DEP/DUA/1/40/54 (Transcript version)

Mary Miller

1786

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Mary Miller. Janr 6^th 1786.

Of disease no room for doubt.

Formerly obs. that prin inst of Ophth

Diseased state then such that eye could not be exam with accur.

And can hardly say that this even yet the case.

From even comm however no doubt of consid inflam.

And that too affect. both body of eye & eye lids.

Hence might be consid as exampl. both of Ophth. Membr. & Palpeb.

And such complic not uncom.

Here however affect of eye lids only of transit nature.

And no reason to believe, that partic sealed in sebac glands

Had more app of ordin inflam than of any thing of scroph nature.

Hence notwith situat cannot at least be consid as of same nature with what comm. known by title of Oph [illegible] or palpeb.

And which if named from nature very gener. Ophth. Scophul.

Here therfore consid disease as merely effect of encr. action of vessels.

For now no doubt that this cause of active inflam.

Abund demonst. by influ of local stimuli

By these as app. to any partic part well know that inflam prod.

From this encr. action blood prop. with greater viol to extrem vess of part.

Red glob. forced in consid quant, into very small vessels natur. trans. very few only.

And in all prob. in not a few cases into vessels intend only for conv. of [illegible] fluids

Hence sense of shooting or pulsat.

The acute pungent pain.

The obv. swelling, burning heat. manf. redness & in [fine] all other sympt. attend on active inflam.

Thus in my opin all phonom of inflam expl. without either suppos. of obstruct, relaxat. spasm. or any simil circum, which diff. Phys. have supp. requis.

For this theory of inflam. that merely effect of encr. action of vessels, in part, are cheifly indebt. to Dr [Wh].

And is as alr. obs. demonst. by many phaenom.

Partic by from induct. of active inflam by topic stim to any part of body.

But espec. to part here diseasd the eye.

Accord no one with whom from action of certain stim cause on eye ophth. may not be induced.

But no doubt that with some infirm greater tend to it than with others.

A circum which can have no hesit in attrib to dispos to encr. action in vessels of eye being with some much greater than other.

Hence [diet], smoke, cold or like which with one no effect, with anoth will induce even high degree of ophthalm.

With pres. pat, tenden to encr. action in vessels of eye, seems to have been very great.

And that too even from very early period of life.

For subj. to freq. attacks of [disea] from 3^d year of age.

At that time are told subj to mea measles

And to this cause, tend to ophthalm, prob. with just [referred].

For would seem, that contag in this affect often partic action on eyes.

And also probab. affected by blood prop. to head in gener. during agit. of coughing.

But whether to be expl. on these prin or not no doubt that Oph often succ. [Per].

Hence nothing extraord. that dispos. to affect origin from this source.

But will obs. that at one period tend to disease seems to have been suspend.

And cause to which susp attrib singular.

Immed followed her being affected with measles.

A compl. also, well known freq. to induce Ophthalm.

Perhaps even still more than Pertus.

For very gener. one of most distress. sympt of disease, affect of eyes.

And would seem that contag of Rub. in espec. manner acts on these organ

But notwith this, still inclind to adopt opin, that dimin of tend to Ophthalm a conseq of meas.

For from immed following that disease strong presumpt that to each other as cause & effect

And without farther reasoning may view it as evid of remark influ. which contag. febrile affect have in prod alterat in hum syst

Change thus indu. however not suff. to give compl. remov. of tend to encr. action.

Accord. after interv. of some years ophthalm again returned.

And when came to apply for our assist. subj to it to consid degree for space of month.

At that time state of eye such that could not with accur. reexam.

Were then however informd that besides Oph. subj to degree of Caligo.

That sloughy scale induced on Cornea of both eyes partic left.

This circum by no means improb.

For such offuscat very comm conseq of freq. inflam.

And indeed perhaps rather surpr. that does not occur in every inst.

So prob. immed prod of coag. Lymph.

This effused by opth in same mannr as from other inflamd [surface].

And to be consid as analo to infus exud in other parts.

Which merely conseq. of atten coag lymph making way through inorg [par].

And prob. less freq. occurs in Cornea than other parts from extreme [finess] of vessels.

Still however a very common & distress conseq of disease.

For often leaves vision very much impaird.

Here then concl. that should have this affect also to treat.

And according suggested that might furnish anoth case for empl. of Pulv Ophthal.

But state of active inflam. natur first occurd as subj both of progn & pract.

With regard to termin little doubt that in end should be able to overc. it.

