DEP/DUA/1/19/07 (Transcript version)

Effy Purdie

(1778-1779)

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Effy Purdie.

Affect of this patient as well as former consist of very few sympt.

And may safely venture to pron it a simple & uncomplic disease.

With regard however to name to be given it greatr diffic.

And still more with respect to nature of affect.

Sole compl. to which this patient subj a pecul. erupt. affect princip legs & arms.

Is at same time however without any febrile affect. or indeed without any sympt indic an affect of syst. in gener

In this state then could have little hesitat in referring it to order of impetig or cutan affect.

Under these however in diff syst a great variety of gener [compreh].

And many of them not to be disting from others without very great diffic.

In many cases would even venture to assert that distinct from any descript impossib.

And may perhaps add that in most cases unnecess.

For a case which at pres. exactly corresp with descript of one genus will in short time as exactly agree with another.

Without therefore aiming at being very minute may I imagine to disease of this patient the name of a Herpetic eruption.

For am inclind to think that to gener of Herpes & Lepra even as most strictly defind all the cutan diseases simil to pres. partic those which among the vulgar here have title of Scurvy may be compreh.

And even with respect to these two often transit from one to other.

To pres. however disposed to give name of Herpes from colour, violent itch & dispos to disch.

The affixing however this name to the disease does not afford us any certain ground for prognos.

For while some cases of this affect where appear very obstin will yeild easily others appear slight will [resist] most effect remed.

As far however as could judge from circum must own did not expect that pres would have yielded very readily.

Had contin at least on some [part] without interrup for very consid space

On legs in partic this eruption had been const for twelve months before she came under our care.

And was in no degree allev by use of some active med partic by Mercury taken to such extent as to affect her mouth.

Must own therefore that here imagind would still prove ted.

And in event which has already taken place have been agreeab. [disapp]

How far however the cure of this patient was in reality effect of med here employd may perhaps be matter of doubt.

Only med used with this patient was the Decoct. [Ulmi].

An artic on which although has not place even in last edit of Ednr Pharm, am I own disp to put very consider confid.

While at same time must acknowled myself ignor of prin on which operate

This decoct. formd by boiling four ounces of inner bark of common elm with three pounds of water.

After one pound evap by action of slow fire remainder straind off for use.

And decoct of this strength, taken from few ounces, to extent of lb or upwards in course of day.

In some other inst as in case of pres patient have before observd it encrease quantity of urine.

But how far was any thing [farther] than merly conseq of induct of water matter of some doubt

And in gener in cases in which have used it, have not perceivd any obvious operat.

In as far then as has good effects these not to be acct for on any manif princip.

To use of this med was first led on on authority of two pract of very consid emmin, & accur observat.

Dr Lyssons of Bath & Dr [Lettsome] of Lond.

In first volume of London medic transact will find a paper by Dr Lyssons in which use of this decoct is highly extolld.

Observat by Dr Lyssons have since been confirmd by remarks on same subj by Dr Lettsome in Med [illegible] of London Dispen.

And has [there] given several cases in which use attended with best [affect]

Since these public have orderd this med to many patients subj to compl of Leprous & Herpet kind.

And must acknowledge that my observat do not altog confirm high charact given of this artic by Dr Lett in partic.

In more than one inst have found it even when pushed to utmost extent ineffect.

In others has at first removed disease which however soon afterwards returned & that although use of med contin.

Yet notwith these facts am still inclind to hold it to be a very useful remed & a valuab addit to Mat. Med.

And in more than one case has had every appear of prod complete cure.

While at same time as far as have ever been able to observe nothing to be dreaded from employm of it.

On this acct then am often disp to have recourse to it as in pres case even for first remedy

And [whence] is employd think that should seldom be given to less than extent of lb for a day.

To this quantity patient contin [use] for space of about two weeks without any obvious change on state of affect.

But at end of that period was seized with a febrile affection.

An occurren which could in no degree ascribe to the decoct. as have never before remarkd from it smallest tendency to prod such effect.

Under this affect eruption very consid dimin.

And must own that look upon it as more probab. that this first stage to recov. proceeded from febrile affect than that was conseq of remed before taken.

After every sympt of fever however had gone, as still some remains of erupt went on with use of Decoct.

And in short time patient dismissd free from all compl.

How far recov. will be a perman one yet remains to be determ.

And how far was affect of medicine, is perhaps not less matter of doubt.

May safely howevr venture to assert that from use in this case no concl can be drawn against effic of med.

And that as far as goes is even in favour of it