DEP/DUA/1/31/43 (Normalised version)

William Davidson

(1782-1783)

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William Davidson

Case somewhat of complicated nature

But principally of dropsical kind.

And these if not induced, at least very much aggravated from influenza.

Besides these indeed, flying pains also in different parts of body.

And especially severe in his head.

But of all symptoms what most distressing was dyspnoea.

And this, attended with some particulars, indicates accumulation of water in breast.

Of this ground for suspicion from being obliged to sleep in erect posture.

From these circumstances I own, not without doubts as to event.

But either suspicion ill founded, or much to be attributed to remedies employed.

For in no long time affection took very favourable turn.

And after being under care for little more than space of a month, dismissed free from affection.

This I must own am inclined to attribute, if not entirely, at least in great measure, to remedies here employed.

First practice to which had recourse blister to side, & Cream of Tartar to extent of ℥p in the day.

Reckoned it of some consequence that from former of these free discharge.

But still more, that by latter quantity of urine, which had been diminished, was augmented even beyond natural standard.

In dropsical affections in general no circumstances better ground for favourable judgement than that of [obstructed] serous excretion readily augmented

And to this am chiefly disposed to attribute sudden disappearance of obvious swelling

To be observed however that after swelling of legs entirely gone dyspnoea still remained.

A circumstance by no means uncommon where dyspnoea from water in chest.

For absorption not always equally readily affected from every cavity.

Hence then, even where anasarca swelling removed, patients yet often cut off from Hydrothorax.

Where however ready increase of Urine & free absorption recovery more to be expected.

And accordingly naturally led to persist in remedy by which had been brought about, use viz of Cream of Tartar.

With this however you will observe conjoined also employment of Peruvian Bark

The combined use of evacuant & tonics, but a late practice in dropsy.

Am however persuaded, that of very great importance.

And in many instances, in place of retarding, even forwards evacuation.

Cannot indeed say that this the case in present instance.

But had at least no contrary effect.

And from commencement of employment, both cough & dyspnoea diminished.

Such circumstance then, it would appear, no sufficient reason why should delay use of tonics, till evacuation completed.

And in present instance an example not only of safety, but even of advantage of giving these, at very time when evacuant used.

And is also example of benefit from Cream of Tartar with former, & Peruvian Bark with latter of these intentions.