DEP/DUA/1/38/63 (Transcript version)

John Henderson

1786

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John Henderson. 7^th Janr 1786

Resp. disease of this pat. must acknowl. that much at loss both with respect to name & nature.

In app. as well as in progr. diff consid from those cutan affect obs. in this [course].

Espec. such as of chron kind & without fever.

Though these consid divers. in app. & in progr. app. changed, yet very gener. refer. to one of two gener.

What disting viz by titles of lepr. & herpet. affect.

Even these, prob. not so much diff, in nature as in appear.

For although former appel. in genr empl. where erupt with consid disch. latter again where dry incrus yet often transit from one to other.

But from appear. in either, those here taking place consid diff.

For pustules more of distinct & circum nature.

More gener. extended over whole body than the case in these [affec] unless after of long contin.

And at same time, much less in size than spots in gener. are, either in affect of lepr. or herpet. kind.

In these partic, had much less resemb. to cutan affect of chron. kind, than to those, which are concom of certain febrile affect.

And which indeed often immed depend on that cause by which fever prod.

But here as far at least as we could learn, no febrile sympt had been obs. at any time during course

And although progr. much more rapid than in gener. obs. either in lepr. or herpet. affect, yet of longer contin than febrile erupt.

For had subs. for three weeks, prior to coming under our care.

And during course of attend here for nearly same length of time cont. with very little dimin.

Hence then while could not with prop. get appellat either of lepr or herpet. could as little be viewd as an inst of febrile erupt.

And was I own disp to consid it as being a cutan erupt in progr & app. somewhat pecul.

But in such cases of less conseq to affix name than to ascert. nature

Here however must acknowl. that had equal diffic.

For no doubt, that where app. even very much the same, may yet proceed from very diff causes.

These in many inst. local & as it were topic.

Thus sometimes from affect of subcut vessels sometime of sebac. glands of skin.

But in these cases very gener. what may be calld partial only.

Here however while pustule small & distinct are as in small Pox & Meas extended over whole surface.

Hence then though no fever, am disp. to conj. that depends as in these cases on affect of comm. mass.

And no doubt that from this cause erupt sometimes arise, where fever wanting.

Thus cutan erupt one of many sympt. prod by syphil virus introd into blood.

And among othr conject, was no improb. suppos, that, erupt from this cause.

But to this also sever obj.

Among these, not least consid. that pat. himself denied its pro. from that cause.

For besides that could have no reason for conceal it, could only expect cure, by giving necess inform.

This acct of his, corrob also by other circum.

Partic by app. for syphyl. erupt in gener. superf. copper colourd blotch which very diff from what here took place.

And by want also of othr sympt of syphyl.

Hence therefore saw here no prob. grounds for going farther, than consid as a pecul. cutan erupt depend on morb. condit of com. mass of fluid

With this uncert. as to nature of disease, could with little confid form any opin as to prognos.

But from shortness of standing had no reason to concl. that would prove an obstin affect.

And from sympt induced no reason to think that would be danger.

Many cutan affect partic those uncon in app. which even of themselves very soon cease.

And at first I own was disp. to think that pres. might prove to be one of that kind.

But during time that attend here contin, had not that progr. to recov. which might have been expected.

And from absence for some weeks past, now prob. that will see nothing more of him

Hence perhaps, no opport. of being acq. with termin.

In treatm here, on idea given of affect great obj to be accompl. was correct of condit of fluids on which the disease depended.

And this alterat. imag. might be brought about by gentle & perman evac

With this intent had here recour to use of crude antim.

An artic which in diseases of cutan kind have often empl. & I think with advant.

Is indeed it must be allowed one of least active of antim.

And hence though sometimes sickness at stom yet very rarely that either purging, vomiting or sweat.

But while from this circum not prod of inconv to patient, [seem] at same time to have perman affect in prod free circul on surface & support regul cutic disch.

On this footing was disp to hope that might be useful in pres affect.

While at same time if disease of that nature which tend to natur termin would at least do nothing to retard recov.

But on contrary every reason to hope that would even somewhat prom it.

After trial however for space of some weeks app. that not only no tend to natur termin, but that remed inadeq. to cure.

For although for some time sympt seemd to be somewhat abated, yet soon after, erupt. rather encr.

And from consid sucumb of [pustule] about eyes vision much affected.

For this led to conj with interm use of antim an [extern] applic.

And as one admitting of safe & ready applic to parts most affectd the eyes, had here recourse to [solut] of Sal. Saturn.

If indeed conject as to cause of affec well founded from this could expect no benef. as prev. fresh erupt.

But at least hoped, that might dimin inflamm., in parts where erupt had already taken place.

And that thus, affection at least of eyes, might be [somewhat] obv.

But if had any influ in tend to counteract inflam about pustules, this more than counterb. by fresh erupt which took place.

And accord at succeeding report affect even aggrav.

From this led to think of making trial of anoth remed.

And as such had here recourse to the Sal. Arsenici.

An artic with prepar. of which I am indeed unacquainted.

Lately invented by Mr Milner a chem of emmin at Cambridge.

And as introd into pract by him, said to be prod of best affects in diff diseases.

But partic in most obstin cutan erupt.

From great activ of this metal here determ on trial in very slight dose only.

Hence at first directed to such extent that could hardly exp. any ben from it.

But since directed have seen noth of pat at this place.

And as return uncert. farther observ. unnecess.