DEP/DUA/1/12/27 (Normalised version)

James Laurie

(1776-1777)

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James Laurie

Of case of this patient propose to say but little for very opposite reason from former.

Is in many respects involved in great difficulty

And to state even probable conjectures with all arguments that could be adduced in respect of them would lead us to longer inquiry than can at present propose to enter into.

Shall only then in general way observe that in this case have almost all the symptoms of Dyspepsia.

Am however disposed to consider it as a much more dangerous & more obstinate affection

From continuation of disease

From constant & fixed seat of pain

And from uneasiness in passage of solid alimentary into stomach, cannot help thinking that great reason for believing that in present instance not mere atonia of stomach but a local affection.

And that this local affection is scirrhous giving stricture.

On this idea of case must own am not disposed to entertain favourable hopes of recovery.

And am very apprehensive that although from different means may obtain temporary relief, yet in end will prove fatal to him.

Scirrhous of viscera an affection which in but few instances is to be overcome.

And when attacks stomach from affecting supply of alimentary cannot fail soon to exhaust system & to disorder every function.

In these ways has already here had considerable influence.

For to this have no doubt in ascribing both exhausted appearance & debility of patient

And should not be astonished that even soon proves fatal to him

Do not however pretend to say with any great confidence that this will be case.

At same time shall reckon myself very agreeably disappointed if patient ever again enjoys good health.

And although attendance on us has now ceased may yet perhaps be able to learn future progress & termination of his affection

According to idea given of this case radical cure must have turned on removal of the scirrhous.

And with this view at one time made trial of use of cicuta.

Than which know no remedy which consider capable of doing more in scirrhous.

Seemed however to have so much affect as aggravating patients symptoms that soon obliged to discontinue it.

And all other measures taken intended merely with view of alleviating complaint.

Employed pill Gummos with view to expulsion of wind.

Calcined Magnesia with view to destruction of acid

And Pill Aloetic, afterwards Pill Colocynth with view to obviating costiveness.

By these was at different times somewhat relieved.

As found however that could not even with safety make attempts to radical cure thought it unnecessary for him to continue attendance longer here.

Especially as residence in country renders it very inconvenient for him.

Dismissed him therefore with some of pills with view of continuing relief which had obtained from belly being kept open.