DEP/DUA/1/31/06 (Normalised version)

James Wilson

(1782-1783)

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James Wilson

This patient but short time under our care.

And affection not very important.

Such as it was however almost entirely an obvious complaint.

For while there took place, an evident cutaneous eruption almost all functions continue in natural state.

Eruption which here took place not extended over whole body but confined entirely to left side particularly to left shoulder.

But during course & at commencement as far as can learn entirely without febrile symptoms.

Hence then no danger of [confounding] it with those eruptive diseases, [where] such affections occur as it were in style of crisis.

For from history of case evidently apparent that cannot be ascribed to fish diet, a cause to which such affections often attributed.

Of difficulty in giving accurate name to such affections have already had occasion to speak.

To present consider term of herpetic eruption as most applicable.

With regard to cause to which to be attributed must own much at loss

Not indeed that would deny influence of fish diet as inducing cutaneous affections

But these either consequence of long continual habituality, or of immediate action on some stomachs as in case of particular shell fish.

In both however appearance very different from what occurs in present case.

But whatever cause inducing it, [appears] most probable supposition that depended on state of action of cutaneous vessels at part.

And on this idea opinion of [termination] as well as plan of treatment proceeded.

When came under our care several circumstances from which reason to look for speedy termination.

Affection had taken place only in very partial manner.

Was not attended with any [marked] indication [considering] affection of system.

But above all was of short duration & had not resisted any mode of cure employed for removal.

On these grounds then expected speedy & successful termination.

But must own should not have been surprised if had run on to greater length than was really the case.

And may even say that terminated sooner than expected.

How far this to be attributed to practices here employed is next our business to enquire

Here remedies used not very numerous.

On idea given of affection that depended viz on state of action in cutaneous vessels of particular part cure chiefly to be expected by external application.

And from evident disposition to inflammation chiefly to be [looked] for from those diminished actions

But from applications of this kind [change] induced in mode of circulation could not fail to be considerable.

Especially when consider state of discharge from affected part.

Would therefore have been imprudent to have had recourse to external application without compensation by some other outlet.

Accordingly previous to any other practice had recourse to Cream of Tartar as a gentle refrigerant cathartic & diuretic

From this alone had reason to expect good consequences.

For from these efforts might look for diminishment of increased action at superficial vessels.

Here however cannot attribute much to it in that way.

For besides that never given to such extent as to produce any obvious operation, even at first report had recourse also to another remedy.

External lotion viz with a saturn preparation the solution of Saccharum Saturnine

This reckon one of most powerful articles with which am acquainted for allaying increased action of vessels.

Influence in this way particularly exemplified in cases of burning or scalding by hot water.

There from application to part influenced as allaying inordinate action exemplified in most immediate case, from excruciating pain

In same manner expected that would diminish action in present instance.

And accordingly after very short [application] affection very considerably diminished.

While this case however, Cream of Tartar, had no obvious effect in moving belly.

And although no bad consequences had taken place yet reckoned it proper to anticipate these by more considerable evacuation.

Had therefore recourse to Glauber salt, as substitute for Cream of Tartar.

And after few doses of these conjoined with former course, affection soon entirely removed.

An event which I think may with justice in some measure at least, be ascribed to practices here employed.

At same time consider it as more owing to slightness of disease & to tendency even to natural recovery.