DEP/DUA/1/11/17 (Transcript version)

Robert Robinson

(1776-1777)

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not to be written.

Robt Robinson.

With case of this patient have I own very great diffic.

At same time symptoms from which at least strong presumpt respecting gen. tendency of compl.

Sympt to which allude are the disch by vomiting & cough.

No room for suppos that any mistakes respecting bloody disch.

And at least strong presumpt for purul. evac.

May be inferrd both from colour, taste & smell.

Still more from quantity at once disch.

For since came under care has vomited it up even to extent of lb. at a time.

But disch of blood & pus not merely by vomiting.

Certain that former fluid also evac by expect.

And although not same certainly pres. also of latter.

May conclude therefore that [somewhere] very consid abscess.

But diffic respecting situation.

Of all viscer lungs perhaps most freq. seat of suppur.

And from this situat could easily understand why blood & purul. matter disch. by expect.

But to this suppos some object from quantity at once disch.

Seldom that any vomic in lungs cont to extent of lb.

Still greater object from mode of disch.

Evac by vomiting.

Would argue that wherever origin situat at least immed from stom.

Natural therefore to think of some other suppos than that solely confind to lungs.

And here may occurr as method of [solv] diffic that more than one abscess.

One may exist entirely in thorax, anoth commun with stomach.

May be supposed that one abscess so situated in conseq. of adhes & eros. as to have commun both with lungs & stomach.

But perhaps upon whole difficulty to be expl. of on suppos. of mistake of patient.

Not improb. that matter seeming to be disch by vomiting from stomach is in reality expect. from lungs.

And that comput of patient respecting quantit highr than ought to be.

Till more satisf. evid however [respectin] case must here remain in state of uncertainty.

Am affraid however that little room even for uncert. respect. conclus.

And great reason to appreh fatal term.

Would not indeed repres. case of patient as totally irrecov.

As have already often remarkd some chance from disch of pus.

And in proport to contin of disease does not yet seem to have much affected constit.

Gives therefore presumpt that not ready absorpt

And indeed from descript of matter might conclude that well digest pus.

From this however less tendency to putrid hectic fever than from putrid sanies.

Yet very rarely happens that intern suppurat even in most fav. circum are not in end fatal.

And with pres. patient, extent of affect evid such as to threaten greatest danger.

Must therefore own that favour concl. of pres. case more than expect.

And from prog. being hitherto slow cannot inferr that will cont. so.

Yet of this greatr presumpt than if hectic sympt. had rapid encrease.

May hope therefore that better oppor of trying what can be done by aid of med.

Yet must own that in pres. case much at loss respecting gener. plan of cure.