DEP/DUA/1/14/16 (Transcript version)

Robert Robertson

(1777)

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Robt Robertson.

This I must own a case with which was somewhat [alarmed].

But shall now probab. have no prop. opport of being satisf. wether appreh. well founded or not.

For since first praescript for this patien have seen nothing of him.

Although am informed from those who have had opport. of seeing him that [cont] engaged in usual employm.

That viz of Chairman.

May conclude therefore that compl not aggrav.

But whether has left us because [these] relieved or from any other reason do not know.

When came under our care symptoms with which he was affected but few in number.

And at same time such as might unquest. have proceeded from very triffling cause.

But cannot help thinking also that may have been [prod] of an affect of most dangr nature.

And of this even some pres [illegible]

Princip part of affection consists in pecul disch. from ear.

This in some respects the appear of [purul] matter.

And Very evid resemb. to it both in colour & consist.

Of a disch. from ear somewhat simil had already occas to make some [observ]

And in this one respect at least have an agreement between pres case & that of Thos. Brown.

There however prin affection to which patient subjectd was deafness.

A circum. not occurring in inst now before us.

In that case had occas to observe that such disch from ear either of [purul] matter or mere encrease of natural serum.

In inst of Brown from sever. circum disp. to consider it as of latter kind.

But in case now under consider. was I own disp. rathr to appreh. former.

Here indeed as well as in case of Br. no character of pus from [illegible].

But to be [rememb.] that disch only of four days cont.

And [illegible] by no means [essential] to pus.

Here however presumpt. of inflam. suppurat & abscess from preceding [sym] of affection.

Disease at first suspected to have been effect of cold

And at that time without any disch patient much affected with pain & vertig without disch.

From this circum room for presum inflam. forming an abscess.

And this presumpt. not a little strengthned by sudden relief on consid disch.

To all this to be added that with pain & vertigo when patient came under care had still also some febrile sympt.

Of this suff. proof in want of appetite & pulse at 120

May mention as farther proof of [suppur] that pain even on external pressure.

Which may naturally suppose conseq. of some degree of inflam. commun from internal to external parts.

From [these] concerning circum then disp. to view disch. here taking place to be purul. matter.

And conclude disease of patient to have been an abscess within cavity of ear.

On this idea entertained I must own rather an unfav. opin as to termin

Is indeed true that not unfreq. suppurat in cavit of ear without fatal termin.

Of this ex. in cases of Otalgia.

But from a suppurat so much in neighb of brain danger certainly in every case to be appreh.

And as evid that such a morbid state may make way into brain shall referr you to a [dissert] in 2d Vol. Med. Com.

There though sympt for some time not more consid than in case of our patient yet soon propag. to brain.

And patient cut off with all those symp which proceed from affect of that organ

Should not then be surprizd yet to find that pres case termin in simil manner

At same time shall not consider more favourable termin as evid that conject a mistaken one.

For abscess here as well as in other parts may no doubt heal mildly.

At same time appreh. that with view to cure of this patient had he even cont. under our care could do very little.

Prescript directed issue viz & [purgative] intended solely as means of dimin [illegible] to ear.

But what even affect of these have never learnt.

Unnecess. therfor to say any thing with regard to future plans of cure which might have been adopted.