DEP/DUA/1/28/04 (Normalised version)

Adam Whitehead

(1781-1782)

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Adam Whitehead

When this patient came under our care must own very much at loss what opinion to form of case.

And during short period of attendance doubts in no degree removed.

Hence unnecessary to offer many observations respecting.

For with regard to practice had no opportunity of trial of medicine intended

And with regard to nature of disease all that can offer mere conjecture.

From symptoms related in history if dependence to be put on account given many different conjectures may be formed.

From cough, affection of breathing & state of expectoration had reason to conclude existence of pectoral complaint.

From pain of back conjoined with colour & scarcity of urine has reason to infer affection of kidney

From sickness, vomiting, soreness at stomach, oppression, headache etc reason to infer existence of stomach ailment.

Besides these many other conjectures might also be mentioned.

And must own that although inclined to think representation of affection somewhat exaggerated yet had little doubt in considering patient as subjected to complication of ailments.

At same time probable that these originate from some one common cause.

And here I own disposed to conject that this cause affection of liver.

To this chiefly led from two circumstances seat of pain viz in [right] hypochondriac.

But still more the obvious enlargement which took place there as discovered both by feel & sight.

For affection of this viscus, a cause adequate to, effect of [illegible] it assigned

Severe blow viz from fall.

And on affection of viscus so important am inclined to think that [most] at least of symptoms may be explained.

From local affection of liver would account for pain enlargement etc.

From vitiated secretion would explain affection both of stomach & urinary organs.

And to this also think it not improbable that pneumonic affection also to be in some degree referred.

At same time as probable in great measure interconnected with other, & was effect of cold to which exposed.

This idea of affection however throw out as mere conjecture which had no opportunity of having confirmed or [illegible] by farther observations of progress of affection.

With these sentiments of complaint however could form no favourable opinion of termination.

And although might not prove suddenly fatal, yet little expectation of recovery.

Was not much displeased therefore at desertion.

Especially as plan of cure which said to promise greatest benefit could not in our mode of practice have fair trial.

Here will observe that for short time that patient remained with us two different practices employed.

First of these friction viz with mere ointment conjoined with small proportion of Camphor intended with view to radical cure

That is to removal as far as could effect it, of cause of complaint.

While latter the Spirit Nitre dulcified intended to obviate complaint considered as merely symptom.

And still more to prevent consequences which imagine would otherwise arise.

From great scarcity of urine [appears] the occurrence of dropsical symptom.

While [be] increasing that discharge expected that vitiated bilious matter introduced into blood [thrown] off.

Employed therefore Spirit Nitre dulcified as one of easiest & best diuretics with which am acquainted.

Mercury ointment intended to act as deobstruent in removing glandular obstruction.

And in this perhaps as effective as any remedy yet introduced into practice.

Is however chiefly to be expected as entering circulatory mass of fluids.

At least if excepting cases where acts immediately on affected glands from reaching these in course of absorbing.

May occur therefore as question why here directed to be [rubbed] on side

As absorbance arising from [thence] no connection with liver.

But by these at least as well as any others may enter system.

And to this practice led not from any theory, but from being well [assured] that often employed with advantage in warm climates where liver complaints most common.

But however from patient leaving us had no opportunity for trial.

And concerning case of which saw so little & with regard to which so uncertain unnecessary to say more