DEP/DUA/1/11/03 (Transcript version)

George Bell

(1776-1777)

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George Bell affected with a disease by no means rarely occurring in pract.

Is farther one all sympt of which obvious to senses.

Yet shall find that consid diffic in affixing to it prop. name

And must indeed make this observ. with regard to cutan affect. in gen.

For to this order of diseases case of pres. patient manif. to be referrd.

Am of opin that cutan diseases not hitherto disting with suffic accuracy either by Nosol. or pract. writers.

Some indeed have multip species to very great extent.

But from descrip impossib. to say to which any partic instance to be referrd.

Would I appreh be of great conseq. [could] distinct gen be here formd disting them according to causes from which proceed.

And probab. might on this footing be referrd to one of three four gen. heads.

1 Morbid condit of gen. mass of fluids.

2. Morbid affection of cutan vessels.

3. Deprived secret by subacous glands of skin

4 Morbid affection of bulbs of hair.

These take to be gener. causes of greatest part of cutan affections.

And according as proceeds from one or other of these cure in many resp. varied.

If therefore prop. marks could be discov. for disting these should consid it as matter of conseq.

But such I appreh. not hitherto pointed out

And can only form uncertain conject from appear & other circum.

All such affections in this part of country at least vulgarly known by name of scurvy

But this term as employd by men of science used to express an affect of a nature totally differ.

And among chronic cutan affections if exclude itch & tinea, know but two gen distinctly markd.

These are Lepra & Herpes.

To one or other of these gener. must own that am disp. to referr all of them.

At same time in some instances [are] such manifest diff. that cannot help thinking that if gener could be ascert genera should be more numer. provided could be prop. disting.

While in others limits between two pres. [genera] such that can hardly say to which ought prop. to be referrd.

Upon whole howevr rank under herpes those eruptions where greatest inflam. most watery disch. & least of scaly [aprn]

And referr to Lepra those instances where little or no obvious inflammat. little obvious rising above skin, but parts affected covered with white scaly matter.

In this view then would be led to consid pres. instance as an ex. of Herpes.

And consider it to be more affect of state of cutan vessels at part than of any other cause.

How far may as parents of patient suspect have derivd origine from sleeping with one affected with simil malady cannot pretend to say.

Must own however that inclind rather to suspect contrary.

Yet by no means so clear in this sentim as to be posit in conclus.

And very intim connex in all such cases unquest. to be avoided.

But whether from this or any other cause will little affect either prognos or plan of cure.

As, exciting cause being now removed prop. judgement respecting these to be rested entirely on state of disease with patient.

And here must own that in giving judgement respecting probab. termin [cannot] be very posit

Am however disp. to hope that may be able to cure it.

And that patient may recov. perfect health

Is consid in his favour that disease comparat. speaking not of long durat.

That has on differ. occasions had appear. of yielding somewhat to med used.

That no reason to suspect its being a heredit affect.

And that patient yet at an early period of life

From all these partic greater reason to hope for success than in contrar. circum.

Should we even be disapp. do not appreh. much danger from affect.

And from contin would be rather trouble than fatal to patient.

May here however remark that not altogether without danger from cure.

Well known that greatest evils sometimes attrib to repuls. as has been calld of eruptions.

And where by these system long accustomed to habit disch easy to see why this should be case.

Necess. becomes object in cure therfore that while endeav to remove this affect do not induce one more danger.

Especially as this I appreh. cheifly to be feared from most effect. mode of cure.

Is from this consid that have put patient on use of sever. med.

Here as have already observd consid disease to be chiefly produced by state of vessels at part.

And place princip confid in Mercur lotion

Which expect to operate in cure in consequence of pecul. stimul power which [exerts] on vessels to which applied.

But if by this means sudden [restorat] to sound state is necess. followd by consider change in [balan] of circul.

At same time with retent of matter which before used to be disch.

Hence instances where has given rise to apoplex, dropsy & other danger affect.

To avoid danger of such wish to encreas disch by other means outletts.

Is with this view that have put him on use of Crude Antim.

A med often employd & I think with success against cutan affect.

Probab from giving perman encrease of disch. by surface.

Is with same intent that have repeatedly exhib. refrig. purgat.

As giving though less perman. yet more certain & more immed disch.

And thus prev. accumul which might otherwise occur.

From this course, contin for prop. length of time am hopeful that patient may be perfectly recov.

And perhaps nothing farther requis. [than] to encrease strength of solut or otherwise regul med according to circum.

If however shall find it ineffect may try both extern & intern med of diff. kind.

And if necess. have thoughts of putting him on use of Vitriol acid.

A med of late partic recommended for cure of itch.

The effic of which both in cases of Scab. sicca & humid. I am told fully [confirmd] by that able Phys. Dr Baldin of Goeting.

Have myself tried it in some cutan affect. & I think with success.

And if on fail. of pres. plan shall [succeed] in this instance will I own have higher opin of it than ever.

If however this also shall fail intern mean to use it extern.

Conjoind with Axunge makes very eleg. ointment.

Of which have not indeed as yet had exper but a priori inclind to hope for good affects from it.

If all means ineffectual shall conclud with recommending him to use of some natural or artif. min. water.