DEP/DUA/1/45/24 (Transcript version)

John Duncan

(1788)

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John Duncan. at 20^th N^o20.

When formerly ment. case of this patient, obs. that consid it as entitled eithr to appell of Herpes or Lepra.

For evid consist in a cutan erupt answ to descript of both.

As describ in our regist indeed [most] nearly corresp with descript of Lepra.

But was at same time evid, that dry white scaly incrust, the effect of ichorous matter, pourd from surface.

And while one part cov with such incrust anoth, in state of yielding consid disch.

Hence though one most corresp to definit of Leprous, other of Herpet erupt, yet both of same nature

And accord diff if not impossib [illegible] to draw limits between the two.

But whatever name [most] prop. [afford] is unquest a very obstin affect.

And often after app. recov. again apt to return.

As however now found not to be that highly contag disease once supp. so also cannot be repres as incur.

For while sometimes admits of natur recov. so no doubt that on other occas has yeilded to artif means.

Some modes of cure have succeedd in one case others in diff. one.

But at the same time recov. to be expected only from active artic & these too contind for consid length of time.

From such however had here hopes that pres affect might be overcome.

And the rather hoped for success [here] as disease though of consid contin had not resisted any active remed.

As one of most powerful of these, & what in former inst, have found attend with best effects, had here recourse to Antimony.

This I need hardly obs. empl. for purp of med under great variety of diff. forms.

And will perhaps imagine that form here empl infer to most others.

For cannot be denied that powder of crude antim the artic here empl, when compared with others both uncert & inactive.

For here regul part of antim united with a large prop of Sulph.

This some have supp. suff entirely to destroy activ.

And that in certain state of combin may have this affect would not deny.

Indeed presumpt of this not only with regard to pres, but also with other very active metalic med ex Mercury.

But that with crude antim, this not altogeth case, appears from obv. operat.

For not only effect of augm [illegible] disch but also of sometimes excit great sickness at stom, & even vomiting.

But from these circum again, have evid of uncert. of operat.

For will sometimes arise to distress. degree, even when small dose only empl.

And prob indeed very much depend on state of acid in stomach.

For always most remark when acidity prev.

And very gener. effect counteract by employing at same time an absorb.

But well known that const [tenden] in some degree to acid in stom.

And prob in most inst suff to give some degree of activ without without much inconv.

Here however must acknowl. that led to use not from any knowl of prin upon which acts, but from exper of use.

For a remedy now for a long time in use against affect of cutan. kind.

And empl. not only with human species, but also against cutan disch of domest anim. partic horses.

Nay with Farriers & horse dealers where no cutan disease, can be prop. said to exist, every day empl. to give more beautif skin.

In my own pract, have empl it in many inst, simil to the pres.

And although must acknowl. that has not unfreq faild, yet have often seen it, prod of best effects.

And under [due] contin, means even of grad accompl. compl. cure.

From former exper. then, led to empl. it on pres occas.

When had recourse to use however, reckond it necess to begin with small dose.

And comb. it with a prop of liquor, merely to promote diffus, & susp in any fluid, in which might be swallowd.

While however empl. Antim intern had recourse also to Ungt Saturn as an extern applic.

This directed to be gently applied to parts most affected.

And expected benef both from [unct] matter & likewise from prop of lead, which it contains.

From former expected that might operate as emollient remov incrust.

From latter, as sedative & [astring]. allaying morb. action & dim disch.

And can be no doubt, that where such disease not very extens, have by topic means best opport of acting on diseased part.

These med as learnt at succeeding [report] empl. without any inconv.

Imag. therefore therefore that quantit of Antim taken might be encr.

And accord directed three doses of a [scrup]. each, that is to quant of ℥i in day.

After contin on this course for a few weeks seemd upon whole to be rather better.

For on parts from which incrust fell off less apt to be speedily renewed.

Upon whole however sympt cont much as before.

But in this situat. lookd for benef from contin & encr. dose.

Accord directed it four times in day.

But since that though sever weeks have elapsed have seen nothing more of patient.

And if, which prob. the case, still contin subj to disease, may consid the remed as having faild only from want of due trial.