DEP/DUA/1/40/44 (Transcript version)

James Liddle

1786

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Jas Liddle. Decr. 2^d. 1786.

Disease obvious.

Yet some diffic even [as] to name.

Still more as to nature.

Here affect evid of cutan kind.

And without any sympt of febr. kind.

Nay even without any affect of [illegible]

Hence concl. not only cutan but even [loc].

In such affect however consid div in app

And from app. receive denom.

In this however consid variety

But without attemp. great or min. two Gen.

Leprous or Herpetic

First appellat where inflamd moist & watery

Second where dry white & scaly.

Often however transit from one to other.

Hence an affect at one time strictly entit to denom of Herpet.

At anoth exactly corresp. to Lepr.

Of such trans remark ex in case before us.

Common app. indeed that of Herp. affec

This concl. from scarlet app. ichor disch & ulcerat.

Yet often an incrust formd on [parts]

Evid prod of matter exud.

This abund app. from regen when falls off.

And prob. in every case where scales whitest or dryest yet merely inorgan.

Always effect of some exud.

Hence more diff in app. than reality.

Here however judging from app. would give name of herpes.

But suppos no doubt in denom yet little light as to nature.

For both lep & herpet affect from diff [cause].

Whatever causes reason to believe that these former oper. more powerf. than at pres.

For in anct. time more freq. dis.

And that both in this & oth. countr. so much case that treated in some degree as would now do Plauge.

Hospit profess. for purp.

And to these pat. strictly confind.

For supposd highly infect.

Gallows said to have been placed at extrem.

And death punish of those exced bounds

Belief of high contag. prev. also [in] other nations.

As evid from laws of Jews.

How far at that period such [cause] necess will not pret to say.

Nor would deny that at pres [infec]

But certainly not to such degree

And prob. that prev then more from other causes.

Partic want of cleanl. & gross [imperf] food.

Circum of which jews not ignor

Hence explicit direct.

And would ascrib. dimin of freq & change in app. to these two parts.

But princip to more freq use of clean linnen.

Hence now cheifly among lower class

And espec those not attend to clean.

But whatever rem. causes prob [allw] oper on few prin.

Either prod erupt from local affec of part or rend of circul. fluids

When from later cause extend over whole surface.

For at least app in progr at very diff. parts.

When in later former more espec. conf to partic parts.

And this case in inst before us.

Here almost entirly conf. to hands

When this local however still diff case

And partic morb. condit in subcut vess. Sebac. glands or Bulbs of hair

In most cases diff. often [import] to [detr] from which.

Still however obj in view nearly [same]

Restor viz of sound state to vessels morb. affected.

And cheifly to be accompl. by alter state of action

An end in diff cases ment often [effectd] by same means.

But before speaking of pract necess to state opin of Prognos.

And with regard to name & nature from what said concl. disease of Herpet kind & depend on local affect.

From this view not at least danger.

For seldom unless from improp [man.] fatal conclus.

And here from sympt no ground of appreh.

For import funct little if at all affec.

Might look even for speedy termin.

For if conject as to cause well founded not of most obst. nature.

And former yielded without much diff.

But immed remov only small part of cure.

And in such affect well known that tend. to recurr.

This often very diff to overcome.

From what has already happ. some presumpt that will be case in pr. inst

Yet may hope at least for second temp remov.

And that too in no long time.

In herpet affect plan of cure somewhat varied accord to cause.

But where affect local whether subcut. vess. Seb. glands or bulbs of hair chief obj to alter morb. cond

And to be effected by immed action on parts themselves.

Partic by altering state of action of vessels.

And this most gener. conseq of pecul. stim.

For to be obs. that in action of stimul causes very great diver.

No two perhaps precis same.

Accord [where] one fails anoth will often succeed.

And where stim unsuccess. may [sometim] be effected by tonics & astring.

But to cure by topic remed strong obj. have been made.

Has been consid as means of repelling eruption.

A driving back infect as it were into blood.

And accus of being thus prod of worst conseq.

That bad effects sometimes conseq of topic applic not to be denied.

But that conseq of repuls of morb. matter into blood not probab.

Indeed in greater part of cases no evid of exist.

When occurr entirely to be ascr. to expd cure

To change thus induced in balan of circulat.

And to obstr. to accust. disch

Hence chiefly takes place where disch consid.

That is where affect. more of herpet than lepr. kind.

And especially where very [extern].

