DEP/DUA/1/19/18 (Transcript version)

Mary Rough

(1778-1779)

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Mary Rough

Of case of this patient as well as of former reckon it necess also to say but little.

Affect to which was subj an obvious one.

And at same time an occurr very freq to [met] with in pract.

From manif affect of eye here occurring can have no doubt in referring it to genus of ophthalm.

Can be no doubt Well known however that this genus a very extens one.

And that with prop. divid into great variety of diff species.

Such divis not only necess for distinct view of affect but even highly useful in pract.

For in as far as disease depends on Erysip, Scroph, Syphyl. or other affect is alone by meas directed to these that can be cured.

Cannot help thinking however that some of nosol. writers have here [multip] species to much greatr extent than necess.

And accord in syst of Mr Sauv. will observe that has referrd to it upwards of twenty

Of all these species howevr that to which our patient subj. most exactly corresp to descript of Herpet. [Humida].

An affect which greater part of pathol at least are disposed to consid as arising not so much from any pecul local [diseas] at eye, as from exit, being as it were afforded by this outlet when [illegible] fluids in vitiated state.

This indeed a mode of reasoning in med which some entirely disp to deny.

But even strongest [oppos] to [humn] pathol. cannot I appreh. without being inconsist with truth deny that may take place to this extent.

And from this cause also would acct for erupt on head in case before us

Affect from this cause partic as acting upon eyes very common at early periods of life

And at same time in gener removd without much diffic.

Hoped therefore that pres. case might soon be brought to fav. termin.

This the rather ground for expect as disease when came under care, had been but of short contin.

And as with pres affect no sympt indic exist of scrophul or any other cause from which reason to fear that affect would be rend. obstin.

Is indeed to be observd that erupt of head gave proof that this not only [affec] to which patient subj.

But this appear, which took place later than affect of eyes consid as being rather fav as otherwise

In inst before us indeed from occurr of this erupt eyes were not relievd.

Yet may observe that such relief does at least occurr in many inst

Partic observd that in infants often an alternat between sore eyes & running from behind ears.

When one pres. other of course ceasing.

A circum which may I think readily be explaind both from outlett from common mass being afforded either by one or other, & from alter in balance of circul at the part.

Here then must own that consid erupt on head as being as it were approach to natural cure.

And that it did not afford manif relief was disp to ascribe to neither disch taking place from the erupt nor alterat in [destrib] of fluids having occurrd to suffic degree to free the eyes.

Was however inclind to view it as having at least tended to prev affect from rising to that height which otherwise would have done.

And as it were pointing out to us manner in which could princip hope to accompl. artif cure

Should here have consid it as most imprud meas. to have endeav. by any external applic to have cured head.

Partic by any artic which could have immed tendency to restrain disch.

On contrary might I think have expected advant from employm of such pract. as would have tended to augm the disch.

But in this way should have induced morbid state which if not equally distress with affect of eyes would at least have provd both incon & loaths to patient.

Reckond it therefore more advis to have recourse to such meas as would at once tend to relief both affect of eyes & of hairy scalp.

From these consid was here led to direct for patient the applic of blister between the shoulders afterwards to be converted into more perman drain by [mean] of Epispas ointment.

This pract in such cases may [illegible] hesit assert to be both common & success.

Nor accord to opin at least already deliv can it be diffic to understand princip on which this success to be lookd for.

All pract writers indeed not agreed as to prin on which issues here operat.

While some consider them as merely having affect from change in distrib of blood others look upon them as going still farther.

And consider artif disch of pus thus brought about as being by no means the result of putrid, but as it were a nerv secret.

And in as far as shews any marks of [illegible] acquis that merly from stagn. after separ has occurd.

This doctrine will find ingen supportd & indeed corrob. by sever. experim in an inaug dissert. lately pub. at this place by Dr [Hendy] now Phys. in Barbad.

And since that translated into English & republ. at London.

Same doctrine indeed before supported & contended for by other.

Partic in an elab. inaug dissertat by Dr Morgan lately Prof of Med at Philad [professidly] on subj of format of pus or as he entit it De [illegible].

Long prior to Dr Morgan same [doctrine] contended for by late Dr Sim of St Andr.

Who in one of his elegant dissert de Re Medic. whose in speak of [iss] or [Setton] express. says that is to be consid quasi nova glandula

Doctr. contended for by these gentlem although at pres oppos. by some names of first emmin. hold to both estab. on solid reasoning & conf. by unquest observ.

For can have no hesit in asserting that have often seen from issues manif advant. where could by no means be acct for from any alterat in distrib of fluids

And where every reason to presume that operated as affording partic outlet from mass of fluids.

On both these grounds then expected advant from this pract in pres [case]

And while consid affect of eyes and head as being as it were conseq of natural issue at these parts, imagind that both might be removed by [instit] artif one supplying place.

Whether these sentim well founded or not were not at least disappointed in [effect] which expected.

For from contin for space of week togeth with first disch from blister affect very consid relievd.

And in this situat could have no hesit in ordering contin. in hopes that might be means of effect complete cure

In order however still more to give determ from super parts & indeed some evac from syst. wishd also gently to move pat. belly.

And as Cream of Tart which first directed had not that effect had recourse to comb. of Tinct of Jallap with simple Syrup of which lately had occas to speak

But have neither least conseq from this nor from contin of issue.

Which inclind to hope proceeds, from her moth consid farther attend to be unnecess.