DEP/DUA/1/29/10 (Normalised version)

Helen Donaldson

(1782)

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Helen Donaldson.

Can have no hesitation in pronouncing this patient subjected to complication of diseases

Oldest dated affection of Respiration.

And for this often before patient.

Had no doubt in considering it then as at present to be chronic catarrh.

And was at least relieved by those remedies most successful against that affection.

But with a patient past age of 60, in low uncomfortable situation & with such cold season as present has been was not to be expected that would keep free from it.

Even in these circumstances however although still continues are informed that much less considerable than formerly.

This particularly the case since another disease supervened.

Viz. Cutaneous eruption to which subjected

Among affections of this kind if [illegible] external appearance very great diversity.

But nothing more common than to observe transition from one to another.

Hence then of very little consequence to distinguish each by particular name.

Especially where there is not as in Psora, [illegible] or like something particular in nature.

All such eruptions as those in present case have not only among vulgar & but among many regular practitioners got name of scorbutus.

Can however be no doubt that in nature essentially different from real Scorbutus or Sea scurvy.

In which indeed cutaneous affection but very inconsiderable part of disease.

This term therefore as strictly [applied] to another disease very improper.

All such affections may I think with greater propriety be included under general title of leprosy or herpetic affection.

And even between these much more difference in name & [appearance] than in reality

This sufficiently evinced by frequent change from one to other.

But at same time appearance so different that no disadvantage at least in having different names for particular states.

And where dry white scurfy [appearance] have name of leprous.

To disease of patient in present state then, would give name of a Herpetic affection.

And may add that such complaints not more common than obstinate.

At least though yield to use of remedies yet very liable to return.

And after has once taken deep root, very difficult matter completely to eradicate them.

This it is true hardly can be said with regard to affection of present patient.

For according to history given us is only of few months duration.

And may presume, that if existed previous to that time was till then but inconsiderable.

But if something favourable in short duration many other particulars in present case against patient.

Besides obstinate nature of affection her situation & circumstances by no means such as can lead us to entertain hopes of speedy cure.

Both from age & poverty cannot reasonably expect that cleanliness which so essential to cure.

While diet must necessarily be accommodated not to disease but to circumstances in life.

From these particulars then must own do not flatter myself with hopes of speedy recovery.

And while must have tendency to support the disease, are also very unfavourable to every practice which could be employed for removal.

[Notwithstanding] this however hope that by proper means may at least be able to mitigate affection.

Perhaps to obtain even complete temporary suspension of it.

Here however may occur as question how far such an event in reality to be wished.

For to be observed that this not only affection to which subjected.

Labours under another affection also which although less obvious neither less troublesome nor less dangerous.

And this will observe more distressing before cutaneous affection commenced than is at present.

Well known however that such diseases often alternate with each other

And reason to presume that on total removal of cutaneous eruption may have return of pectoral complaint.

This many pathologists disposed to attribute to repulsion as they call it of cutaneous eruption.

Explain it from introduction of morbid matter into system.

But although can by no means adopt this theory yet consider fact as undeniable.

And in my opinion to be explained merely on change which takes place in determination of blood.

In such cases as present circulation much augmented on affected part

And often no inconsiderable discharge.

Hence then in some degree analogous to an artificial discharge by issue or like

If therefore speedy cure without some compensation for accustomed discharge may naturally expect aggravation of former affection.

This however hardly any objection to most effective remedy for removal of cutaneous affection.

As can easily give similar determination to some other part & more considerable evacuation in a way much less distressing to patient.

At the same time a circumstance to be had in view in treatment.

And although cutaneous affection is naturally at present first object of attention yet remaining affection of breast not to be overlooked.

Hitherto however practice principally directed towards former.

And that probably will be case till some change induced in state affection.

In such cutaneous affections as present a great variety of remedies in common use.

And although none certainly or [invariably] successful yet many of them at least which on some occasions attended with good effects.

With regard however to almost all of them a very difficult matter to say on what principle operation to be explained.

Many with regard to which cannot even offer probable conjecture

And used merely on footing of former experience or as suggested by analogy.

This very much the case with regard to first remedy here employed.

And hold also with regard to some other practices which shall suggest as intended trials if present should prove unsuccessful.

Began treatment you will observe by use of Mistura Vitriol.

This mixture consists of ℥i of Vitriol acid, the Spirit Vitriol fortis or oil of Vitriol as commonly called [united] with ℥p of water & as much Simple Syrup.

This remedy introduced into practice some years ago as a cure for Psora.

Probably suggested from well known efficacy of Sulphur in that affection

And from its being equally certain that by much greatest part of Sulphur consists of Vitriol acid.

From efficacy in Psora have of late been led to employ it in other cutaneous affections at least similar in appearance.

And in some cases after ordinary practice had failed have found it attended with very considerable benefit

Cannot indeed represent it as having always succeeded

Yet can with confidence venture to say that success such as to encourage to future trials.

As subject of one of these have selected present case.

And to this the rather led as look upon this medicine to be favourable also for pectoral affections.

While at same time circumstances of case such, that if does produce cure, may safely venture to say, that has done a great deal.

But while engaged in this trial is by no means my intention to [neglect] other modes of cure either for removing affection or alleviating symptoms.

Accordingly will observe that with this even from beginning another practice also conjoined.

Use viz of Camphorated Oil.

This also an application which in different cutaneous affections have of late frequently employed.

Have not indeed used it unless in conjunction with internal remedies.

Particularly with those calculated to increase discharge by surface in way of diaphoresis

But in conjunction with these have I think seen benefits from it both in Leprotic & Herpetic affections.

Particularly in former where dry & parched state.

And even in some slight instances of Tinea Capitis.

Was on these grounds, then, that began present course with this patient.

And unless something particular shall occur to prevent it, is intention to give it fair trial.

With this view shall not only order more frequent repetition of Camphor oil but increase also quantity of mixture taken.

In this however must be entirely regulated by effects.

And upon whole better to lose a little time than by imprudent [illegible] to be disappointed of intended trial.

During this course may also be farther requisite to employ practices with view of obviating urgent symptoms.

And accordingly for counteracting costiveness have already had occasion to employ an electuary of Cream of Tartar with Sulphur.

If cure shall proceed as wish with view of [compressing] discharge & [counteracting] affection of breast may perhaps have recourse to issue.

But if shall find that this mode of cure unsuccessful must have recourse to other practices.

And if circumstances of case not [illegible] have next thoughts of trial of Oenanthe Crocata.

If alteration takes place cure must be accommodated to circumstances which shall then occur.