DEP/DUA/1/29/22 (Transcript version)

Fanny Aitken

(1782)

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Fanny Aitken.

Disease of this patient very obvious

Is subj to a compl. no less common than troublesome. viz Ophthal.

As this disease however varied in app. so also in nature.

Accord requir very diff nay opp. modes of cure.

Sometimes affect conf. entirely to palpab.

Sometimes to eyes themselves

And both affect. in diff ways.

When ball of the eye affected with app inflam as indic by red app. is yet of diff. kinds.

Sometimes the effect of mere relax by which in consid quant. enter [vessel] in which not nat to be found.

Sometimes again proceeds from encr. action by which blood [impl.] into these vessels

And in inst before us this seems to have been very much case.

Reason to pres. that was entirly so at commen.

Yet after contin ground to appreh. that some degree of relax induced.

But that at first merly encr. [action] may be inferrd from cause by which brought on.

Immed succeeded cure of an [erupt] on head.

Which accord to acct. given us app. to have been Tinea Capit.

This affect though while contin be loathsome & distress. yet by [precip] cure worse conseq often induced.

And among these none more freq. than obstin diseases of the eyes.

Such gener. ascribd to repuls as calld of morbif. matter.

But in my opin in reality to be attrib to change of mode of circul.

By dimin flow to head unless prop. evac substit. determ made to some other part.

And thus augm impet. at eyes a very common conseq. of cure of Tinea.

In this manner then suppose affect of pres patient to have orig.

But as already obs. has now by long contin. prob. induced consid degree of relax.

And to this would in part at least attrib both encr. flow of watery fluid & obv. swelling.

With this idea of compl. progn. cannot be very fav.

For now can neither pros. with confid treatm adapt to encr. action nor to relax.

Still so much tend to formr that restr. from what best adapt. to latter.

While again in counteract active inflam must have in view that even morb. relax already induced.

At same time no such local affect of eyes as to give any reason to dread loss of sight or such other disagreeab. conseq.

Nor has disease contin for such length of time or with such obst. as to give reason to dread that will resist power of med.

Though now of sever. months standing yet during that time consid remiss.

Such from prop. attent may soon again be obt.

And hope soon to be able to dismiss pat. if not cured at least with affect consid allev.

For this purp. in first place necess to remove pres. inflam.

And afterwards to restore such tone to parts, that will not again be readily renewed from slight causes.

Is with these views, that have had recourse to diff pract. recomm employd in pres. case.

Began treatm by applic of blister converted into issue.

Than which few pract more effect. in giving determin from eye.

For is on this princip I appreh. not by any [illegible] of morbid matter, that benef of issues to be expl.

But whatever princip of operat, no doubt that such drains near the part of greatest service.

Indeed in inst of obstin ophth. know no pract of equal service.

And accord. none more freq. empl. than issues settons or like.

But besides issue, in pres. case had recourse also to extern applic of solut. of Sach. Saturn.

Influence of saturn applic in gener, as allaying inord action well known.

Of late use in diff forms has become extremely common.

But perhaps no one under which may be empl. with more advant. than that of solut of Sach or Sal [Sat]

For besides that admits of ready applic is also one of those forms, in which lead exerts most consid sedat effects.

From this therefore expected both that pres encr. action would be allayed, & that tend to return dimin

By means of these therfore, hopd that both intent in cure might be at length accompl.

But while pros these meas, thought also would be of great conseq. to keep belly gent. open.

For by this means, both [remov] of causes of irrit acceler. circulat, & still farther determ from affected eye

With this intent had recourse to cream of Tart.

One of most gentle of refrig cathart.

Directed that should be taken only to quant of single dram.

From which could expect no more than that would keep belly gently open.

In this effect however were not disappointed.

And while Cream of Tart operatd as gentle laxat. issue & lotion prob. also prod of good conseq.

For at succeeding report, found eyes consid mended.

In this situat could not natur think of any other pract than contin.

And from farther use, compl. still more mitig.

At last report indeed besides affect of eyes subj also to some cough for which the drinking infus of Linseed, as demulc, was directed.

Under this course then from progr already made, may hope that all compl. will soon be removed.

At same time few inflam more liab. to recurr from slight cause.

And shall by no means be surp if, as has often formerly happend, such should take place here

Will however I hope still require no farther [pract].

And by persist in pres hope [for] remov of affect