DEP/DUA/1/38/47 (Transcript version)

Ann Ross

(1785-1786)

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Ann Ross. Decr.

Of princip compl. to which this patient subj no room for doubt

From even slightest inspect of head when came under our care could be no doubt, that was subj to Tinea Capitis.

An affect which like other cut diseases reason to believe now much less freq in this country than formerly.

But at same time still often to be met with.

And espec. among lab. poor where want of due attent to cleanliness

Prob. often proceeding from diseased condit of parts below, induced by scales allowd to collect above.

But whether from this or from any othr cause no doubt that chief morbid affect diseasd cond of bulbs of hair.

That in conseq. of this there takes place a vitiated secret.

That matter thus separated, by degrees effused upon surface & these grad thickend

And that from want of prop nourish hairs themselves at length tot destr.

While at same time when any prop of incrust. thrown off, parts below are found in raw or ulceratd state

And from fresh effus very foetid odour emitted.

This if not a danger. is at least a very loathsome disease.

And may also add freq. a very obstin one.

But besides Tinea, patient subj also to some other sympt.

Partic before came under our care was freq. affected with pain of belly.

Abdom obs. to be somewhat more swelld than natural.

And had lately dischargd a few lumbr.

A circum from which presumpt afforded that gripes proceeded from that cause.

While enlargem probab. the affect of flatul.

And no farther connected with worms, than as in aton state of intest. those matters furnish [nidus] most apt to be retaind.

How far dulness & heav. of dispos. in any degree connected with othr parts of affect hard to say.

Not unfreq. the concomit of either

And may I appreh proceed from either as its cause.

But no less probab. that merely natural dispos of patient.

Or at least merely conseq. of want of usual health.

And that as far as admits of remov. will be conseq of cure of other affect.

These others then only subj either of progn or pract.

And with respect to first Tinea Capit while of longest standing & most import. shall as have already hinted probab. also find it the most import obstin.

At same time however nothing in circum with which attended that can be consid as unfav.

Though already of two years durat. yet for Tinea Capit, this cannot I appreh. be consid as of long stand.

And although has repeatedly returned after formr removal yet this a very common occurr. in the disease.

And by no means any suffic reasn why may not yet hope for radic cure

What remed indeed has hitherto [resis] cannot pretend to say.

Perhaps even most powerful applic already tried without success.

And if were assured of this being case, would render progn. much more doubtful.

All however that able to learn, that was plaster of adhesive nature.

If indeed such adhes as to bring away with it, bulbs of hair, remov. as it were both seat & cause of disease.

And accord, hold applic of pitch plaster to be, though cruel & even danger. yet most cert. mode of cure.

But in this case adhes plaster, perhaps merely [illegible] as to remov. incrust, without acting on condit of parts below or remov. [these]

Hence then by remed affect produc [change] on these may yet hope for removal of this part of affect.

Sympt from worms, were in this case upon whole very slight

And indeed, reason to presume, as have very much subs. without any farther disch, that no more now pres in intest.

Hence then even from begining these sympt. but very second obj in treatm.

And endeav. princip directed to the cure of Tinea.

In this disease, as have already obs., consider prin. morbid affect as [const] in morbid condit diseased state in bulbs of hair.

Hence then cure to be affected on one of two princip.

Either by restor bulbs of hair to natural condit.

Or by total removal of diseased parts

From latter have unquest most effect. means of radic cure.

And chiefly affected by applic of pitch plaster.

This allowed to remain, till so firmly fixd, that on remov. parts mechan brought along with it.

But as already hinted is a pract both painful & danger.

For sometimes has excited inflam of very alarm nature.

And probab. from penet to brain itself induc even Phrenit.

Hence then wherever can be accompl. is most desirab obj. to bring it about on first princip.

And this often to be done by differ stimul applic altering state of action & conseq of secret at part.

For this purpose recourse had to diff. prepar of Merc. Copper & even Arsenic.

And although some of these by no means free from danger, yet no doubt that by all cure has been affected.

Before howver can be supp. to have any influ. necess. that should have as it were access to part.

And for this purp. requis. that incrust. already formed should be removed.

Which most readily done by means of some gentle emol, as poultice of bread & milk or like.

While however cure thus attempt necess also to attend to conseq. if should take place.

For no doubt that by removal of affect of head, change of circulat will be prod in part.

And from this, determ may take place to other part, prod of bad conseq.

Hence then, in general proper to give determin to some part from which no bad conseq.

Ex to neck or back by means of issue or to surface by gentle diaphor.

These gener. prin will abund expl. pract to which have had recourse with pres. patient.

Began you will obs. by direct an emollient catap to be applied over all affected parts.

Effect of this, was as we wishd, compl. remov. of pretty thick incrust.

And had then opport of seeing, that parts below, were some of them, even in ulcerated state.

Others however only a raw & red appear.

And this indeed, may obs. is gener. state in which found.

Even thus however suffic ready applic afforded to what may be consid as seat of disease.

And accord had now recourse to an applic intended to alter state of action & conseq secret.

With this intent might as have already said have had recourse to diff. artic.

But here empl. the Ungt Citrin an applic which have often found effect always safe.

Of this artic, as you will obs. from formula for prepar in Ednr Pharm. the active basis in Merc.

And here merc brought to saline state, by means of Nitrous acid.

Under this form, while less apt to enter absorb, than when rend active by trit, is, at same time, more powerf. stim to parts to which applied.

In so much indeed, that before applic requires to be farther diffus.

But this also necess. in order to give prop consist for applic.

For by acid the axung so thicknd that has much firmer & harder consist than any plaster.

Hence then here directed you will obs. in prop only of ℥i of Ungt Cir to ℥i of Ax. [Porain].

And of this strength while suffic soft for ready applic. also suffic mild to be brought into [contact] with even tenderest parts.

But while directd this extern applic had also recourse to an intern remed.

A mixt viz of crude antim with powder of Sem. Santon.

From first of these had in view the prod of gentle diaphor.

And is a remedy, which with this intent, have often success. empl in affect of cutan kind.

Here as for conven, wishd to exhib it in tea spoonfuls, became necess to mix with it some powder to encr size

For though to adults, freely exhib even to greater extent, yet apt to excite sickness at stomach

And partic so with infants in [whose] stomach acid abounds.

For on acid which there meets with little doubt that activ very much dep

In such cases as means of diffus antim & at same time in part destroying acid sometimes empl. Magn

But more comm, as merely a means of diffus, the powder of Liquor.

Here however had recourse to powder of Sem Santon, which while answ. that intent might also have influ on worms.

And if any remained [be] means of expuls.

Under these med has now contin for some weeks.

And although has not altog. prev renew of incrust yet upon whole consid better.

While at same time neither disch of worms nor any farther sympt indic pres.

This however no reason for giv up Sem Santon, which as enr. [size] of antim powder, at least as good as any other inno. veget.

And hope that by contin of this course affect may in no long time be removed.

If this however should not be the case, to the Mercur. have here thoughts of subtit Aerug. [Aeris].

And to the diaphor, an issue in neck or between shoulders.

But in these partic, must be regulated, by situat of patient, after pres trial is finishd.