DEP/DUA/1/37/37 (Transcript version)

Ann Laurie

(1785)

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Ann Laurie April 3^d.

This patient may be consid as in some degree lab. under complic of affect.

And these prob. but little connectd with each other.

With regard however to none of them any great room for doubt.

Princip affect in partic the cutan disease to which subj a very obv. one.

Was evid that affect which in com language & even among med pract. has name of Scurvy.

But which among nosol. writers has accord to partic app. which may for time put on the name of Lepra Herpes or Impetigo.

For my own part however consider these as much more [nearly] [attend] than from defin of nosol should be incl to [illegible]

For an affect at one time exactly corresp to defin of one will soon have transit to anoth.

And thus even alternat freq. obs. to take place.

Perhaps though name a formidab. one, better disting by title of lepr affect than any other.

Especially where as was case with our patient parts affected often cover. with white scales.

And here, affect occup. so great a part of surface that could have no doubt in consid it as exist to a very consid degree.

But lepr. or impetig affect not only compl. to which this patient subj.

Affected also with consid dulness of hearing.

And this attendd with pain & heaviness of head.

Lesion of this as well as of other senses even where no concom [symp] justly consid as constit a genus of

And indeed when attend to [import] in oeconomy, not wonderful that varieties in affect should have been looked upon as constit diff. gener.

Hence diff gener. names of Dysecoea Cophosis, Surditas, Paracusis, Syrigm &e have been empl.

May consider all of them however as consist either in encease, dimin or in what may be stild deprav of sensation.

And in case before us had an example of very remark degree of dimin.

This an affect arrising from many diff causes.

And in case before us, had no reason to imagine, that in any degree connected with cutan affect.

To which accord to acct given us had been long prior.

But if here inclind to suppose that these affect in no degree connected, with regard to anoth had I own more doubt.

Affect viz of menst. disch which here took place.

This we are told had been obst for some time past.

And not an imposs. suppos. that may have occurrd as conseq of the impetig affect.

For while sometimes an idiopath disease yet still more freq sympt.

And perhaps hardly any affect, by which may not be induced.

But must also remark that in many inst very consid leprous affect without any such conseq.

And in pres case no concom circum as attack at same time or like which [could] lead us to inferr connex

Hence then rather inclind to consider this also as being a separ & distinct disease.

And to look upon patient as subject to Lepra. Dysecoea & Amenorh unconnected with each other.

From this view of nature of affect. room from simil diversity with respect to prognosis.

And every part of affect. not to be consid as equally subj of attent.

No part of disease however which could be consid as alarm or danger.

What to herself most distress & what prin led her to apply for our assist was the impetig affect.

And of this had greatr reason to hope for removal than perhaps any other part.

At least more so than of deafness which an affect of much longer standing

Is indeed true that such cutan affect often baffle utmost efforts of art.

And in other cases where seem appar to yeild to med empl. yet soon again recurr.

Hence then no reason with conf. to expect either speedy or radic cure.

Will not however be denied that such sometimes obt.

And had at least reason to hope that from use of prop remed some advant might be obt.

Accordingly progr. to recover. seems to have been consid.

And have I think reason to hope that may be able to accompl. radic cure.

Cannot however make same obs. with respect to Amenorrh.

But absence of disch. here for pres at least prod of no inconv.

And hitherto therfore no remed employd with this intent.

Whether connected with cutan affect or not have unquest better chance of restor, after that disease removed.

If therefore does not naturally [return] may then have recourse to remed suited for this compl.

But in mean time attent [directed] to cutan affect.

Is on same acct. that have done nothing with respect to deafness.

But with regard to this have I own less hopes.

For though sometimes from slight & transit causes yet more freq from such as are incap of remov.

And here with regard to cause entirely in the dark.

But though somewhat inconven was not distress. to her.

Hence then not hitherto obj of pract.

After however free from cutan affect if shall be able to accompl. that, may try also remed for removal of this.

And if affect of obstruct to meatus audit. of dimin secret in ear or even of dimin of sensib in nerves, have some chance of removal.

On these grounds remov of dysecoea freq. obt.

But need hardly remarkd, that with none of these intent have had [recour] to remed already used.

And indeed almost unnecess to obs. that these solely directed again cutan affect.

Had here as in some inst formerly treated recourse to intern use of crude antim.

An article of good [effects] of which have already had [examples] in pres [course]

And whether operates by encreas cutic disch or in any othr manner can be no doubt, that often empl. in such with best effects.

While antim taken internally had recourse externally to a mercurial prep. of which also have oftener than once had occas to speak.

The Ungt Citrin viz where Merc. rendered active, from combin with the nitrous acid.

But so far diffused, with hogs lard, as to render it both easy & mild in applic.

Under these med has have already indeed had occas to obs. progr to recov. has been very consid.

And in hopes that by persist in use cure may be accompl.

At same time from nature of affect would be improp to entert too sang. hopes

And as not unfreq. happens recurr may take place even in worse state than before.

In that case may employ som other remed.

And as a means both of combat cutan affect & restor menst disch. may if can be proc have recourse to infus of Oenanthe crocata.

And if this also unsuccessful to Vitriol Acid, Decoct [ulmi] or like.

By some of these hope that if not radic cure at least temporary removal may be accompl.

And then with more prosp of success may accord to circum of case direct such remed against other parts of affect as may seem most advis.