DEP/DUA/1/29/24 (Normalised version)

Daniel Riddell

(1782)

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Daniel Riddell.

Affection of this patient obvious.

And but little room for doubt as to nature.

Consisted entirely in ill conditioned ulcer of right foot.

This we are told derived first origin from accidental injury received by a cart wheel.

But from appearance some reason to presume that of scrofulous nature.

This the rather to be presumed from observing that no ulceration took place for a long time after accident.

That progressed very much in same way, that scrofula affection in bones, & [article] generally occur.

And that where no scrofula disposition, if such accidents are not at first product of remarkable injury, have little influence afterwards.

But although thus consider it as scrofula, would not be understood to insinuate that accident no share as inducing it.

Look upon it as having given rise to this, in same manner as strokes in knee, often do to white swellings or like.

And have no doubt that scrofula, when exists in constitution, often excited at particular parts by different accidents.

But whatever either cause or nature of affection, was not here disposed to consider either obvious swelling or ulceration as worst part of disease.

From situation of part from hard feel, & from long continuation had but too much reason to dread an affection of the bones.

Of this indeed had no certain evidence from parts of bones being discharged.

At least if this had been cause had escaped observation of patient.

But well known that without any exfoliating condition of bone below often supports ulceration above.

And this I own was idea with regard to present case.

With this view will readily suppose that opinion of termination could not be favourable.

And after having already resisted attempts to cure under direction of able practitioners must own that entertain no expectation of being of service to patient.

At the same time was still desirous to give patient some farther chance of recovery.

And the rather selected case as subject of treatment, from obstinacy of nature with view to trial of medicine which hitherto has been in such affection but little employed.

I mean internal use of Mezereon in powder.

This medicine I need not observe first introduced against [obstinate] venereal affections.

And in these often attended with best effects.

Success there has led to employment also in other obstinate ulcerations.

And often with very considerable benefits.

Hitherto however has been employed only [almost] in form of decoction.

And great acrimony to taste indeed might seem objection to use in any other way.

But no doubt that for Dispensary practitioners this both an expensive & troublesome mode of exhibiting.

From this then first led to think of employment in substance.

In which way not only more convenient exhibition but much smaller quantity sufficient to answer purpose

From experience which have had of effects in other cases am convinced that in this way full benefit to be derived from it may be attained.

From these considerations then led to exhibition of Mezereon in substance in present case

When in general given it in this way have for most part conjoined with powder of Liquor.

Both as one of best articles for giving form, & for [sheathing] [illegible] from mucilaginous qualities.

Here however in place of Liquor have had recourse to powder of Peruvian Bark.

Principally as patient had before employed bark with some advantage.

And imagined that by this means would more readily be got to persist regularly in use of medicine for some length of time

Was intention then, by gradually increasing dose of Mezereon as found that patient could bear it, to give full & fair trial.

As already observed opinion of case such that although had failed would have been no ground for concluding again the practice.

If had succeeded would have been strong instance of efficacy.

Since first presented however patient has not hitherto either returned [hence] or sent any account of situation

More than probable therefore that shall be altogether disappointed of intended trial.

Here any farther suggestions with regard to case altogether unnecessary.