DEP/DUA/1/22/09 (Transcript version)

Alexander Ogillvie

(1779-1780)

---

Alexr Ogillvie

Affected with sever diff sympts some of which in all probab no connex with others.

Some parts of disease pectoral compl [ver] suff [commo] & with regard to which no [room] for doubt

Others however with regard to which have very great diffic.

And that too princip & most import part of disease affect viz of foot & leg.

Here must acknowl. that equally at loss with regard both to prop name & nature of affect.

From gener. nature appear would reason. expect to find it either under head of tumores or of intumesentia

But by no means corresp. to definit of any genus referrd to these heads by any nosol. whose writing I have exam

Would not however from this circum repres it as an affect which have never before met with.

Have often than once seen simil inst. where affect sometimes in one sometimes in both legs.

To these some Surgeons & these too of great emmin & most accur observat give name of Elephantias.

This partic, denom employd by a Gentl of this place who some years ago deliv lect on Surger.

And would not deny that perhaps with greater prop referrd to that genus than to any other.

Yet [cert] does not corresp to gener defin of nosol.

And elephant in some of species afford exampl of very diff affect.

Partic that so preval in some parts of India.

And as that disease justly consid as elephant [legittima], would seem improp to give same appellat to any other affect which in all prob nothing of same nature.

Of much less conseq however to determ name than nature.

And giving it merly gener appellat of swelling of legs of much more conseq more useful inquir here to determ nature.

For on knowl of this cure, in as far as can be [cond] on ration prin must proceed.

Here manif enlarg which takes place can proceed only from one of two causes.

Either from morb. depos of fluids or from pretern encrease of solids.

Of these two first by much most comm

And may prod affect in many diff ways.

Depos may consist either of blood, watr or other fluids of diff kinds.

And these may either be cont in vessel or cavit natur to them, or praeternat.

From one or other of these causes great divers of enlargem.

And as this cause most common gives some presumpt that may oper in pres case.

Farther prob from nature & acct given of origin of affect.

For according to repres did not com in pres form.

And at begining progr of affection more rapid than should have expectd of encrease of solids.

Although however affect of solids more rare yet not to be repres as never occurring.

Has happened not only of softer solids partic from [accret] of cellul memb. but sometimes even of hardest.

Thus swelling of limb from preter enlargem of bone.

Circum then of less freq, not even ground of strong presumpt.

Nor on other hand can we [rest] much on sudden encrese at commen.

For though then depend on fluid, may now have assumed solid state

Transit from one condit to other well known freq to occurr.

And indeed addit to all solids [brough] in fluid state.

Besides this from matters depos in fluid form, watery part carried off [by] absorp.

And from long stagnat natur tend in coag part of any fluid to assum solid state

From these circum then presumpt that to some degree at least may have here occurrd

And this corrob by feel on press.

For does not yeild to finger any more than solids may be supp to do.

Has not like swelling from [most] fluids any change of shape on [ch] of situat

If therefore entirely from fluid may concl of very viscid nature.

Yet more probab that both in some degree conj.

And that with viscid fluid [mucus] comb also some enlargem from solids.

From this idea of nature preclud from entert expect of speedy cure.

Here cannot as might be case with watery fluids hope for immed remov. by artif outlet

Nor on other hand can we imagine that matter on which swell. depends ready subj of absorpt.

In as far however as ground for entert expect is in this way alone that can expect will be affected.

And evid appears from many [phaen] that in cases even of hardest solids this not impossib.

In some inst whole earth of [bones] taken up.

This indeed the case only where morbid absorpt occurrs

But presumpt that to cert. extent take place during health.

At least while growth of body cont.

For is only by suppos absorpt from intern cavit surface that can [act] from encrease of cavit.

When consider then extens action of absorb. gives some ground for hope.

Or rather prev us from pron affect as altogeth incurab.

And this perhaps utmost length that can with prop. go.

If cure affected can be expected only in very grad manner.

