DEP/DUA/1/23/12 (Normalised version)

Robert Bruce

(1780)

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Of next patient in order Robert Bruce reckon it necessary to say very little.

1) yet can hardly say that has been our patient here

Concerning disease to which was subjected no room for doubt.

According to history given us a distinctly marked intermittent

And that too without any symptoms that could be considered as anomalous.

Was however in quotidian form.

The state of all others most apt to have degenerated into [continual].

Besides this from length of time for which patient subjected to it before came under our care could not consider it as slight.

During that time also had resisted those remedies to which commonly yields

Hence then should not have been disappointed if still found obstinate.

Still however as already remarked free from any alarming symptoms.

And approaching summer season afforded at least most favourable opportunity for trial of medicine.

May farther add that in cure of intermittents if sometimes disappointed in use of Peruvian Bark is at least but rarely the case.

Trusted then that by this means disease might in no long time be overcome.

And accordingly to the Peruvian Bark after [illegible] use of emetics resolved [immediately] to have recourse.

As to most proper administration of bark in case of intermittents practitioners are not [agreed].

On all hands indeed allowed that sufficient quantity thrown in during interval will in general soon cure the disease

But has been much disputed whether best immediately before, immediately after paroxysm, or during intervals.

That is in which way may be most expediently affected & by least quantity of bark.

As far as my own observation goes see very little reason to think that less quantity of Bark sufficient in one way than in other.

In small doses gradually exhibited may indeed perhaps thrown in more than necessary.

But still am for my own part inclined to consider it as more certain & easier way than by loading stomach with great quantity at once.

Here however shortness of interval induced me to give preference to other mode considerable quantity immediately after paroxysm

Especially as wished to have farther experience of it than have yet had.

Directed therefore an ounce to be taken within space of few hours after fit.

Since that however have never seen or heard anything farther of patient at this place

A circumstance which at least gives some presumption of recovery.

But whether so or not now very little prospect that will visit us again

1) References are made throughout the case notes to a dispensary patient register. However, no evidence has been found that this register survives.