DEP/DUA/1/19/17 (Normalised version)

Thomas Bannister

(1778-1779)

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Thomas Bannister, attended us so little here that reckoned it unnecessary to say much with regard to his case

His affection consisted of severe pains

And these at same time without being fixed to any particular part or attended with any manifest local affection.

These pains represented as being deep seated and as chiefly affecting the bones

Well known that pains of this kind induced from various causes.

But particularly may proceed either from a Rheumatic or Venereal affection.

And in case before us some circumstances giving presumption of each.

Affection according to account given us had been of no long duration.

And had not begun with those febrile appearances which occur as necessary constituents of acute Rheumatism

Is however at least very generally in this form that chronic Rheumatism has its commencement.

But while this somewhat against Rheumatism is also in favour of supposition of Syphilis that affected with violent pain in middle of bones.

But on other hand to be observed that in as far as can put dependence on account of patient did not arise from venereal cause

And, with us, while could have little inducement to conceal his affection, must at same time have supposition that had best chance of recovery from telling the truth.

Farther while pains seated in middle of bones were also very severe in joints

These pains as is common with Rheumatism, rarely the case with those of Syphilis, aggravated by heat of bed.

And lastly not here attended with [nodes] [ exort.] or any other local affection of bones indicating Syphilis or indeed with any other Venereal symptom.

From all these circumstances then taken together must own am rather disposed to consider complaint as being Rheumatism as otherwise

Yet do not imagine that such dependence to be put on account of patient as to entitle us to form certain conclusion.

On this account then must be rather more doubtful with respect to prognosis.

Yet whether Rheumatic or Venereal certainly [not] in case which could alarm us.

On either supposition might have concluded that in no long time would have been overcome.

This however particularly to be expected on supposition which have here adopted.

And indeed reckon it probable that that patient having so soon discontinued attendance was consequence of getting rid of affection

And that even without any assistance from measures here directed for him

Supposing disease to be Rheumatism but yet not altogether without doubts respecting Lues thought most advisable to have [recourse] to cure in some measure [advantageous] to both.

And was with this intention that here had recourse to use of Mercury.

Of efficacy of Mercury in Syphilis need say nothing.

However much practitioners may differ as to principle of operation yet universally allowed that in almost all its different states is a very efficacious cure for that malady.

This indeed where Syphilis affects bones can only be expected in consequence of entering system.

And some who allege that this not case with Calomel which consider in no other light than as a purgative.

This supposition however cannot help considering as being a very extraordinary one

Since they admit that both milder preparation as those by triture & more [acrid] of saline [tribe] do enter system.

But besides that supposition is improbable may add that contrary to fact.

For can be no doubt that as entering system shows even specific effects of Mercury from exciting salivation

And some even who in constant habit of employing it even as ordinary cure for syphilis.

Are even disposed to think that besides disposition to run off by other excretions will even sooner affect salivatory glands than milder [preparation]

From every view of effects then must hold it as being an useful mercury in cases of Syphilis.

Of use of Mercury in general & of Calomel in particular in Rheumatic cases have lately had occasion to speak.

And shall not now repeat observations then offered

May only add that looked upon it as well suited for the disease in present state

For although consider Mercury as having greatest efficacy in paralytic stage, yet look upon it also as well adapted to what would term irritation.

For unquestionably combines both evacuation & stimulating powers then wanted.

Was then on these grounds that here directed

But what affect of exhibition or indeed whether taken or not have not been able to learn