And even more probab., after contin which has already had that will [obstin] resist any meas which can employ.

Shall not even be surp. if in place of progr to recov. has degen into state more alarm than at pres.

Yet against this suppos also [stat] condit in which has remaind for some length of time an object.

But whatever may be future progr or termin, at least hope that may afford us opport for trial of diff pract

And is with this view that have selected patient as subj of treatm.

If meas directed any obv influ on swelling shall consider it as stong proof of effic.

And although fail may justly I think consider it as dep on obstin of disease

From idea given of case will easily understand prin on which alone could hope for success.

Whatever cause of swelling imagind that possib of remov by absorpt.

Concl. therefore that great obj to be aimd at the prom this.

Was with this intent that had recourse to Sal Ammon externally applied.

This hold to be an acrid & penet [salin] subst.

In cert states even exerts consid degree of caustic

And hence even in watery solut employ as means of remov warts.

Can not indeed be consid as powerful with this intent

Yet has unquest some effect as prod erosion

Influ in this manner not here requis

Yet wishd that should operate as powerful stim.

Was with view of obt these effects that here comb with axunge.

From this hoped that would obtain ready & long cont. applic

While at same time from unct matter, activ so involvd that reason to hope would not be prod of any incon.

On these grounds then although had not high expect from use yet consid it as meriting trial.

Even from begin however had recourse also to anoth med.

Imag. that effect as prom absorpt might be aided by addit of a diuret.

As thus matter absorbd would obt more ready exit from syst.

And demand even for action of absorb might be encreased.

For this purpose had recourse to use of Nitre.

And to dimin influ on stom as well as with view to demulc effect comb it with G. Arab.

On this course patient contin for space of three weeks.

During that time Nitre no obv. influ as prom urine.

Nor on other hand was either this or ointm with Sal Ammon prod of any inconven.

Did not however appear to have had any effect as dimin affect of leg.

Pain indeed somewhat relievd.

But whether this in any degree effect of med or not cannot venture to say.

Can hardly ascribe it to intern med.

And if effect of extern applic prob more from frict than from any [pecu] virtue of ointm.

With this dimin of pain howevr uneasy itchy sensat still remaind.

And what more matter no change of swelling.

From these circum then led to desert it as unequal to cure

Since that have had recourse to another pract from which do not know whether can entert any higher expect.

That is electricit.

Here employd on same prin as [formr]

With view viz of oper as stim & [thus] encreasing absorpt.

Of various modes of applying electr has been doubted of some whether stim or sedat effect.

With regard however to effect of electric spark drawn from part can be no disp.

That operates as stim provd [from] inflam & even vesic which excites.

But besides affect on skin am inclin to consider it as no less powerful than penetrat.

And hence hold it capab. in many cases both of prom absorp & of renewing circulat

Under this form In this way therefore have here directed use.

Has now contin use for space of two weeks

But cannot say that employm prod of any obv good effect

At same time however affect not encreased.

Shall wish therfore still to persist in employ a little longer.

And to use it even with encreased strength.

Partic by giving pretty brisk shock passing through affect part.

Begun however to fear that will be equally ineffect as former [pract].

If this case have next thoughts of trial with Mercury.

And partic as acting immed on diseased parts.

For this purpose am inclind to hope more from stimul than mild Merc

And is intent to employ corros sublim.

Rather however under form of ointm than of solut.

As by this means may I appreh. obt. longer cont & more active applic

For this purpose due propor. just dissolvd in Spt of wine may be diff through necess quant of axunge.

If from extern applic do not soon derive benef shall wish to conj intern use

By this means may at least obt full affect of it in as far as here able to bring about cure.

And if disapp. both from electric & mercury hopes of recov here still less than at pres.

Still however other partic which may be tried.

Partic the use both intern & extern of diff active veget lately introd into med & recomm as so effect, in remov of schirros & other indol tum.

Such for ex as Cicut. Belladon. Aromat &e

And if any of them success will give still [higher] opin of power, than have hitherto entert.