DEP/DUA/1/36/29 (Normalised version)

Margaret Runciman

(1784-1785)

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Margaret Runciman.

Disease of this patient consists of very few symptoms.

For may consider it as entirely constituted by eruption which took place in face.

And this as far as could judge from appearance might I think very readily consider as being of Herpetic kind.

To appearance had much resemblance of confluent smallpox.

A proof that for the formation of incrustation a considerable discharge had taken place

Here may perhaps be questionable how far disease in any degree depends on smallpox

For to this disease are told that patient subjected about two months before commencement of present affection.

And well known that many obstinate affections occurring as sequelae of these.

Thus in part often gives rise to even Scrofula.

But in these cases sequelae immediate consequence of preceding smallpox.

Here however there took place an interval of near two months of good health.

And besides well known that such eruptions often occur particularly at early periods of life without any [manifest] cause.

Here therefore am inclined to conclude that no connection.

Would therefore be rather disposed to refer it, to some accidental circumstance, giving obstruction perspiration, increased action of vessels or like.

But whatever cause now almost unnecessary to offer any thing respecting prognosis.

For disease already completely removed.

And if any return, should now rather consider it, as a fresh affection than continuation of former disease.

Whether recovery consequence of remedy employed cannot positively pretend to say.

For from appearance of affection, when came under our care, had reason to hope that would soon scale off.

But if no influence in removal, probable that had at least some share, in preventing return

And this, in such affections, an objective of no less, if not of greater importance than removal.

Remedies to which had here recourse were Unguent Saturn externally & Crude Antimony internally.

First even from simple friction & from operation by oily matters which contained might be supposed to promote [illegible]

But still more benefit to be expected from saturn impregnation.

For influence of these as allaying inordinate action well known.

And from affect in this way may be supposed to prevent fresh effusion renewing incrustation.

And indeed as far as my experience goes am convinced that in immediate removal at least of such affections more may be done by external than internal [medicine]

Former however not in every case equally safe.

And indeed by many considered as highly dangerous to repel cutaneous eruption as has been called by external remedies.

But without giving into idea that actual repulsion of matter takes place, yet no doubt that sometimes bad consequences.

Probably the effect of change in mode of circulation.

As thus determination may occur to parts in the system more important.

Hence then, when external means employed, particularly if to check any considerable discharge, is proper that determination should be given to some other part.

To intestinal canal for example by purgative.

To particular part of surface by issue.

Or to surface in general by diaphoresis.

Was with latter of these intentions, that had here recourse to Crude Antimony.

Which here conjoined with powder of Liquor, merely to cover taste, & to give form.

Crude Antimony unquestionably not the most active state under which the regular part of that metal can be exhibited.

But while one of most gentle, not least efficacious preparation.

For while in general without either vomiting or looseness & indeed but rarely any considerable sickness at stomach has effect of inducing & supporting regularly increased perspiration.

Accordingly often successfully employed in cutaneous affections.

And indeed not merely with human species, but against cutaneous diseases of horses.

For with Farriers, frequently employed to give to horses, fine & smooth skin.

In case before us, neither external nor internal medicine, attended with any obvious operation.

Nor were they product of any uneasiness.

And in short time incrustation on brow fell off, leaving parts below apparently in sound state.

In this situation reckoned continuation of ointment unnecessary.

But directed that should persist in Antimony, as hoped that by free perspiration, return might be prevented.

At this time, what might in some measure be considered as new complaint appeared.

A swelling viz, of submaxillary glands.

Not improbable that this the consequence of eruption being removed.

Or perhaps may have proceeded from matter absorbed affecting these glands, in course through lymph.

But from whatever cause might [arise] hoped that would soon yield to friction with Camphorated oil.

To this therefore had recourse.

And from this, together with continuation of antimony, soon freed from all symptoms

In this condition has now remained for such time without return, that reckon farther attendance unnecessary.

And as have already remarked if again subjected to same affection should rather consider it, as new disease, than continuation of former