DEP/DUA/1/29/14 (Transcript version)

Duncan Kennedy

1782

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Duncan Kennedy. June 7^th 1782

Concerning disease of this patien very little room for doubt.

Princip compl. affect of neck.

First began under form of tumour termin in [suppurat].

And after once healing has again broke out afresh.

And in this way has now [continued] for space of a year.

From progress as well as pres app then have now doubt in consid it a being a scroph affect.

Of same nature also am inclind to consider swelling & soreness of legs.

At this part indeed affect has not made such progr. as to terminate in that state of suppurat by which scroph prin charact.

But in this nothing uncommon.

For well known that as affect diff parts of syst. will long cont. in the state of indol. swellings.

Or at least of swellings with [little] pain.

And that in progr of disease these at diff time app first in one part then in anoth.

Here then from distinctly markd scroph in neck have at least every reason to inferr that tum of leg of same kind.

Espec. as has already subsisted for space of two months

Yet must be allowed from app. alone, if no other sympt could not pron it scroph.

And even in pres circum if but of short contin there would be ground for hopes that might not be of so obstin tendency.

But from duration which has already had, conj with app on neck no room for doubt.

Here indeed can draw no argum in fav of affect from cause to which attributed.

Is not referrd to any of those circum to which scroph. cheifly [traced].

Did not succeed as sequel of any of those diseases of which often a conseq

Nor did it arise from any hered [taint]

At least as far as could learn from inquir, no such acknowl. to be in family.

Was even attrib to a cause to which scroph. very rarely if ever to be referrd.

viz to an accid fall.

In deriving it however from this source, prob that parents mistaken

Is but too common for parents in this partic to deceive themselves from anxiety to be able to entert hope that such affect not scroph.

But well known that scroph often commen when cannot be traced to any partic accid.

Am therfore inclind to think that here to consid scroph fall as having happened at time when sympt of scrop first manif themselves.

And that between too no connex. Viewing disease in this light progn cannot be very fav.

Well known that scroph a very obstin disease.

That often even by itself proves fatal in diff ways partic by hectic fever induced.

That when this not the case gives rise to other fatal affect as Phthisis & the like.

Here then will be by no means surpr., if baffling all attempts to cure, contin to encrease till in end fatal termin.

May at least venture to say howev that of this no immed prosp.

And sever circum in case of pres pat rather fav than otherwise.

Disease has yet made no great progress.

No reason to suspect that so deeply rooted in constit as if were a hered compl.

Has not already been found to baffle power of remed, as such have not been tried.

And even if these no on prop trial should be found to fail, patient has yet chance of recov. from appr. of that period of life at which scroph often of itself ceases.

In these circum then, attempts to cure, may I think be made with some prosp of success.

At least if patients mother can be got to best. that attent which is requis, which however some reason to doubt.

Contended myself therfore, with directing for sores dressing with Ungt Saturn.

In treatm of Scroph in general two great obj prin claiming attent.

The tumours & the ulcerations.

Here in first last of these ways little to be done.

For sore on neck by no means consider.

And affect of leg still entirely in state of tumour.

> +

& Was therefore to first princip that measures to be directed.

And with this view attempts in cure hitherto employd.

As means of obt. resolut, have here had recourse to pract, both externally & internally.

Have employd externally frict with Camph Oil.

A pract from which in simil inst have often before directed with very great benefite

Have ordered internally the use of Cicuta.

A med from which even in Cancer tumours have I think seen good [effect]

But which much more freq. cap. of doing some service in Scrop. [tumour]

Here Cicuta comb. with Magnes. merely to give form.

Although at same time expectd also, that might have some [influ] as moving belly

An event the rather to be wishd as patient costive.

Under this course then from exper. which have formerly had am inclind to hope for some advant.

At same time can be no means repres them as success. in every case

And in any even slightest inst much advant to be expected only from regul & long contin course.

This however from irregul which has already taken place in empl of med perhaps hardly to be expectd.

But notwith such irregul. since use of med begun, compl upon whole rather on the decline.

In this situat then encourage to contin.

But as Magnes. has not had effect of moving belly have had recourse to Cream of Tart.

And if this also fails shall prob employ some other purgat.

But except such means of obviating sympt is intent to contin as regul. as possib in course begun till had full & fair trial.

And if after that unsuccess. shall probably recomm to patient, while season fav. the use of sea bathing

Or direct such other meas. as situa of compl at that time may suggest.