DEP/DUA/1/33/34 (Transcript version)

Jean Jackson

1784

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Jean Jackson Janr 31^st 1784

Of disease to which this patient subj no room for doubt.

Consisted entirely in affect of head

And these princip app under form of white incrust

This could have no doubt in consid as an inst of Tinea Cap of scald head.

Though of consid standing had not proceeded such a length as to effect gener. health.

And in every other resp. free from compl. except small gland tum about behind ears.

These we are told nearly of same standing with the Tinea

And may therfore reason concl. that the two affect connected with each other.

This the rather to be concl. as simil swelling in diff. parts about neck by no means unfreq with [Tin]

And always consid prob. with great justice as being effect of some matter absorbd from hairy scalp retaind in lymph glands.

Here therfore to be consid merely as sympt of origin affect.

And on removal of one reason to hope that other will soon disapp.

Even if this should not be case no ground for appreh. that after cause removed liable to any encrease

And from contin in pres state no inconven to be dreaded.

Consid Tinea therefore as being here sole object of attent.

And some circum in case it must be allowed rather unfav.

Among these may justly mention the contin of this affect.

Before she came under our care affect had subsisted for three years.

Not indeed when, comp with other inst to be consid as very long cont of this affect.

At same time suff. long to have induced even incurab. state

This the rather to be appreh from condit of compl when came under our care.

For about that period, observd to have much more rapid encr. than before.

This indeed mother herself inclind to attrib to applic of burnt butter to which by advice of neighb. had then recourse.

But from this applic little in my opin to be expected & as little [found].

And was inclind to attrib change solely to alter in state of compl itself.

If disposed to diff from mother in this partic, could as little argue with her with regard to cause to which she refers comm of affect.

This she is inclind to attrib, to an accident [stroke].

And to conseq irritat, the effect of freq. combing.

That such a cause cannot possib prod this disease would not take upon me to say.

May howevr observe that not ment as such by greater part at least, of pract. writers.

And among all cases which have before occurred to me, have met with no inst, where reason to suspect that had any share

Freq. combing on other hand in place of inducing is in my opin one of strong means of prev. this affect.

For convinced that in great maj. of cases, is effect of want of due attent to cleanliness of head.

Some indeed hold it to be a disease very readily propag by infect.

And in support of this [argued] that freq affect sever child of same family.

And still more, that in large boarding schools, many childr. of diff families living togeth at once affected with it.

But both inst somewhat doubtful.

For same want of attent to cleanlin. which takes place with one, may be extended to several.

While at same time its being entirely conf to one part of body hairy scalp against suppos of contag

In case before us as well as most others probab. to be attrib to that cause.

From pecul circum therfore to which attrib it can draw no concl. with respect to progn.

And although durat as well as rapid progr somewhat against fav. termin. yet no suffic ground for conclud. that beyond reach of ordin pract.

While at same time from pres app. state, reason now to hope that compl. cure may soon be accompl.

And if this shall be found to be the case can I think be little doubt in attrib to pract here empl.

In this disease, suppos, as is gener. admitted to be the case, that that consist entirely in affect of bulb of hair, obj must be to rest these to natur. state.

And this chiefly at least to be brought about by acrid stimul applic acting immed on diseased part.

But before such applic can be supposed to have any influ. necess that incrust should be so far remov. that may have access to diseased part.

This may in gener. be done by means of any warm [emol.] poult.

And where does not succeed at first yet will seldom be disapp. by due repet.

Here had recourse to a cataplasm of bread & milk.

And soon obt. from it desired effect. After incrust removed am for my own part acquainted with no artic more freq success as restor. sound condit to parts below than Mercur

Nay may in some inst. succeed when extern applic insuff

This some advice in cases of Tinea to be empl internally & that too to great extent.

In so much that salivat even a mode of cure not unfreq recom.

But in my opin without any good reason.

While on other hand exposes pat. to much inconven & even some danger.

Would not indeed deny that from intern use, Mercury, may reach diseased bulbs of hair, as well as does every other part of syst.

And in this manner employin internally, may aid extern applic.

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But no benef derived from influ. on system in other respects.

And while extern applic most ready means of obt. immed action in gener. also suffic powerful

In this compl. a mercur of consid acrim requis.

And that to which I have hitherto in gener. given prefer. is corros. sublim.

From careful lotion with a [watery] solut of this artic, have known many cures obt.

And where thus, suff long contin applic could not be obtained will often succeed under form of poult

But from cold thus acting upon head, troublesome catarrh sympt sometimes induced.

An inconven seldom to be dreaded from applic of unctuous matters.

From this therefore, led in pres inst. to employ a diff saline mercur, the Ungt Citrin.

Where mercury in saline state, by means of [illegible] acid.

A formula of such activ that with justice restored to pres edit of Pharm after being rejected from last.

For more commod applic howev as well as for moder [strength], [requir] farther diffus.

And on this acct. here directed to be united with axunge.

This applic have lately empl with success, in sever affect of the leprous kind.

But pres. first inst of Tinea, in which have empl. here it.

And here use app. attended with best conseq.

For from regul applic, after first removal of incrust, return of effus seems to have been prev.

And from length of time which has elapsed now ground for [hopes] at [illegible] that no consid incrust will again be [formd].

During this treatm anoth [pract] indeed also empl.

Use viz of repeated doses of Glaub salts.

These however do not for my own part consider as having had any share in cure.

Here used merely with view of prev. bad conseq which might have arisen from it

For without suppos repuls of morbid matter, yet cert. that from change in mode of circul. inconv. sometimes prod.

And by remov of disease, put stop as it were to accust disch, which requires being [compen].

As answering this intent, no pract more easy than use of some gentle refrig cathart.

And was merely as such, that here employd Glaub [salt]

Now however cure so far compl. that for some time omitted, & ointm contin alone.

And in hopes that may soon [dismiss] patient without any other pract.

But if this should not be the case a variety of other [illegible] may be tried

Such for ex as Verdigris saturn applic, Vitriol acid or like.

For all these on diff occas success.

But in pref. to any of them may prob. first try an applic which have heard has been empl. in some of Lond hospit with success.

And by means of which the [nurses] have sometimes succeeded where Phys had failed.

Use viz of a lotion made by [boiling] [pepper] for some length of time in urine. But hope that neither this nor any other pract here necess