DEP/DUA/1/45/42 (Transcript version)

Alexander Dingwall

(1789)

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Alexr Dingwall at 14. N^o29.

When formerly spoke of case of this patient entr. into inquir at consid length respect name & nature.

And do not now mean to resume observ on either.

Then obs. that consid it as an affec not describ by any of nosol. & taken notice of but by few of pract. writers.

Indeed know only one Dr Graaf who has describd it under title of Petechiae sine febre.

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From obs sympt. may I think be disting by title of Petechian, or more prop of [Amarrhoea].

For haemorrhage a more gener sympt than even petechiae.

Has indeed by some been cont that only to be consid as scorb.

But this opin can be entert only by those who have nevr had opport of witness both diseases.

And have now seen upwards of dozen of inst of this affect, so essent diff from scorb. in most essent import partic that can entert no doubt as to real diff of the diseases.

But a much easier matter to affix names to diseases than to ascert nature.

And here must acknowl. that at great loss.

Am however inclind to view both [petchiae] & vibices as a sort of intern [haemomor].

At least no doubt with regard to latter that depend upon effus of blood in cellul memb.

And indeed perhaps to be consid as in no respect diff from [illegible] where effus the effect of accid.

Petechiae also prob to be consid as of same kind.

And only more limited to spot in cutic vera or between that & cutic not effus in cell. memb.

Here then phaenom chiefly if not only to be expl. is haemorrh tend. This As evin by phaenom already ment by spont haemorh, from almost every excret. & by haemorh. from slightest accid.

This must I think depend, either on condit of cont fluids, or of cont solids.

Formr may obt such a state of fluid, that cannot any longer, be cont within vessels natur fitted for reception.

Or latter partic extreme superf vessels may be so tender that on slightest injury, not only rupt must take place, but from want if contr. power that rupt. gives rise to disch that can hardly be stopt.

Of these two opin must own have always been most inclin to first.

Prin because thought that most supported, by anal of affect in some respects simil.

Partic the Haemorrhages from bite of some serp.

And the haemorrh. petechiae & vibices from putrid fevers.

Must however acknowl. that pract founded on this conj. have not proved success.

Have indeed in some inst seen disease disapp under use of Peruv B. & Vitr. acid.

But these in other inst have tried to fullest extent without effect.

And at least satisf that do not always or even gener. afford cure for this affect.

But while this the case with these have not been more success with other plans of cure.

[Have] tried without effect, a diet consist of vegetab. & partic of large prepart of [illegible] veget fruits.

Have tried diet of most [illegible] [illegible] matters.

Have tried stimul & cordials as aromat tinct, wine & like.

Have tried, as indic by natural craving in one case the cop use of absorbents. But all with equally little success.

+ Here given then on second suppos. that viz, Haemorr not conseq of any [illegible] whatever on state of blood, but merely of extreme vessels

Even with pres patient before selectd as subj for colleg Cas. diff trials had been made

Partic of Peruv. bark. with diluted vitriol acid conj with some arom.

But from these though sometime slight app for better, yet upon whole no perman benef obt.

Resolved therefore to give trial to anoth pract.

And accrd when came under care as Col. Cas patient gave up vitriol mixt & directed G. Kino with alum.

These I need hardly remark now constit the pulv. stypt of our Phar.

And are well known to be both of them powerful astring.

And in all prob. oper as inducing [contrict] of bleeding vessels. +

On this med our patient has now contin for space of two months

And as you will obs. from state of sympt describd in various rep. with app. sometimes allev sometimes augm.

Can hardly however say more than that med has not disagr with him.

At first indeed from use had [sickn] at stom & vomit.

But since that taken without any inconv.

Cannot however say with matter benef.

For though by last report numb of petechiae much dimin yet very lately before subj to consid haem.

And but too much reason to susp. that fresh [petech] erupt will again [ocur]

+ Still another pract in view from pecul conj. as to pathol of disease.

Certain that stop of Haemor. [illegible] effect of [illegible] of coagul. lymph in bleeding vessels.

Tend to haemmorh therfore may be effect of want of Glut or morb. condit in it, without any putres.

Hence may try to supply [defec] [from] those artic most abound with glut veget animale as calld by [Beccar].

[illegible] & [illegible].

May direct diet of milk, cheese, bread & Potat.

And as med, starch.

Effects of this howevr as of others exper alone must determ.

And must even allow that success would by no means afford confirm of conject.

If this the case shall now [desert] [astrin] powders, consid them to have had full & fair trial without effect.

Have then thoughts of trying with this patient the Eau de Luce, or Spt Ammon Succin of Lond. Pharm

An artic which as you will obs. from last vol of med comment. empl. in East Ind with surp success against bite of rattle snake.

And since that have received addit commun in supp of effic which will app in next vol.

On anal. in app of two disease consid it as here at least deserv trial

But what will be its effects expr alone can determine.

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