For a disease seldom if ever fatal.

And indeed in most inst not obstin.

Though liab to recurr. from slight causes yet in most inst. soon removd or at least allev.

And had reason to hope that this would be case in pres. inst.

For though freq. liab. to recur. attack had never in form inst proved very obstin.

And on pres. occas. no active remed employd to counter. it.

Hence from idea given of affect. great & even alm sole obj to dim encr. action.

For affect this where part so access as eye various pract may be empl.

And partic [those] dimin impet in gener. or at part in partic, from determ to others.

Thus recourse had to bloodletting both gener. & topic, to Blisters issues &e

But these, unless indic by partic circum. more painful & incon. than some other pract, often succeeding.

And partic those applic to eye tenden immed to allay encr. action.

Such therfore consid as in general entit to first trial.

Was with this intent that directed Solut. Saturn.

An artic. formd entirely of Sal. Plumb. dissolved in common water.

Need hardly remark that saturn med long in use as topic applic.

Nor that of late, in conseq of writing of Goulard in partic, more fash than ever.

That he has extold his Extr. Saturn more than deserv. readily allow.

But still no doubt that very powerful.

And for most incontest. evid. referr to writing of Dr [Aikin] of Warr.

In no case is effic more remark than in scalding from hot water.

There need hardly remark that active inflam immed conseq.

And that attend with most excruct pain.

In such cases from keeping part const wet with saturn solute [imm] ease.

An evid proof of influence as [abt] action of vessels.

And prob. even, on same prin, that lead app in partic ways, gives rise to Paralysis.

On what this prop of allaying [illegible] depends cannot pret. to say.

And indeed can as little expl how stim induce motion, or encr. [prom] of action.

Both one & other, will in all prob. remain mystr. till know something more as to nerv. fluid.

And respect nature of this great agent in muscul. action, still total in dark.

But whatever nature no more difficult in conceiv that some [subst] should dimin than others encr. energy for action

And from observ. of facts that artic poss. power in both ways [illegible]

From effect then, in prod dimin of action, here reason to expect good conseq, from Saturn applic.

And though not always, yet often even of itself adeq. to remov. of such action.

For this purp. however where encr. action consid, very const applic req.

Is not by washing once or twice in a day that can exp. much benef.

Necess that as colyr. should be used every hour or so.

And contin at each applic for some length of time.

Often even great advant from const applic, either by wet cloath or poultice.

Partic during night when freq applic not otherw to be obt.

Although however effect great when thus prop. app. yet by no means suff in every case.

And in many cases, may not at least be aided, from being conj with other pract.

Of these one of most advant. is use of gentle cathart.

These have effect on diff prin.

Some of them In some degree useful as evac contin of intest canal & thus remov. cause of irritat from syst.

In some degree as evact. dimin [genr] impet. in conseq of evac from Syst in gen

But still more as giving determin. to intest canal & thus dimin impet at head.

Was then on these grounds that here exp. some benef. from comp. powder of Jallap.

An artic which in such inst have often, I think bef. empl. with advant.

Began by direct. it, in conj with saturn solut, twice in week to ext of ℥p.

This imag. might prove suf. dose for girl at 10.

Finding however that not desired effect. directed double quant.

From this brisk cathars.

And little doubt in attrib to operat of med, good effect soon prod on compl

For although vision still imp, & great [sensit] of eye, yet both pain & inflam much dimin.

Hoped therfore that by contin of med, this most distress part of affect, might for time at least be overcome.

But in such cases even from most triff accid prog of cure often inter.

And this occurd in pres. inst.

Cathart. prob. from some [discord] in stom, in place of oper. prop. exi. Vomit

While at same time there occurd aggrav of ophth.

This however only of few days contin.

And without farther aid, subs. before we had opp. of seeing her

In these circum howver, thought it improp to urge contin of Jallap.

While at same time flushing & heat of face still indic in employm of cathart.

Thought it pref. to employ Crem of Tart alone & to greater extent

As thus, benef both of cathar & refrig.

Conj. it however with small prop of powder of Cassia.

As thus exp. would sit more [ease] on stom.

Taken in this manner prod of desired effect.

And when last saw pat. opth much more dimin than ever.

Has not however attend for some weeks past.

Which own I am incl to attrib to finding that at pres. no farther occas for assist.

For as far at least as could judge offuscat by no means consid.

Now hardly expect that will again return.

If does, must be directed in pract & in partic in empl Pulv. Ophth or not by situat in which shall then find her.