DEP/DUA/1/45/46 (Normalised version)

James Shulbread

(1789)

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James Shulbread at 59. N^o31.

When this patient first came under our care had some suspicion of calculus.

But as no stone found on sounding consider this as stronger argument that none existed, than symptoms affording of presence.

Accordingly when last spoke of case represented it as example of Dysuria from some other cause.

And this conjecture what afterwards saw of case has tended to confirm.

For in very short time patient in such condition that any farther attendance became unnecessary.

In short time had complete recovery.

But how far this in any degree consequence of practice here employed very doubtful.

Not improbable that were as much consequence of natural recovery as of any remedy here directed.

Or at least if anything were [directly] of service to him, was probably merely what used to ascertain his disease

viz sounding.

This as have already observed directed with view of determining whether any stone could be felt in bladder.

But not improbable that introduction of sound removed cause both occasioning difficulty in discharge of urine & preventing its being discharged in full stream.

For [after] introduction of sounding passed urine with [profuse] facility.

And when Dysuria first commenced a viscid mucous matter observed to be discharged.

Part of which adhering to urethra, may readily conceive, to have given obstruction.

Besides this indeed patient directed also to another medicine.

Use viz of mucilaginous mixture containing proportion of dulcified spirit of Nitre & Tincture Thebaic.

This intended as a gentle diuretic.

And to promote operation in that way, was also advised to drink freely of an infusion of Juniper berries.

How far these any influence in altering state of secretion cannot pretend to say.

But during use no more appearance either of bloody or mucilaginous matter.

And in very few days was in every respect in state of perfect health.

Wished however to see for some little time how far this relief [permanent].

But at end of eight days more found that urine discharged without inconvenience & perfectly of natural colour.

Hence as well as himself consider any father attendance as unnecessary.