DEP/DUA/1/43/26 (Transcript version)

James Galloway

(1787-1788)

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Jas Galloway. at 35

Formerly remarkd that consid affect to which this pat subj as ex of a rare disease

Though at same time could not be consid as solit. case.

For in my own pract have met with 8 or ten simil inst.

And for more full acct of it may referr you to a vol. of cases, which publis some years ago selected from records of Disp.

Does not in my opin enter any nosol. syst.

Its charact sympt. Petechiae. Vibic & Haemorrh.

And all these will obs. to remark degree take place with pres. pat.

At first disp. to give it name of Petechian or morb. petechial.

As thus charact by Graaf & som others who have recorded cases.

And as petechiae most leading app. & most stricking sympt.

Have since however met with [cases] where no petchiae.

And where with few vibices even chief sympt. Haemorr of pass. kind.

Occur to very great extent from very slight accid. as triff [scratch], cut &e

And am inclind to think that both petchiae & vibic to be ascribd to what may calld intern haem.

That is slight slight effus of blood

Essent part of disease therefore consists in tend to escape of blood from vessels.

And this not conseq of any prop power or actions of vessels

Hence in contradic to Heamorrh would give it gener. name of [aimar] [acomp] of aima – Sanguis & rheo fluo.

But of much less conseq to affix prop name than to determ [real] nature.

For on this both Prognos & Pract must depend.

Must however [ackn] that with regard to nature still not without doubts.

And not imposs. that from more exten obser. may change pres opin resp it.

Partic if shall hereafter be able to ascert. remote causes from [which] arises

Of these however have not from any thing I have yet seen been able to form any prob. conj.

Neither as far as any obs. goes [conn] with age, sex, or temper.

For have met with it both in pat much older than pres. and also at very early period of life.

In one inst that of boy of name of Moore, was told that had formerly [lost] other children from simil sympt.

A circum giving some conten to idea of being in some degree hered.

But at same time these parents had sever other childr. perf. [healthy]

Were themselves & had long been free from every disease.

And husb. in that class of [illegible] which enab. both him & his family to enjoy not only necess but even comf. & conven of life.

Here therefore would still attrib. disease to [this] child [diff] being acted upon by same excit cause whatvr was.

But this cause I was not able to discov.

Have in some cases indeed been told of preced accid to which parents & pat sometimes disp. to attrib it.

Thus with one came on after eating a large quant. of comm black beans.

But how that should induce it very diffic to conceiv.

And certain that often eat withou any such effect.

With another both before disease & during course their occurd an uncom dispos. for eating earthy subs.

Partic lime & ashes.

But thought it no less prob. that this a natur. instinct feeling [pointing] out cure than that cause of disease

Accord made a trial of absorb. to a very consid extent.

But without any influ either in aggrav or dimin affect.

While in sever other cases patiens could assign no cause.

And this we are told holds with resp to pres. pat.

Here may perhaps be imag. that though patient assigns no cause yet conj as to it may be formd from situ in life.

Will prob. have had occas to see him in diff parts of town a street begg

And hence exposed to many powef causes of disease.

Partic to action of cold & want of food.

Prob. also to want of cleanliness & to [actions] of bad air.

But to all [these] his children equally exposed without any app of this affect.

And many others also with whom never occurr.

[Cannot] by any means be repres as a disease of misery or want.

Have not indeed met with it in higher ranks of life.

But as already obs. have seen it where comf. & conv were afforded.

And pres first inst. where have met with it in great pov & in a common mendic.

Besides accord to this patients act already at former periods of life [were] subj to same disease.

And then occurred, when by no means placed in same miserab circm as at pres.

Hence then as to praedisp or exciting causes must acknowl. myself [totl] at loss.

And accord from these no conjec as to [prox].

Or in other words that morbid condit from which sympt. arises.

Of this however some conj. at least from consid by what condit such sympt. most readily induced.

And here may remark that funct in gener. remain remain in state of health.

Neither vital natur. nor animal any farther affected than may reason concl. happ. only in second way.

While intellect powers unimp. From these consid then may I think reason concl. that disease has not its orig. in vital prin. or nerv. syst. as comon. calld.

Although to affect of this some now disp. to attrib every disease whatever.

For my own part. must here obs. that never a conv. to this doctr.

Readily indeed alow that many diseases have orig. in vital prin.

And that in conseq of this both solids & fluids of body, consid as simple & inanim subs. may be affect. in second way.

