DEP/DUA/1/41/26 (Transcript version)

Alexander Paterson

(1786-1787)

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Alexr Paterson. March 31^st.

Former obs. that affect of this patient evid ex of Tinea Cap.

But at same time not without pecul.

For did not app. under form of that thick white incrust comm observ in Tinea.

Or at least this case only at partic part of it.

And even these not consid.

While in other parts where disease affect evid exist shining red surf.

And that too yielding consid disch.

This however always case even where incrust thickest [illegible] after remov.

And indeed seems to be by [such] a surface giving exud that incrus entirely formd.

For incrust consists merely of extran matter, which has exuded from part & after passess from fluid to solid state.

From this then would only inf that dispos to such transit less than usual.

That matter disch perhaps more in watery form than usual.

And that thus app. greater quant of disch & thinner incrust.

While in [illegible] [red] [illegible] app. have much more essen mark of that morb. condit in which Tinea [illegible].

This therfore consid as less pecul. than some other circum

Tinea I need hardly remarkd very gener. consid as depend on morbid condit of bulbs of hair.

Hence almost univ conf. to hairy scalp.

And while this affected to [great] degree other parts entirely free.

Often in every other resp. state of perf. health.

Unless where matter falling upn neighb parts as about neck give app erupt & ulcert of these.

But in pres inst an affect of a nature somewhat simil app also on distant parts.

Some tend to simil effect even in [pustule] on his cheek.

For although accord to acct given began under form of small pimple yet had not usual termin of [such]

But when came under our care cover with an incrust.

And that very much of app of what takes place in Tinea.

But besides this a simil affect much more [distinct].

An incrust of consid extent on left arm.

And this under form of white scurf without any disch.

Not imposs. that both these altog unconn with pres affect.

Partic that on face which but of very recent date.

But think it more prob that were of same nature.

And though extern to other parts uncon yet consid it as having here occurd.

And on these other situat also might have been conseq of affect of bulbs of hair.

For alm no part of surface alm without these

If howevr singul in this exten anoth circum still more so

Connex viz with state of weath

For told that during sum almost entirely disapp.

And that return again in win winter.

This may conceive to [happen] from diff circum.

But partic from state of persp.

For well ascert. by stat exper. that in winter much less consid than in summer.

Unless therfore where compen by some vicar evac as urine easy to see how may [unden] [act] [illegible]

Accord some of these much affected by it.

This howevr for my own part at least have never in any former inst obs. to be case with Tin.

For when induced in gener a perm disease.

This then as well as former circum consid as pecul in pres case.

Here at loss to determ with regard to progn whether these pecul. for or against pat.

For could not at least speak from former expr.

But upon whole was inclind rather to consid them as unfav.

And while Tinea in ordin inst an obst. disease from thence conj that on pres occas still more so.

To idea of obstin also contin for four years some addit.

Hence expressd doubts how far should be able to overcome it.

But in this prognos. appreh it would now app. greatr than well founded.

For patient dismissed from attend with affect if not remov. at least consid allev.

And this I am inclind to think not a little owing to remed emp.

On idea that Tinea dep on morb. condit of bulbs of hair cure cheifly to be expectd from imm action on these.

Either by total remov, as effected by extract by means of pitch plas

Or by stim applic altering state of action in parts.

Formr a painful & in some degree a danger mode of cure.

Hence latter where adeq to effec very gener at least to be pref.

Was with this intent that had here recourse to Ungt Citrin

An ointm which has for bas. merc brought to active state by means of Nitr acid.

For ready applic howevr Ungt Citrin of Ednr Pharm requires to be [red] both in [const] & [streng]

There therfore dir. Ungt Citr. mot.

Made by unit it with axung in proport of ʒi to ℥i.

Under this form have often directed it in simil inst.

And if not much deceivd in these as well as in lepr & herpet affect with best conseq.

Is seldom however in any inst that can venture to cure Tinea without prod some vicar disch.

For by cure in every case chan in balance of circul.

And from determ to import organs might be prod of bad effect

But this partic necess where disch consid as in pres inst.

From this then here directd crud antim as means of prom encr disch by surface.

Which indeed the rather indic from relief of pat during warm weathr.

From powder no inconv

And indeed at first no obv oper.

But although no obv sweat yet still presumpt that encr perspirat. effect wanted.

And from time that ointm begun disch dimin

By contin of this applic app of part changed still for better.

But at this period became in some degree affected with looness.

An occurr which it is not improb was effect of antim.

But even supp this the case did not considr it as suff. reason for omitting use.

For presumpt that by a little farthr habit would cease.

And at any rate slight diarh by no means unfav.

But whether effect of powders or not was of no long contin.

And its ceasing did not seem to interrupt progr of cure.

For at every succeeding report affect seemd to be dimin.

In this situat wishd I own that pat had been able to cont somewhat longr with us.

As now entert hopes of being able to accompl. compl. cure.

But partic situat of some of his relat made it necess for him to go to country.

Was therfore dismissd sooner than could have wishd.

But still pract in this case evid shews I think, influ of this mercur prep in comb. such affect.

And also app. that while thus advant. when comb with crude antim not in other resp prod of inconven