DEP/DUA/1/29/28 (Transcript version)

Cath Thomson

(1782)

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Cath Thomson.

This patient as well as formr subject also to Ophthal.

Or at least although not only is yet in my opin both most evid & most matter disease to which subjected.

Here also as in former case affec consists prin. in Ophthal. palpab.

And as well as former this case also has pecul.

But these in sever. partic at least diff. from last.

Here much less evid of affect of sentient part of eye.

Disch however much more mark affected.

For not only encr. in quantity but also has acquird qualit [illegible] acrim.

In so much that excor. cheeks & other parts to which applied.

This would be very far from repres as any thing very uncom or [praeter].

Is an occurr in ophthalm which to some degree at least more freq. pres than wanting.

And when does take place not the effect of any pecul. morbid matter

But merely of encr. of that [salin] impregn which naturally enters secret. by the eye.

Although however both augm. & encrease of acrim gener. take place, yet seldom to that extent that descr. in hist of pres. pat. [comp].

This morbid secret. attended also with anoth pecul.

Which however prob. to be consid as cause connected with pres. perhaps even as cause.

That is the manif larger of vessels in neigh of eyes.

And what prob. depend on it pain in frontal sinus temples & vertigo with which affected.

In all these partic have [marks] of more than common determin of blood to eyes & neigh parts.

And to this prob. ophthalm as well as other sympt. just ment. to be attributed.

This affect are told has now subsisted with patient for greater part of life.

And that too although has alredy passd her 40^th year.

Are informd that subj to this compl. when a child & has never since been entirely free from it.

Nay that family to which belongs freq. subj to sore eyes.

Hence then may infer that inflicted with it in some degree as a heredit disease.

And not more diffic to conceive how uncommon determ of blood to partic part should be transm from parents to child, than how one should inherit from other partic set of feat. or make in any other partic. respect.

But whatever be cause no doubt that in many inst. ophthal a heredit or family affect.

This however must be allowed most commonly the case when it depends on scroph.

And of this cause no evid marks at least in pres. case

But besides hered dispos. here also from hist. of case reason to presume that ophthalm [connec] also with anoth partic.

State viz of Menst. disch.

Catamen we are told though regul. in point of time scanty in point of quantit.

Have now been in this situat for space of two years

And during that period affect of eyes aggrav.

From this then reason to inferr that these compl. in some degr. [conn]

And would natural occurr as a quest whether scanty menst. [cause] of aggrav of ophthalm. Or whether ophthalm has occas. dimin of menst disch.

Of these two opin must own am most inclind to former.

Cannot indeed suppose that ammen at all to be viewd as cause of Ophth.

For from hist of case appear that began long prior to any tend to that disch.

And at period when syst of uterus no influ in anim oeconom

But on other hand every day inst of ophthalm to most invet degree, without any affect of menst disch.

While again nothing more common than to observe from obstruct or dimin of this evac augm determ to other parts.

This then take to be case in pres inst.

From what cause scanty menst arises cannot pretend to say.

But when consid that patient [alred] past 40^th year of age may concl. that period now appr. when this disch will entirely leave her.

And while in some cases, such an event ush. in, by evac more prof than natural in others again [there] occurs as it were grad dimin.

Even then however still apt to give determ to other parts.

Partic to those in which any origin or habit morb. affect.

Thus then suppose that natur tenden to cessat of menst. flux may have given rise to augm of ophthalm.

Or may concl. with not less prob. that ophthalm aggrav. from dimin of menst. prod by some other cause.

Besides what immed connected with Ophthalm & Ammen. sever [diver] sympt also in pres. hist.

Of these some as cold & hot fits quickness of pulse & the like consd as being symptom of Ophthalm.

But others which cannot be viewd in that light.

Partic what said with respect to state of disch by the belly.

Are informed indeed that when patient came under our care belly natural.

But formerly liable to Diarrh from very slight occas causes

From this therefore may inferr that intest canal not in sound or vigor. state.

But that subj to pecul irrit.

Although this however may have been constit disease not nothing affected with it since pat. came under care.

Hence therfore not at pres an obj of consid

Unless indeed in as far as may determ conduct with respect to diff partic in mode of cure.

But without paying any regard to this disease as already obs. to be viewed as of complic nature

And cannot give same prognos. with respect to all parts of it.

Of affect of menst disch. may soon without any artif means expect complete cure.

For in no long time will in all probab. cease.

And this at least happen when it will, the most prob. way in which affect of menstr. will be term.

But with regard to Ophthalm prognos. cannot be so fav.

And if many partic against speedy recov in case of last pat. still more in pres.

Is not indeed at tender age, or with habit of body, prev use of most effect modes of cure.

But disease already of very long standing, & as have obs. even hered to patient.

During course of 40 years has already resisted repeated employm of most effect modes of cure.

At least utmost that could ever be obt. from these but tempor. mitig of affect

Hence then can now expect [nothing] farther.

And even this from irregul of attend on part of pat. hardly to be expected.

Since applied for assist have seen so little of her that almost unnecess to add any thing with regard to pract.

Here also had recourse to saturn lotion as means of dim encr. action

From this hoped that pain swelling & inflam of palpab. might be dimin.

But expected also that would have effect as altering state of secret.

And that would by means of it obt. dimin both of quantity & acrim of disch from eye.

While however thus aimd at dimin of impet. at one part, though it necess to give determ to some others

The more espec. as by this means affect of eye more readily combat by topic applic.

While therefore advised saturn lotion, directed also setton in neck

By this means no doubt that powerful determ given to the part & flow of pus induced.

Accord always rankd among most powerful of epispas. [suppr]

Is however it must be allowed a more inconven. & less immed mode of induc disch of pus than blister converted into issue.

But here a good reason for pref. the setton.

Had been found by former exper. that from blisters heat & uneas. without any benef.

And in some constit this an unavoid conseq. from state of subcut. vessels or nerves.

In such habits then use to be shunned.

And where mere purul. disch. wanted may be affected by pea issue or still more certainly by setton.

From these pract therfore expected benef.

But still farther to dimin [determ] to eye & indeed to head in gener. ordered Cream of Tart as gentle laxat

From natural tenden to Diarrh however could employ it only to small extent.

Hence then ordered merly ℥i. twice a day.

A quantit to which without hesit had had recourse even in form. [case].

From use of these med were inform at succeeding report that compl. somewhat relievd.

Had no hesit therfore in ordering contin

But since that have seen nothing farther of patient.

And as know nothing of cause of desert. cannot venture to say any thing farther resp. case.

But in concl. obs. may not be improp. to take notice of a pract. to which had recourse before came under our care.

Use viz of Snuff.

This in cases of Ophthal. often empl. with advant.

And indeed where Tobacco as a sternut fails recourse had to more powerful [illegible].

Partic to use of [illegible], & of [illegible].

In pres. case however had a bad effect.

And here I think this not to be wondered at.

For cheifly useful in those cases where little disch by eye.

And Or where ophthal. has [illegible] want of usual disch from nose.

But in pres inst. not only [delr] to eye but also to neighb. parts.

And by every stimul. cause applied to any of these augm impetus encreased.

Thus also topic bleeding which in some cases of utmost advant in others prejudic.

Partic with leeches the pecul. impress given by which propag. to some dist. from part.

Accord always necess. to prev. fixing very near the eye.

Thus then would explain why snuff & other [illegible] [illegible] often highly advant yet in other cases prejud.