DEP/DUA/1/19/04 (Normalised version)

Robert Robertson

(1778-1779)

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Robert Robertson.

Case of this patient selected as subject of lecture from idea that exhibits example of very uncommon affection.

At least according to account given us had never before met with any case which had [seen] near resemblance to present.

Patient we are told affected with periodic swelling attacking him regularly every day at certain hour & continuing for limited time.

May reasonably conclude that from transitory nature could depend on no fixed cause.

And accordingly are informed that at no time attended with any obvious fluctuation

Swellings of abdomen of transitory nature not unfrequently the affect of flatulence.

And these will even be so far propagated through alimentary canal as to give unease at throat & affection of breathing.

Such however are the symptoms marked in this case.

But even these symptoms as occurring from flatulence by no means correspond with appearance as here described.

For with flatulence very rarely that symptoms attack periodically.

And when do so almost never happens that continue only for limited time.

Besides swellings of this kind attended with evident indication of flatulence from borborygmi or such other symptoms.

And when relief occurs is in consequence of discharge of wind by flatus or eructation.

No circumstances of this kind however as far at least as we have been informed took place with present patient.

Besides this farther extraordinary as flatulence a very rare affection to so early a period of life.

Singular also that should have occurred suddenly & without any manifest cause

And what of all others most surprising that should have continued regularly for so long space as four weeks without alteration

From account [then], thus given was inclined to consider case as singular.

And thought might not be unworthy of attention to examine progress & symptoms

At same time, singularity such as might naturally have [created] some doubt, as to truth of account.

For cannot pretend to affirm that patient had no inducement to deceive either us or parents.

And without any such intention may have exaggerated description.

Here then would naturally have been first objective to determine facts.

And particularly by taking opportunity of examining patient during course of paroxysm as it might be called.

Was rather then with view of not appearing entirely inactive, till such opportunity should be afforded than from hopes of any great benefit that directed for patient medicines which at first ordered.

At same time will evidently observe that was principally intended against flatulence

Perhaps few articles more immediately useful as expelling wind from alimentary canal than peppermint water.

And of all tribe of stimulants to stomach employed with this view is one of most innocent.

At least while equally efficacious astringent much less pernicious than spirit liquor.

But here combined this article with another the Tincture Amarum.

And while one intended [for] expulsion of wind other meant with view to prevention of return.

How far however had influence in either of these ways have not since been informed.

For since got first prescription have seen nothing more of patient.

A circumstance which while gives some room to conjecture that may be freed from complaint, affords no less grounds for suspicion, that account at first given not fair representation.

At any rate farther conjecture unnecessary.