DEP/DUA/1/42/36 (Normalised version)

Duncan Stewart

1787

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N^o6^th November 7^th 1787

Duncan Stewart at 77. Has a large open ulceration on his scrotum about three or four inches in diameter. It in general discharges an ichorous fluid of a thin consistence but sometimes there is a considerable discharge of blood. This ulceration is not deep, but its central part has an irregular & fungous appearance & its edges are considerably retroverted. From this ulcer he has very great pain, & it is almost constantly affected with an uneasy sense of burning heat which frequently prevents him from sleeping during the night. When a discharge of blood takes place from the ulcer the pain & heat are in general most severe.

His strength is much impaired, Pulse above 80 & irregular, Belly natural, Appetite bad, but he is free from thirst.

To this affection he has now been subjected for about two years. It first began under the form of a small tumour in the scrotum, which gradually increased in size & afterwards ulcerated.

He does not recollect his having ever received any injury upon the part nor does he know any other cause to which it can be attributed.

Since this complaint began he has employed many different medicines, but they have neither had much influence in giving temporary ease, nor any effect in checking the progress of the ulceration.

Rx. Pulv. Fol. Belladon grXII

Sap. Alb. Hispan Jii

Syr. Simp. g. s. f. mas.

divid in pil. XII cap I. om. noct.

h. s. & Hab. Ungt. Saturn. ℥ ii quo curet. ulcus.

17.

Has taken the Belladonna pills without any sensible operation

The sore continues as painful as ever, with the same discharge & frequent haemorrhages. Pulse 104.

Cont. Pil. sed cap. Pil. ii. om noct. & Pil. i. om. m.

24

Has continued the pills regularly, without any obvious effect than slight sickness from the evening dose. But the pain from the sore continues nearly as before & he is often affected with general flushings attended with a great [sense] of heat & dryness in his mouth

Cont. Med. sed cap Pil. ii

Belladon. om. m. & vesp

December 1.

[Feels] no uneasiness from the increased dose of the Belladonna & he thinks that his pain is somewhat easier, for an hour or two after they are taken. But the sore continues much as before & is still subjected to frequent haemorrhages

Cont. Pil. ex Belladon. sed cap

Pil iii om m. & Pil. ii. om. m.

Cont. Ungt. Saturn & hab. Solut

Saturn. ℥ IV

8.

The ulceration continues nearly as before & the pain is nothing alleviated by the saturnine solution.

Cont. Med. u. a.

December 15.

Pain still severe & the ulceration rather increased.

Cont. Pil ex Belladon. sed cap.

Pil. iii. bis indies, cont. Sol. Satur nec non sumat. Pil. Theb. grXV om. m.

22.

Pain nothing abated from the use of the Pill Thebaic & the ulceration is much in the same state as before.

Cont. Pil ex Belladon u. a. Interm. Pil. Theb. & cap. Opii griii om n. h. s.

29

There has been a considerable haemorrhage from the ulcer & all his symptoms are rather aggravated

Cont. Med. u. a.