DEP/DUA/1/28/03 (Normalised version)

Adam Whitehead

(1781-1782)

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Adam Whitehead at 36.

Complains of considerable pain in the right hypochondrium, which strikes from thence to the back & down the course of both ureters.

The pain is attended with great difficulty of breathing & some cough both of which are considerably aggravated towards evening & continue so during the night.

But in the morning when he rises his breathing seems as free as if the disease had entirely left him. He observes likewise that the pain at that time is a great deal easier.

He spits up with his cough in the morning a thick viscid, yellow coloured & salt tasted matter

But before evening the matter which he spits up turns thinner & more white. He has also considerable vomiting immediately after he rises from bed & of a thin greenish matter which is very sour. He has considerable oppression at the stomach before the vomiting comes on. Every afternoon he is affected with a dull & heavy pain in the forehead & crown of the head, which continues through great part of the night but it goes off before morning.

Pulse rather quick & full, belly bound. Tongue moist & clean but he is very thirsty. Urine very scanty only passing a little every other day. It is very high coloured & remarkably hot, & in passing the last drops he sometimes observes a little blood to come away with it.

The pain of his side commenced last August in consequence of a fall he got from a wall six feet in height. All his other complaints supervened since that time

But they have been much aggravated within these three weeks

He thinks that together with the fall exposure to heat & cold contributed to bring on his complaint.

Rx Ungt Merc. ℥i.

Camph ℥i. ter opt simul & illin [paux] part. dolent. nec non

Cap. bis ind. Spt Nitri dulc [gr] XX

February 2.

The quantity of his urine is not increased from the use of the Spirit Nitre dulcified & there is no change on its colour. But he has been less affected with the heat in passing it. The pains & swelling of his side continue as before.

Cont Med. u. a.