But as little doubt that the [affect] may be mutual.

That human syst. both during life & also when entirely depr. of powers of animat. consist of consid mass both of solid & fluid matter no one can deny.

And in my opin altogth abs. to suppos. that either one or other of these may not be subj. to dis.

May I think as well deny that blood exists in living body as that may not there be morb. affected both with resp. to quant & qualit.

Have been led to offer these obs. because since downf of humour. [pathn] consid of matter. syst. has in my opin been too much negl.

Am very far indeed from supp. with Galen, that every disease [affect] of one of four prev. humr.

Or with writers of later date that no affect which does not dep. on [pec] morb. matter in blood.

Mean merely to say that consid those as falling into equal error, who think that from simple solids or fluids of body no disease can have orig.

The contrary of this have I think strong reason to presume happ. in case before us.

Disease evid charact by pecul tend in blood to escape from vessels.

And when consider how little any of powers, either mental or corp. imm. conn with life are affected, must I think seek for this tenden. either in condit. of cont vessels or of cont. fluid.

From pecul tender. of vessels can easily underst. why rupt. on conseq. disch of cont. fluid should be conseq even of slight accid.

Or should happen as it were spont. that is from ordin impulse of circulat.

And if affect took place locally merely, should consid. this cause of haemor. as most prob.

But diff. to conceive how such tender. extended over whole syst.

Espec. as except. haemorrh. no other marks of it, either in cond of cellul memb or mov fibre in other respects.

No marks of such disease in either from app. from feel or from volunt. action.

But if phaenom may be expl. from condit of vessels, so may also from that of cont. fluid.

Blood in natural state besides serous part consists of red glob. of partic size & figure, & of a gluten which has remark dispos. to pass from fluid to solid state.

Red glob. however may have [illegible] destroyd in conseq of which may pass through orific not otherw. allowin escape.

Or gluten may be deprivd or [illegible] of coagul in conseq of which no [illegible] formed to stop bleeding vessels.

And no matter afforded by which parts impaird glued togeth.

Thus then haemorr. will equally ensue either from slight causes or even spont.

And where such an affect gener. over every part of the syst. of two suppos. stated this app. least liab to diff.

To this suppos. farther [count] given by late experim of Mr [Font.] in treatise on poison of viper.

If these to be relied upon does not prove fatal from immed action [affection] of nerv. syst. but from immed action on circul. fluids.

May be applied to nerves when detachd from blood vessels copiously & freely without small injur to anim.

But when introd into blood, without even [touching] any solid, all dreadful consq. speedily ensue.

And of these some analog. to what [here] take place.

A disch. of blood viz from alm every pore.

If therefore some certain subst capab of doing so much others may at [leas] do something.

And while see how such sympt as take place in pres. case may be expl. from condit of mass of blod can also underst that this may be conseq. of accid introd of certain artic into blood.

Thus then may form some conj. both with regard, to remote & prox cause of [aimarhoea], Petechianosos or morbus petechealis sine febre.

But have already extended conj. perhaps farther than ought to have done.

And shall now concl. observ. with very few remarks upon pract.

Before this patient selected as subj of pract at Col. Cas. empl. to consid extent the Peruv. Bark.

To this chiefly led with view to antisep to tonic powers.

As imag. that condit event chief to be appreh. was degen from pres. condit of fluids to putres. state

And whatever cause of haemorh reason to expect that less consid if greater tend to constrict of vessels.

Since came under care selected for C.C. have with same intent empl. vitr. acid.

An artic which need hardly remark possess to very consid degree both astring & [antispas] power.

In state of concentr. indeed [dissolv] & corrodes solids.

And to living fibre with certain strength oper. as powerful stim.

But with proper dilut. high degree of astrin manif on application to dead or living solid.

And influ as prev. animal subst. from passing into septic state to which have natur tend. no less clearly demonst. by [unden] exper.

Imag. therefore that might at least moder sympt. & prev. those danger. conseq to which otherwise tend.

While opp. afforded for recov of proper [crasis] of blood by operat of syst. itself.

Is at least so far in supp of probab. of this reasoning that under use affect rather dimin than otherwise.

And some ground for hoping that by contin may be entirely overcom

Espec. as under same med have witnessd recov. in former inst.

Must however concl. with [illegible] that to such spon recov. circum of our patient in every resp. very unfav.

And from miserable condit, that viz of comm. mendicant, is much less fit subj for Dispen than for Hospit pract. where supp. with food as well as med.