis.

An affection of which already some observations in case of John Ormond.

There an instance of disease which in as far as of longer duration more obstinate than present, & which seems now to be cured.

In that case indeed some symptoms such for example as affection of eyes still remains.

These however I have already given it as opinion that disease complicated with scrofula.

A combination by no means infrequent.

And here perhaps question whether such conjunction does not also take place

For besides common symptoms of Tinea some other appearances also mentioned.

Before however mention these may observe that in description of this case very distinct account of ordinary progression of Tinea.

At same time began in way rather uncommon.

By incrustation viz first formed on chin.

This however from account given but of short continuation.

And soon succeeded by that sort of discharge from head which gives incrustation from which principal appearance in Tinea arises.

When came under our care, disease about three months standing.

During that time however very thick incrustation formed.

And hence little opportunity afforded for discharge.

Accordingly informed that at first much more considerable than at that time.

Though this however the case yet still probable that morbid secretion going on.

And while part discharged, part giving additional thickness to incrustation, part also absorbed.

At least is I think no improbable supposition that to this cause are to refer another appearance mentioned in case.

That is tumour on back side of neck, which seemed when last saw patient, to have terminated in suppuration

This as have already hinted may be supposed indeed to depend on similar combination as have alleged to take place in other case.

Patient viz being at same time affected with scrofula.

No doubt indeed that such tumours about neck one of most common forms in which scrofula appears.

But then in general seldom yields proper purulent matter.

And when once in ulcerous state seldom heals so soon, as before happened in present case.

Besides this such tumours in neck & neighbouring parts by no means rare occurrence in Tinea.

At least certainly much more frequently take place than affection of eyes [such] as occurred in case of [Ormond].

And may I think be explained as consequence of absorption from head.

From matter taken up by [absorbance] being retained in lymph glands whole train of consequences of irritation, swelling, inflammation, suppuration are [induced]

In this manner then consider whole symptoms in case as being merely dependent on Tinea Capitis.

And view disease as uncomplicated.

From this consideration joined to other circumstances state & appearance of disease, short continuation etc hoped for favourable termination.

Expected that in consequence of regular attendance & due attention might in no long time have been removed.

Here however wished to vary practices

And as in former case had an example of cure by corrosive sublimate wished here to give trial to verdigris.

For this purpose directed it in form of ointment, united with Hogs Lard.

In proportion of Ji of [ Oeng] to ℥i, which as large proportion as can at first I think be ventured upon.

With this measure however others at same time conjoined.

To tumour with view of forwarding suppuration, poultices directed to be applied.

And to prevent inconvenience from suppuration of discharge by head, as well as to give determination from affected parts, blister directed between shoulders.

Since these measures however enjoined have seen nothing of patient.

And therefore cannot say how far have been used or if used have had any affect.

Probability also is that now shall see nothing farther of him¹

Hence any farther remarks unnecessary.

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Explanatory notes:

1) Refers to patient as 'him' but patient is female.