DEP/DUA/1/27/05 (Transcript version)

Isabel Alexr

(1781-1782)

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Isabel Alexr.

Of this case do not reckon it necess. to say very little. make many observat.

Has hitherto been irregul in attend & if no return of affect shall prob. see very little no more of her.

May however observe that althoug case appar not urgent, yet in some inst affect obstin.

And although temp removal often easily obt. yet radic cure often sometimes very diff matter.

Almost only constit of case inflam & excoriat of pharynx.

And this are told occurring as effect of cold.

Must therefore consider it as an instance of Angina or Cynanche.

In this disease diff species formd from situat of affect.

And even where simple inflam affect. sympt from thence unquest for much diversified.

So that in some inst. princip affect of Respir, in other of deglut.

Yet where affect merely inflam from this circum & where entirely effect of cold from treatm in no degree varied by situat.

Such obv. app however often from othr causes.

In some inst from pecul febrile contag. giving Angina maligna in others from contag of Syphil giving vener. sore throat.

Form however in general distin by concom sympt as well as pecul app. in throat itself.

Partic by pres of fever & that too of typhoid type.

Of this therfore no suspic in pres case.

Same observat however cannot be made with respect to vener.

And besides that know nothing of charact of patient, two circum giving some susp of it.

viz Absence of Fever, & long contin of affect.

Must indeed be allowed that inflam sore throat from cold, for most part at least with fever

And that seld contin for space of two weeks in place of two years, period for which this patient has been affected.

Notwith these circum howevr still disp to take own acct of matter

For even independ of reliance to be put on veracity sever circum against suppos of being vener.

Has not common appear of those ulcerat which from vener cause obs to affect pharynx, palate & uvula.

Is situated back in pharynx where these rarely at least appear.

And there more under form of mere excoriat than of ulcer.

To these circum must also add that this not only inst case of simil kind which have met with in pract.

Have met with more than one inst where inflam affect of throat at first unquest effect of cold, renewed for long time by every triffling accid.

In these cases very much same appear as in pres.

Am inclind therfore to suspect that in case before us an inst of that affect.

With this view of the disease, from what have before seen, should not be disp to give unfav prognos.

And think it even very prob, that patient has already given up attend from pres attack of affect being fav termin

But although this even the case, can by no means look upon disease as removed.

For from same dispos. in parts still remaining, again apt to be renewed, on any triffling cause.

Even by use of prop meas. can hardly expect, that this dispos. soon compl. overcome.

But for use of these, as attend of patient hitherto very irregul, probab. that opport. will not here be afforded.

May only remark, that in treat of this case, two obj natur. pres. [them]

1 The removal of inflam & excor, which was pres at time when came under care.

& 2^dly. Removal of that disposit, in conseq of which from every slight accid, patient exposed to return of affect.

First of these intent hoped might soon be accompl in conseq of natur conval.

But imagind also that might here be somewhat forwarded by gently astring mixt.

For to be observd that inflam in such cases often accomp with laxit of vessels.

And as in some inst of Ophthalm, removed from these being [braced] up.

With this intent, had here recourse to a gently astring gargle.

Of this, you will observe, that basis was infus rosar.

This formula, derives name & [elegan] appear from rose leaves.

But from these although some yet very little of medic qualit

Astring. which its princip power is derivd from vitriol acid

And this in certain state of solut dilut one of most powerful astring of Mat Med.

In ordin state however consid as rather too strong to be immed applied to a part somewhat excor.

And was merely with view to dilut that here empl. in conj with equal parts of Hysop water.

That however might be more attachd & applied, from some degree of adhes, added small quant of [mixt] of G. Arab.

By this addit, am inclind to think, that where infus Rosar indic as a gargle, have often seen it prod of greater advan, than should have otherwise expected.

And in simil manner, I think is also useful addit, in cases of [vener] sore throat, where gargle of Cor Sub. empl.

Infus Rosar you will observe is one of new names in Ednr Pharm.

But not to be consid as New [form]

For in reality nothing diff from Tinct [illegible] of former edit.

All ingred & even prep of these still precis same.

One change indeed made in mode of prepar.

For acid which formerly mixd with boiling water, now only added after [infus] completed.

And this unquest an improv, as well indeed as change of name.

For mere watery infus could with no prop. be stild a Tinct.

If from use of this gargle, pres affect of throat should have been removed, was intent still to have contin. it, with a view of strength parts.

And at same time to have put patient on use of Peruv. Bark.

What however has been affect, as patient has not attend regul have not been able to learn.

And now presumpt that may not see more of her.

But if does return, unless circum [altered] shall still think of pros. [same] [illegible]