DEP/DUA/1/14/12 (Transcript version)

John Campbell

(1777)

---

John Campbell

Case of this patient as introd into our regist. might be subj of many obser.

Or rather perhaps conject.

But these here to be given to use merely on stile of vague suppos.

For from patient visiting us only once had no opport. of observing progr of affect.

Or of puting such quest respecting it as might afford satisf.

And must own entert some doubt how far acct. was to be entirely depended on.

Was so [pathol] in [descript] of his affect that concluded that either in reality felt much or wishd that we should believe so

And his leaving so soon gave [conv] in some meas. to latter of these suppos.

Princip affect according to his own acct was a compl. of stomach.

This he describd as giving same sensat. as if an anim [within] const tearing it.

This could be describd in no othr manner than by [stiling] it gnawing pain in oppos. to purg. & gravat.

A sensat of this kind sometimes the affect of schirrous.

And to such a suppos. const. & sever of pain seemd to give some counten.

While at same time well known that schirrous affect of stomach either at card. pylor or any other part not uncom.

But to such a suppos. many object.

Seldom that takes place to great degr when some local hardness cannot be felt.

No such howevr in pres [case].

Besides schirros of this viscus almost univ attended with vomiting.

With this however not alledged that patient in any degree affected.

On contrary appetite for food little if any thing impaird.

Constip indeed to which patient subj. sometimes to viol degree the affect of of schirros.

Especially when situat at pylor giving rise to stricture.

But this also a sympt from various other affect of intest. tube.

And indeed conseq. of every thing weaken tone or dimin action.

May be supposed then equally to give counten to another suppos.

That viz affect arose from wind.

Freq. of this as a cause of stomach comp well known.

And such might have been suspected from sensat. which patient describd.

According to his own acct. felt [some] resembling wind moving about in stomach.

And by no means uncommon for distens from wind in stomach to give vertigo

This though unquest to be attrib to pecul. stimul which distens gives to [nerv] yet very gener. describd by patient as if felt something moving to head.

Thus far then circum in favour of probab. of such a suppos.

But to this also sever. strong perhaps may even add unsurmount obj.

Were told that never any evid distens of stomach.

And not alledged to be affected either with eructat, flatus or borborigmi.

If air [howevr] pres. to consid degree in alim canal must have appeared under [some] one perhaps all of these forms.

Naturally led therefore to think on what othr possib suppos could be expl.

And if to discard suppos already [mentiond] know nothing more probab. than opin that might dep. on pecul. morbid affec of nerves of stomach.

Was here therfore wish before proceed on any other suppos to make some trials at least on this idea

But even allowing that such affect did exist if acct. to be credited was not whole of his disease.

Besides pecul stomach compl. subj also to affect. in disch of urine.

Told that this excretion fluid though natural both in colour & quantit, yet in gener. passed with diff.

And at one time are told that [app] for 24 hours togeth.

When after very viol efforts [moved] out as if from disch of stone.

This might be supposed to give some counten to suppos. that compl. wholy from calcul.

And well known that from this [cause] stomach affect. often arise.

But when this the case not under form of pain in stomach but of sickness & vomiting

And that even affect of urine here [were] from calcul. might admit of great doubt.

For unless in single circum of diff. of disch. water no other sympt of it.

No pain either in region of kidneys or bladder.

No sandy appear of urine.

And no morbid change in any respect either in colour or quantity.

Upon whole then considerd this case as exhib rather contrad. than uncom [appear]

But whether proceeded from any inten in patient to decieve, from indistinct [natr] of telling compl. or from singul in affect cannot pretend to say.

In this uncertainty howevr can give no opin as to termin

Especially as from want of attendance precluded from opport of making inquiry.

This also a suffic reason why should say nothing respecting practice.

Entered on treatment of this case without having laid down any plan of cure.

Was intent for some time to watch appear of disease & to discov. affects of partic prescript on his compl.

For by this means nature of affect often as certainly ascertaind as in any other way.

Was with this intent that prescribd [Aloe] wine combind with [paragor.] elix.

From anod here on suppos of Nerv. affect of stomach being cause of pain expect at least tempor. relief.

And from purgat expected to obviate costiveness.

But how far these intent answered have nevr had opport of learning.