DEP/DUA/1/30/09 (Normalised version)

David Minto

(1782-1783)

---

David Minto.

Affection to which this patient subjected both simple & obvious.

And as little doubt respecting cause to which to be attributed.

In following some nosologists¹ would give his affection name of Caligo.

Which however may observe is very vague & extensive genus.

But particularly so as defined by Dr Cullen. For according to his definition, [illegible] not only Cataracta but also several species of Amaurosis of Sauvages.

And can be no doubt, that includes affections, essentially differing both in nature & mode of treatment

Hence cannot I think with propriety be included under one genus.

But differences thence arising, removed by species into which has divided it.

In case before us an example of that species which Dr. Cullen in his [system], has styled Caligo Cornea.

And according to Mr Sauvages name of Caligo [a] Leucomate.

Nor is there more room for difficulty respecting nature than name.

In case before us, has occurred in consequence of repeated inflammation to which subjected

And from this cause, such want of transparency every day observed to arise.

Probably consequence of effusion of gluten acquiring solid state, in same manner as inflammation exuded, on other parts.

But whatever cause, opacity [indeed] such, that passage of rays of light obstructed.

In so much that vision often much diminished, sometimes as in case of our patient, almost totally lost.

When occurs restoration of vision to be brought about only by removal.

Sometimes of such size & thickness that can only be effectively done by operation.

But in other cases even where considerably affects vision, will yet gradually wear off, without any application

While seldom however that either requires or admits of former treatment rarely that patients are willing to rest satisfied with latter.

And many different practices proposed & employed, with view of forwarding removal.

For this purpose recourse advised to be had, even to variety of internal medicines.

Particularly mercury, cathartics, etc.

But from these may safely venture to assert that no benefit to be expected.

While on contrary if pushed to great extent, cannot fail to be product of dangerous consequences.

Only remedies to be used with safety or advantage are different external applications.

Of these greater part operate on principles merely mechanical.

And not a few of them, of such nature, that product of inconvenience from irritation.

Especially if happen not to be reduced to very fine powder.

In this way, powder of sugar, of [illegible] oyster shells, of Os Sepiae etc in frequent use.

And sometimes recourse had to powder of alum, of aerugine aeris, & of vitriol.

Of activity these applications I have never used any [one], which in my practice has answered better, than that here used.

What viz, following Dr Baldinger of Gottingen, have here styled P. Opth.

This article, as here employed, consists of equal parts of very fine powder of Cream of Tartar, & fine sugar.

Had first recourse to it on recommendation of practitioner just mentioned Dr Baldinger.

Formula however here used somewhat different from his.

For besides Cream of Tartar & Sugar contained also Armenian Bole, & several other articles.

His original prescription will find in edition which has published of Edinburgh Pharmacopoeia².

Of the different articles however was inclined to think that greatest effect from Cream of Tartar.

While some of them as bole from not [being] soluble in eye, might be product of inconvenience.

As Cream of Tartar slowly dissolves, have at least for some time, all the advantages of mechanical triture.

And probably not liable at least to any great inconvenience from irritation.

Accordingly from reducing it to more simple state expectations have not been disappointed.

For while have never found it distressing to patient, in almost every instance where duly applied has had good effect.

In case before us, from continuation for few weeks, affection considerably diminished.

And hope that by persisting in use, in no long time, complete cure may be accomplished.

Here however would be far from representing it, as having done, what would not have taken place without use.

Think it probable, that in process of time, obfuscation would have gone off of itself.

Yet certainly a matter of some importance to restore sight sooner than would otherwise been case

And have no hesitation in attributing this effect to it.

By continuation may expect still more.

But at same time now in such a state, that will hardly think of persisting in use much longer.

Consideration of next case delay to future lecture which now propose to deliver on Saturday next at 9 o’Clock in the morning in the Dispensary.

And hope it will not be inconvenient for you that continue them at that hour as long as Dr Monro [meets] on Saturday forenoon.

After he gives up Saturday lecture which generally does after Christmas we shall again return to hour of eleven.

---

Explanatory notes:

1) Nosology is the branch of medical science dealing with the classification of diseases. Individuals referred to in the case notes as nosologists were commonly those who had published nosological, or classificatory, medical texts.

2) An official publication containing a list of medicinal drugs with their effects and directions for their use. The Royal College of Physicians of Edinburgh's Pharmacopoeia was first published in 1699.