DEP/DUA/1/19/16 (Transcript version)

David Bouthron

(1778-1779)

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Case of David Bouthran as well as that of which last spoke by no means entirely without diffic.

Differs however essent from former in this partic that greatest part of sympt obvious.

Princip part of affect to which subj of the cutan kind.

And from dry scaly appear. should at first have been disp to pron it as belong to Genus of lepra kind.

This suppos. corrob. from length of time for which had contin.

From having at first taken rise without any manif cause.

From spont. appearing, as it were, at same season for these success years.

And from ceasing of itself after certain contin in good meas without aid of med.

But notwith all these concur circum some partic from which inclind to form rather diff suppos with respect it

Well known that erupt of simil appear by no means unfreq. the conseq of Syphil affect.

And here pres patient manif subj to other vener. sympt.

Besides running from the urethra other sympt also mentiond in case which must referr to same cause, indic a more fixd affect.

These partic were tumour in [illegible] of urethra with sense of tension in groin probab from affect of glands.

But besides this after patient [cam] under our care found that subj to anoth sympt. giving still stronger indicat that syphil virus had enterd the habit.

That was pains of bones.

From these circum then reason to believe for suspect that erupt here occurring might not depend on cause so obscure as patient inclind to imag. but that really of syphil kind.

To this suppos indeed may occur as object. that erupt existed prev to vener. infect.

And that has resisted mode of cure by which vener sympt in gener overcom

But with regard to first origin of vener compl. acct of patients not always to be depended upon.

And even allowing that erupt prev [illegible] to vener infect. yet would not prev occur from that cause.

While from former morbid tendency of this part of system vener affect would more readily appear under that form.

[illegible] Contin of this sympt after use of [Merc] not more surpr. than that other sympt manif vener. should also remain.

Hence then consid diffic to the [supp] as being less consid than might at first be imag.

And upon whole disp to look upon it either as being vener or at least as acquiring pecul modif from that affect.

From this view then of nature of princip part of affect could be no means look upon case as one [where] reason to desp of cure

And from erupt having before on diff occas yielded spont. was in hopes that even in short time might be [remov] or at least disapp.

Was indeed appreh. that should find pains of bones a more obstin compl.

But still more so with regard to local affect of urethra.

And here disposed to [consider] the running at least since has been last renewed not as mere mucous disch but as proceeding from some ulcerat.

If this howevr the case better chance of removal than if tumour without any tendency to suppurat.

At any rate howevr cannot look for speedy termin of all compl.

Yet in hopes that may at length be able to dismiss him completely freed from greatest part of them.

And with other at least consid allev.

In progr towards cure must here observe that greater advances already made than I expected.

And during two months for which has been under our care prin part of affect the erupt viz has been grad diminishd & now almost entirely gone.

Is now also in great meas freed from other urgent sympt partic pain.

And according to informat given us both running & tumour on urethra consid dimin.

Will not pretend to say that these changes for better, entirely affect of pract here employd.

Yet cannot help thinking that has at least had consid share in recov. as far as has yet gone.

Here will observe that since patient came under our care has been kept entirely on use of one med.

A combinat viz of [Sarsap.] & Mezer in form of powder.

To trial of this the rather led as were informd that before patient came under our care had taken Mercury to very great extent.

Hope therfore that now cheifly necessary to remove conseq of the disease & indeed of Vener. Mercur course.

With this intent [Sarsa] has long been highly celeb.

Although indeed some pract disp very much to quest its possess. these virtues which have been attrib to it.

And here I own was cheifly on [latter], the Mezer viz that disp to put depend.

This artic never I believe till of late used for purpos of med.

And for some time after introd kept as secrete first in Portugal & afterwards in London.

Now little doubt however that is the active basis both of [Lisbon] Diet Drink & of Kennedy’s decoction.

And since came into gener use has been found attended with best affect both in cases of obstin Syphil & likewise in other affect.

Hitherto however has I believe been chiefly if not only used, as acted upon by a watery menst.

And pres the first inst. in which for my own part have ventured to employ it in subst.

Same also, with me at least, the case with the Sarsap.

But am informd that at pres the powder of the Sarsap. in powder a very fashion remdy at London.

This pract. led me to think of pres combin.

And whatever may be case with regard to Sarsap. am persuaded that if Mezer can be exhib in safety in this way activit may be had both to greater degree & with less expence of quantit.

In pres instance even when taken to small extent had obvious operat, both as acting on alim canal & at excret.

In formr way occas sickness vomit & looseness in latter encrease of quanty of urine.

And although now habit to use for consid length of time yet these affects still in some degree contin.

Under this course however as have already observd many of sympt gone & others consid allev.

Am hopeful however that may not be necess to cont. it much longer.

And if patient contin in pres state have thoughts of subst. to it a few doses of Peruv Bark.

After which shall either return to it or not as found necess.

At same time from changes already prod cannot help thinking that have evid of good affect from it.

And am in hopes that little more now necess to be done.