DEP/DUA/1/37/46 (Transcript version)

Betty Brown

1785

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Betty Brown. April 9^th 1785.

Disease of this patient somewhat of complic nature.

But at same time, in this compl. nothing giving much diffic, either with respect to name, or nature of affect. or with regard to pract.

Patient, evid subj to two sets of sympts.

Was affected with pect compl, partic cough & dysp. – A catarrhal affect.

But was also subj to an impetig affect to a very consid degree.

This consisted in large blotches for most part cov. with dry white scurff.

And hence better entit to appellat of lepra than any other.

Here naturally occurrs as quest. whether these two had any connex

In pres case no hesitat in consid as perfectly distinct & separ from each other.

Would not indeed alledge that no inst in which pector compl. found connected with cutan affect.

Many singul cases of this kind on record.

Partic where two affect, obs. to altern with each other.

Where on occurr of cutan erupt, dysp. before to high degree distress to pat, compl. cured.

And where on remov. of cutan affect dysp. again returned.

In my own pract, have oftener than once had occas to obs. both these occurr.

But partic latter where viz on remov of a cutan affect, distress dyspn was induced.

In these cases seems to be effect of some pecul. idiosyncr.

And am inclind to think that better explained, from change in bal. of circulat than on any other footing

Although others, & that too not without probab. argum, are inclind to referr it to sympath.

But on whatever footing may happ. that does sometimes occur unden.

At same time, far from being gener, or even common occurr.

And no reason to suspect it, in pres. inst.

When does happen, as have already said, disease very gener. obs. to alter.

Here however, both occurrd at same time.

While had by no means same date, as to [commencm].

And alterat on one, prod no effect whatever on other.

Hence then might without hesit view it as merely accid catarrh prob effect of some imprud expos to cold, superveening on Lepra prev. exist.

Besides these, anoth circum ment in case, which might be supposed to constit, even third disease.

State viz of Menst. disch.

Catamenia we are told, had not appeard for eight weeks.

For this however, a very suff. reasn

Our patient, a married woman, who already had sever children, & now every reason to believe herself, in pregn. state.

Obstruct therefore, not to be reckond morbid.

Yet cause from which proceeded, a circum to be had in view in pract.

Perhaps also in some degree in prognos.

At least as restr. from med, which might otherwise be empl. with freedom & advant.

In progn here no ground for any appreh of danger.

And with regard to catarrh, althou when pat first came under care, was somewhat distress to her, yet hoped that would have ordin course of such affect.

And that in short time, would without aid of med, be removed by natur termin.

Could not however entert same expect with regard to lepr. affect.

This very gener. a much more obstin disease.

And after contin which had already had, as well as extent to which had arisen would not have been surpriz if had baffled utmost efforts.

Still however notwith pregn state some remed which might here think of empl. not without hopes of success.

And after progr. to recov, which has already taken place, now inclin to flatter myself with expect, that in no long time, may obt. compl cure.

In treatm of this case, have you will obs, trusted to use of Vitriol acid

From quant of this acid, cont in sulph, might natur be concluded that should afford cure in Psora.

And first introd, of intern use, again affect of impet. kind in that disease

Since that however, has been emp in same manner, in affect both of lepr & herpet kind.

Have partic used it in these in Dispen pract.

And besides benef. which have there seen derived from it, I observe also some inst of its success empl. pub by Dr Smyth Carmich of Lond in vol of Med Comm. lately pub, by a Soc. there

In judging from my own exper. can by no means repres, as success in every case.

But have no doubt in assert that have found it attended with best affects in many.

Partic when can be empl at same time, both extern & internally.

And espec deserves trial where obj. occur, to antim or mercul course.

Which from pregn of pres patien rend inadvis.

From extern use of vitriol acid only effect result is sense of heat in part to which applied.

From internal use, often no [illegible] oper.

Sometimes however, as in pres. inst. has affect of encr. urine.

And when this the case, in general most success.

Since began use of this med pector compl. have entirely disap.

This however I attrib to spont termin of catarrh affect.

But in removal of cutan disease, consid progr. has also been made

And in hopes, therefore, that by contin, cure may be effect.

If in this howevr disapp. may have recourse to some other artic.

Partic the Infus. Junip, or Dec [ulmi]

For as already obs. against antim & [mercur.] still more against Hemlock Dropwort, pregn. an obj.