DEP/DUA/1/28/06 (Normalised version)

Alexander Taylor

(1781-1782)

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Alexander Taylor

From symptoms enumerated in this patients case little room to doubt nature of affection.

When came under our care consisted of tumours, evident glandular affection.

And one of these on former occasion suppurating had discharged in place of pus a bloody ichorous matter.

In these then what at least most common [appearance] of Scrofula at any part.

But besides this, argument for that opinion from situation here occupies.

For of all parts of body scrofula most frequently at least in glands about neck & under part of face.

This supposition favoured also by age of patient.

For at that period of life when scrofula a most frequent occurrence.

Hence then little doubt in considering as incipient state of that disease.

And this not less probable as knew no particular cause to which could be referred.

If indeed similar affection had existed in parents or near relatives so that could have been traced to hereditary affection probably still strengthened.

But although not hereditariness does not follow that is not scrofula.

For although undeniably one of those affections transmitted from parents to child yet in more than one half of those subjected to it, takes place in child whose parent no taint of this kind.

Hence then from other circumstances here no difficulty with respect to the disease

While however pronounce affection to be of scrofula nature must at same time observe that very slight.

When came under care was in point of standing in incipient state.

And under practices employed during course of attendance entirely ceased.

By this therefore observations on Prognosis in some degree superseded.

Here however though temporary [removal] of complaint obtained would not venture to say that radical cure.

What has already happened sufficient to show tendency to Scrofula in habit.

And although for present counteracted may again be renewed by trifling circumstance.

Or even without any other cause than mere season of year.

And in succeeding spring may again be renewed with greater violence.

For at that period of year in particular marks of this affection apt to appear.

And am inclined to think that was from season operating as exciting cause that appeared at present.

x And at least for present may be said to be cured of affection.

But whether completely gone or not is a question in some degree foreign to present business, as patient already dismissed.

Of more importance to consider how far present removal was consequence of medicine employed.

And here I must own not altogether without doubt.

For some of practices directed more with view to obviating symptoms than cure of affection.

While before others employed evidence of itself on the decline.

At first visit directed for patient a blister betwixt shoulders.

And ordered that after discharge thus excited should be supported by epispastic ointment

In this had in view the diminishment of determination of blood to head & other affected parts.

For besides mere glandular tumours swelling of other parts & even flushing of [face]

Such a state however could not fail to give tendency to speedy aggravation of affection.

And therefore by removal though did not produce resolution of tumours [might] yet prevent termination in suppuration.

With intention of producing such derivation different practices might have been employed.

And in particular may have had recourse to use of purgatives.

For as appeared from influence in lower complaint, no doubt that in this way [an] powerful effect.

But same also the consequence of blisters

While these produce it, with at least a lesser degree of evacuation from system in general.

In this way however cannot suppose that had here much influence

For from blister little discharge & running not afterwards supported.

To this therefore could hardly [attach] mitigation of swelling which by next report had taken place.

And perhaps even, if no other medicine had been employed, progress to resolution would have gone on.

At same time judged it inexpedient to lose present opportunity for employment of remedy.

And especially as then, when only requisite that should forward natural progress, have in general more effect.

At this time therefore had recourse to two practices.

Friction viz of tumour with Camphor Oil, & use of Cicuta internally.

Am very far from thinking that from either of these practices, resolution of scrofula tumour to be ensured.

Nay must allow that in majority of cases are inadequate to this affect.

At same time I own, have high opinion of effects of both

And still more from conjoined [influence]

In what manner operation to be explained in this or other complaints must own am at loss to say.

But am fully persuaded that in similar cases have soon good effects from them.

And that too where previous to use no tendency to resolution.

Here indeed such tendency had already manifestly taken place, & might have gone on, without use of any medicine.

But can at least say, that under use, tumours suffered more rapid decline than commonly observed to happen in such instances.

In so much that in little more than space of month, affection seemed to be totally removed.

And for my own part at least was disposed to think that external friction with camphor oil, together with internal use of Cicuta had at least some share in forwarding it.

And am upon whole disposed to consider present case as affording proof of benefits to be derived from these practices.