DEP/DUA/1/14/14 (Normalised version)

William Reid

(1777)

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Next patient in order of admission William Reid, properly speaking can hardly be said to have been ever under care.

For although mother applied for advice yet seems to have expected, that disease to be cured by words alone.

Since case taken have never once seen her & have had no opportunity of prescribing for him

Her not having attended perhaps in some measure effect of residing at some distance in country.

But probably still more proceeded from advice received, before she came under our care.

A practitioner whom she had then [consulted] told her that disease of child incurable & would certainly prove fatal.

And that less her child was [tampered] with more chance of living for some time

Will not pretend to say that was not some truth in this advice

And at least more than equal chance that patient rather [hurt] by medicine than cured of affection.

Do not however consider this as sufficient argument why seemingly desperate cases medicine should be altogether neglected.

And consider case before us to be one in which some measure might have been taken without at least appearance of hastening death.

Respecting affection to which patient subjected no room for doubt.

Could have no hesitation in pronouncing it according to language which have already employed to be Hydrocephalus of Cranium.

And this third instance of that affection which has been presented to us within space of few months.

A certain evidence that the disease not to be considered as a rare one.

That this affection here took place at once manifest from size of head.

Especially when attend to part which had suffered increase & to state of bones.

That manifest separation of these from [containing] water appeared even on slightest examination.

Vacuity from bone at fontanelle, which to some degree with all infants, here of uncommonly [large] extent

And through whole course of sagittal & caron [illegible] bones at very considerable distance from each other.

Besides enlarging size of head, no doubt water from compressing brain, cause of other symptoms here occurring.

Particularly of impaired sense of vision & of uncommon drowsiness.

For although infants sleep much of time & although respecting extent of senses cannot judge with much certainty yet in both particulars mentioned was opinion of mother at least that morbid affection had occurred.

And indeed more astonishing that [sense] should remain entire than that should be affected.

In present case see no circumstances that could lead to particularly favourable prognosis.

And affection known to be one if not universally at least very generally mortal.

When consider early period of life at which appeared & that arose from no obvious cause may presume it congenital.

And from affection of senses had evidence of influence on system.

Little grounds then for expecting favourable termination

But while no expectation of natural cure should not I apprehend neglect even faint hopes which means of artificial may afford.

Do not indeed consider desperate nature of disease as warranting use of remedies under operation of which great probability that patient will die.

Or where even strong presumption that will apparently die of effects of remedy.

For necessary that practitioner in every case some regard to own reputation as a man of prudence & caution.

And although patient would certainly die of disease yet reputation of practitioner will suffer where [previously] cut off by means employed for cure.

This I own now consider as stronger objection than before to proposition of [puncture]

For since last spoke of this subject have heard of one instance in which [perforated] by a late surgeon of eminence in this city.

And there during very time of discharge of water patient [illegible] with convulsive fit which terminated mortally.

Would not indeed positively affirm that this convulsion the consequence of puncture.

May have occurred accidentally although operation not performed.

And shall be happy to learn that has been tried in other cases where same consequence did not follow.

But consider even solitary fact as giving grounds for suspicion that convulsions may proceed from this operation.

Without however attempting so bold a practice might here have done something.

Might have attempted without manifest danger at least evacuation of water by artificial outlet in way of blisters, & by natural in way of purging.

Do not indeed mean that from these should have entertained high expectations.

But while some chance of doing good would not apparently have been cause of death.

And if even effect of shortening life in such a desperate affection chance of doing service more than sufficient to counterbalance it