DEP/DUA/1/43/46 (Normalised version)

James Short

(1787-1788)

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N^o34. James Short. at 9.

Case of this patient formerly represented as somewhat doubtful.

Had indeed evident mark of Haematuria or discharge of bloody urine.

And presumption from seat of pain that this bloody discharge from kidney.

But difficult to say from what cause these proceeded.

To supposition of Calculus most common cause many circumstances occurred as objections.

And was inclined rather to consider it as depending on some other morbid affection of kidney.

But whatever supposition adopted could entertain no hopes of speedy recovery.

While patient indeed continued under our care symptoms in some respects easier.

But at same time cannot represent him as having obtained any material advantage from practices employed.

Began by directing for him use of Cream of Tartar conjoined with proportion of Cassia.

This hoped might operate as gentle laxative & refrigerant.

And as far as haemorrhage anything of active kind have tendency to diminish.

Expect however still more from it in consequence of action as gentle diuretic.

As thus sand, or other irritating matter, carried off from kidney.

And from free discharge less fullness of vessels, giving disposition to rupture.

From Cream of Tartar, no effect in opening belly.

Nor could it be said that promoted urinary discharge

Secretion indeed for some time clear.

But this what might readily have conceived to happen without any influence of Cream of Tartar.

And that had no great affect, apparent from being still subjected to severe pain.

Hoped however, that by continuatioon influence might be increased.

But in this much disappointed.

For very soon after had much more severe attack of pain, than before.

This succeeded by very considerable haemorrhage.

And that too almost under form of pure blood.

Or at least told that so little diluted with urine as to be coagulated in short time on exposure to air.

And this as usually the case followed by considerable [temporary] ease.

In this situation with continuation of Cream of Tartar directed use of powders of Uva Ursi to extent of ℈i twice a day.

This article not many years ago introduced as a remedy in calculus cases.

And at one time even supposed to operate as solvent.

After however this opinion entirely [discarded] yet still found an useful remedy in calculus cases.

And employed also with advantage in many other affections of urinary organs.

That found generally useful may be inferred from holding place, in almost every modern [pharmacopoeia]¹

And have not unfrequently I think seen it of advantage in [other] cases of [urinary] Haemorrhage.

Hence therefore thought that deserved [trial] And for space of week at least under its employment continued tolerably easy

An evident proof that could not be considered as disagreeing with him.

But since that have seen nothing farther of him at this place.

And can therefore say nothing farther respecting him.

If however attendance discontinued from [being] [easy] can hardly be attributed to Uva Ursi

For in all probability medicine but little employed.

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Explanatory notes:

1) An official publication containing a list of medicinal drugs with their effects and directions for their use. The Royal College of Physicians of Edinburgh's Pharmacopoeia was first published in 1699.