DEP/DUA/1/25/13 (Transcript version)

John Omond

(1780-1781)

---

John Omond.

In case of this patient an evid examp. of an affect not uncomm.

And which when allowed to go to great height often most obst. always most loathsome disease

From even slightest view of cond of head no diffic in assert that subj to Tinea Capit.

Perhaps better defind by Vogel than by any of other nosol.

Ulcus capitis, quod denssissimam, durissimam aridissimamgue crustam facit.

But much better known from having once seen it than from any descript.

And that here occurrd in most distin markd form, could be matter of no doubt

Affection of hairy scalp howevr not only sympt with this patient

And while pron him subj to Tinea, quest whether this be only disease.

For also very consid affect of eyes

That this may be connected with affect of hairy scalp would not deny.

And if here any connex, when consid period of attack, prob a conseq of it.

For app only after sev months subj to former compl.

If however connex here subs. may at least be pointed out as uncom.

As far as I know not markd as circum of that affect by any pract writer.

And num cases of Tinea which have had occas to treat, have not in any former inst met with this conj.

From these circum then probab. that merely accid. conjunct.

And this the rather to be pres. from some other circum

From app of eyes, as being affect more of eye lids than of eye, some ground for pres of dep on scroph.

This farther confirmd by obstin ulcerat at under part of face.

But most of all from simil affect of eyes obv occurring in case of one of patients viz mother.

Well known that ophth sometim heredit.

And will on all [hands] be allowed that cheifly if not only so from dep. on scroph.

Besides Tinea capitis then, when came under our care, disp to consid him as subj to Ophth. Scroph.

With this view of compl. could not enter prosp of speedy cure.

Tinea an affect very gener. in its nature obstin.

When allowed to take deep root often proven proves incurab

And unless where most severe & painful means of cure empl, often consid as oppob medicor.

Here indeed neither colour nor thick of crust, such as to lead us to pron case unfav

Nor had, it as often happens, before cure begun subsisted for years.

At same time could not be consid as slight case.

And own should not have been surp. to find that with some degree of obstin resist. meas empl. in cure.

If this however to be appreh of Tinea, not less to be expect of Ophtha.

Simple ophthalm indeed often an affect but of short durat.

But this by no means the case where in any degree depend on Scroph.

And espec where that Scroph origin or from hered taint as app to be case in pres inst.

Upon whole however opin now less unfav. than was formerly.

For reason to presume that Tinea already happily termin.

And that by prop attent to cleanlin & other meas. return may be happ. [prev]

Cannot indeed say so much with regard to affect of eyes.

But in these also diseased state has at times been consid dimin since came under care.

May hope therefore that if not total remov. at least tempor. mitig. may soon be obt.

And that in no long time further attend on part of patient will be unnecess.

That this change partic with respect to Tinea in great meas if not entirely effect of meas here employd, no room to doubt.

Of this affect. have very latly had occas to state sentim to you in pract course.

And case before us affords I think stricking exampl of effic of remedy then recommended.

In Tinea consid affect as being entirely local.

And indeed as being princip if not solely seated in bulbs of hair.

Were can be effected is much less painful & more safe mode of cure to rest. these to natur state, than to be obliged to have recourse to remov.

Such restor may unquest be effected by means of intern med.

Partic from those which like Mercury when introd into circul fluids, are again capab of exert topic action at extrem vessels.

Yet in this way operat both slow & uncert.

And may obt. full effects much more exped, in conseq of topic applic.

While however such a meas to be adopted necess, to prev bad conseq, that should endeav to prod determ from affected parts.

And this besides counteract [illegible] often also [consp] in cure.

Was with these views then that with this patient, had recourse to meas here first directed.

Although already issue in arm yet directed blister between should as more immed means of abstract.

And to support determ from head orderd disch to be contin by means of issue ointm.

By this hoped that effects of topic applic might be rend both more effect & more safe.

And as such had recourse to one of most active saline Mercur vizr Corros. sublim

From this however reason to exp but little effect till hard incrust first removed.

For otherwise diseased parts [deffrd] by an [exudat.] merely in organ.

With this view, [directd] applic of bread & milk poult.

A means which where applic duly made, unless incrust partic hard, seld fails to accompl. remov.

In inst before us had desird affec.

And from careful & repeatd [lotion] every day with Mercur solut, contin of that disch giving fresh incrust. seems to have been stopt.

In this situat while thus prosp of cure could have wishd that disch from blister on back had been contin.

But as allowed entirely to heal up, for obt this fresh applic of blister necess.

And to this with a young patient pain some obj.

To disch by blister therefore was led to substit cathartic.

And with this intent as an agreab yet powerful refrig cathart. empl. Inf of Tamarind with senna.

That might obt effect requis, without doing too much, directed in small doses of ounce at time.

From 2^d ℥ full & free operat obt.

But although might have some influ in forwarding cure of Tinea seems to have had little effect on compl of eyes.

For at succeeding report while head contin sound, affect of these [rather] aggrav.

This I imag. might in part proceed from cure of Tinea.

And in some meas disp. to attrib it to augm determ to these.

Led me therefore besides contin of purgat again to direct applic of blister.

Pain however such that contin disch was not supported.

And in few days allowed to heal up entirely.

Whethr from this however or from repeated purgat, affect of eyes somewhat dimin.

In this situat thought it unness immed to repeat blister.

But with contin of cathartic orderd saturn solut by way of [Coly]

At succeeding report all sympt in more fav train.

Contin of Saturn solut therefore thought unnecess.

And now hope that will no more be affected with Tinea.

Have also therefore omitted even Infus Tamarind.

And if nothing urgent shall perhaps contin for week or two with issue from [illegible].

If no new occurr. may dismiss patient, with recom when season will permit, to try Sea bathing or drinking sea water.

And by this hope that farther progr of scroph affection may be prev. & disease eradic.

If however any new occurr, pract must be accomod to these.

And none more to be dreaded than affect of eyes.

Taking these to be depend on Scroph if meas requis must be accomod accordingly

And have some thoughts of trial of Ointm with Aerug [Aeries] externally, conj with artif purging miner water from Sal. Polych. as taken internally.

But in this respect as already obs. entirely to be regul. by future occurr.