DEP/DUA/1/36/27 (Normalised version)

Donald Grantson

(1784-1785)

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Donald Grantson.

Symptoms to which this patient subjected but few in number.

These however with sufficient distinction mark the disease to which is subjected

Affection consists entirely of pains in inferior extremities.

And can have no doubt in considering these of the Rheumatic kind.

This however a disease which as exists in different states requires very different modes of treatment.

In case before us none of those symptoms which characterise it, either in states of inflammation or irritation.

Is here evident in the atonic varying even to the paralytic state.

And to this indeed, age & infirmity of patient, already in 60 year, as well as frequent former attacks of affection particularly favourable

These particulars nothing in favour of patient with respect to prognosis.

For although rheumatism in inflamed state, perhaps as much under our power as almost any acute disease yet in this condition far from being readily overcome.

And when does yield, very apt to suffer recurrence from slight causes.

This therefore may I think expect with present patient.

But what will really be the case, shall probably have but little opportunity of knowing.

As patient has for some time given up attendance to the Dispensary.

Perhaps the effect as we may conject at least from ease he had obtained at last report, of temporary remission of symptoms.

And this, whether to be of any long continuation or not, am inclined to think, may consider as consequence of practices here directed for him.

Began practice by directing for him a medicine to be taken internally & another to be used in way of external application.

As an internal medicine had here recourse to use of Gauiacum.

An article of Gummi resinous nature operating in stomach as warm stimulant.

And while sometimes produces looseness has more frequently the affect, of giving rise to gentle diaphoresis.

This article long employed with success in Rheumatic cases.

And in these has been given under a variety of different forms.

Particularly celebrated under form of Volatile Tincture, where diaphoresis as well as stimulating power increased by the menstruum used the volatile alkaline spirit.

But while this an expensive is also a disagreeable medicine.

For few able to bear quantity requisite without very disagreeable sense of heat in mouth, fauces, & stomach.

Hence very commonly employ such as menstruum.

And from this as well as simple Tincture often best affects.

Am however inclined to think that often no less beneficial from exhibiting it in substance.

And particularly under formula here used as combined viz with Cream of Tartar.

In this way has in general effect of gently opening belly, & inducing gentle diaphoresis or at least promoting perspiration.

And whether from these obvious operation or not, have often found it attended with best consequences, as alleviating pain in Rheumatic cases.

Here however did not wish to trust to this alone.

But directed also external application of the Oleum Terebinth.

Formed by adding to an ounce of Hogs Lard, a dram of Oleum or Spirit Terebinth.

Which need hardly observe is one of most penetrating & pungent stimulants of vegetable kingdom

From external application therefore [illegible] a stimulant & tonic [indicant] often product of best effects.

In such rheumatic cases as present, have in my own practice, often employed it with advantage.

Here therefore hoped that patient might reap benefit from use.

Powder taken internally produced no sensible operation from which may infer that at utmost had effect merely of increasing perspiration.

But under this medicine with the external friction found that at succeeding report pains considerably alleviated.

Since that have seen or heard nothing more of him at this place.

Probably effect of his not at present at least standing in any farther need of assistance.

But whether this the case or not can hardly flatter ourselves, that at his period of life & at this season of year, will long continue free from his affection.