But in every case become obj of atten

Requis that change in balance prev. from affect import funct.

And that accus. distr. [illegible]

These pract if not contrib to cure of at least prev inconv. which might otherwise result from it.

On plan now ment remed here emp

Began by direct intern use of prep crude Antim

And extern applic of Ungt. Citrin [illegible]

Latter applic intended with view to immed action on affected parts.

And from it chiefly exp. [cure].

Ungt. Citrin need hardly obs an active mercur. ointment.

Merc. brought to saline state by nitrous acid.

Like other saline prepar not [ready] [entrance] by [lymph].

But powerful action in giving pecul stim which Merc. prod.

As directed to be prep however in our pharm activ in gener. greater than tend parts can easily bear.

While in conseq of action of acid on unct. mater so hard that not easily born applied.

On both acct addit required.

Accord in Dispen pract. Ungt. Citr. Mot.

Made by Ungt. Cur. ℥ i. Axung. ℥i.

In this form suff. active & suff. easily applied.

To this quant in simil cases have often had recourse

And I think with best effects.

Cannot indeed repres it as always success

And where others this fail this other will sometimes succeeded.

But upon whole, consider it as in such cases one of best & most [active] applic with which acquainted.

While from this hopes of remov of affect, thought it necess. to prev [inconv] of sudden cure.

And chiefly with this view that had recourse to antim.

Antim under variety of forms oper as sudorif diaphor.

But perhaps with more ease & greater perman in crud state than any other.

Hence often useful in cutan affect [when] want of due perspir.

Not only used with hum species but with other animals.

Partic among farriers a comm med with horses.

Alledged effect of giving fine skin.

And from gener. belief prob. well formed.

Have for my own part often empl. it in cutan affect with great advan

More however in conjunct with topic applic than by itself.

And highly useful as prev. inconv. from these.

For by giving determ to surface counteracts influ of change of balance, as affect other parts

And by prom perspir [compen] accust disch.

In some cases however even in this form consid influ as giving sickness.

Espec. where superab. acid.

Hence requis to begin with small dos.

On this acct here directed to quant of ℥p every night at bed time.

As then prob. more influ in prom perspir.

Under these med contin for space of week.

From Antim no sickness.

While at same time no obv. disch by sweat.

Circum indic that for full effect larger dose & more freq repet necess.

Exter. applic of Ungt Citr. no uneas.

That is not more stim than parts could easily bear.

But erupt upon whole nothing dim

And disch from aff. parts augm.

Notwith this should have hoped for good effect from contin.

And indeed in such affect seldom much to be exp. in space of week.

But then informd of anothr circum.

Benef. viz formerly [reaped] from use of lime water.

Lime water, from affects on living animal fibre well known to oper as gentle astring.

And in this manner tend to restr. disch whether natur or morbid.

Hence may prev exud taking place in herpetic cases.

Is not I must own an applic of which can say any thing from my own exper.

Yet can readily conceive that [may] be of service.

And success with pres patient on former occas. suff. ground for having [aga] recourse to it.

When formerly used, directed in way of simple lotion.

And this probab. not least active form.

But reason to think that in some cases too powerf as astring, perhaps as stimul.

And cannot easily admit of long contin applic.

On this account, here directed in diff form.

That of linim viz consist of equal parts of lime water & olive oil.

This linim have not [indeed] empl. in herpet cases.

But for sever years past have empl it in many inst of topic & superfic inflam.

Such for ex as burns or scalding from hot water or like.

And in gener. at least know no applic more effect.

In some inst indeed, more allev of pain from Saturn med.

But after this linim of lime water more effect in prom speedy healing.

Accord at pres. very gener. used.

Is almost univ applic at Iron & [Alumn] works where accid from burning & scalding very freq.

Being prob. with justice pref. to others

Under this form then thought that might be more safely & advant empl. here than in [mere] state of lotion

Would have less influ as tending to give immed check to disch.

Would be less apt to excite inflam being of mild & emol nature.

And would admit of more ready & easy applic.

Am I own not without hopes that in conj. with Antim may accompl. aim

But if after proper trial ineffect. shall next try lime water by itself.

Or order it under form of lotion in conjunct with linim

If this also fails may have recourse to some strong astring

Ex. Vitriol acid with Ax. Ungt. Vitriol.

An artic which have often used & with great benef in herpet affect.

But in this as well as in other pract. must be must directed by circum of case at time