DEP/DUA/1/39/04 (Transcript version)

William Oswald

1786

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Wm Oswald. Febr. 4^th 86.

In hist. of this patients case but few sympt enum.

Consisted almost entirely in dull grav. pain of head.

As well therefore as some former inst might be consid as x of Cephal.

Here however was inclind to consid it as a spec or modif of the disease diff from others already treated of.

Thus consid last treated as being an ex of Cephal. Stomach. Here no suspic of such spec.

For in pres case both appet & belly natural.

Neither compl of thirst nor any foulness of tongue a sympt at least very comm. where affect of stomach.

Some circum indeed from which might conj it to be a nerv. headach

Partic affect of sight.

But while this partic an attend of nerv. headach well known that may arise also from other causes.

Indeed very few inst of severe head where does not in some degr. take [pla]

And here no other sympt, which comm. consid as of nerv. kind.

While at same time other affect. with which strong reason to believe, that this compl. connected.

Are informd in hist of case, that from infan, subj to freq. [attack] of Tinea capit.

Which however so slight, as to be readily removed, by applic of soap & water.

This may remark, is for [slighr] cases of [that] disease, very comm remed in [this] [country]

And a remed by no means void of activ.

For what here usually empl. is the common black soap.

In this the alk. in more penet & active state than in hard soap.

Accord where parts raw or tender applic excites very severe [smarting] pain.

Hence then not surpr. that should be often adeq. to cure.

But while cure affected by this remed no means empl. for compen. disch.

And in conseq of this neglect, not surpr. that from change in determ, should have ind. headach.

For well known that from [suppr]. of this evac. not from any repuls of morb. matter, cephal. often arises.

But besides presumpt from this source in pres. case anoth circum [puttin] matter almost beyond doubt.

That is alternat of headach with disch.

For since comm of headach, on accid return of Tinea, affect very consid allev.

From this then at least evid proof whether dep on cure of Tinea or not, that allev. by change in mode of circulat.

And this app. likewise, from [anot]. circum.

Besides Tinea, are informed in hist of case that had also been freq. subj to swellings under ear & about neck.

These from circum. state may have been concl. to be gland affect.

And from situat, some susp at least of scroph.

But presumpt arising from situat, more than countrb. by another circum.

By heating viz mildly [when] term in suppurat.

For this almost never case with scroph. tumors.

Here then concluded that tumor not scroph.

And may at least occurr as quest. whether were connected with Tinea.

This it is well known, by no means unfreq. the case.

And indeed can readily see how should happen.

For while an acrid matter gener at hairy scalp, as app. from affect, when effus and app. to other parts, may concl. that also [absord].

And when taken up by [lymph] will natur. as well as other virus, be retaind in glands.

Thus excit in these, swelling inflam & sometimes suppurat.

Hence then perhaps rather surp. that is not a more freq. occurr.

But whether thus depen. on Tinea or not, what here claims notice is connect with headach.

For to be obs. that when supp. took place, headach dimin as long as disch contin.

An addit proof of influ of change in determ as allev.

And a circum naturally [suggs] simil disch as mode of cure.

Before however having recourse to this wishd at least for a short time to make trial of affect of anoth med.

And in an affect. where sympt not immed urgent, which had alr. subs. for more than year, thought not great inconven from delay of addit. week.

Accord put patient on use of a med. from which in cases of nerv. headach have often I think seen very consid benef obt.

Use viz of Valer.

From empl. here however no allev.

On contrary during that period pain of head consid augm.

From this then addit evid affordd that not to be consid as of nerv. kind

And at same time addit reason for immed attempt cure by endeav. to induce change in balance of circul. from instit artic disch.

For this purpose directed applic of blister to back part of neck.

And ordered that disch should be supported by use of issue oint.

While that might more certainly judge of affects former med omitted.

In very short time from this pract consid change for better.

For at succeeding report, found that alm entirely free, from affect of vision to which before subj.

And that although still compl. somewhat of headach yet upon whole very consid allev.

Had hopes therefore that from due contin might be means of comp cure.

Of this however no evid app in regist from desert. of pat.

But this desert. we have reason to concl. arose from his imag. that had no farther occas for assist.

For some weeks after gave up attend here met on street accord to own acct in perf. health.

And in that situat. prop unwillin to cont a pract. both troub. & painful

But reason to think that too [precit] in relinq this mode of cure.

For very lately informd by his father that again return of his affect.

But circum which led him to apply what may perhaps create some susp with resp. to reality.

It seems since was our patient has enlist as a sold. in a march regt.

And his father request was that I should give certif of his being unfit for service.

This however a purp. for which well known that compl. freq. feignd

Hence acct not to be dep. on.

While even suppos. reality would not have warranted certif.

But at same time that had return seems to me by no means [imposs]

Without however conject on this subj. may concl. obs. on this case with few pract. deduct.

And may here obs.

That freq. returns of Tinea cap. ment in hist. shew prop. of persist in use of remed for some length of time after affect app. remov.

That occurr on headach on cure of that disease, points out necess of substit same [vicar] [evact].

That relief from return of Tinea capit. from accid supp, as well from issue, shews benef. of change in balance of circul as relieving some inst at least of cephal.

And finally, that return of Cephal if has realy taken place, shews necess. of support disch for consid length of time