DEP/DUA/1/15/07 (Transcript version)

John Thomas

(1777-1778)

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John Thomas.

Compl. of this patient very simple in nature.

And here while no complic of disease no room for doubt respect cause

When came under our care only sympt. invol. disch of urine.

This however perfectly of passive nature

Did not arise in conseq. of any [action] contrary to inclin.

But merely effect of want of power of retent.

This suff. evid from having taken place only during day.

That is while from erect posture weight of urine in bladder operated as cause prod disch.

Returned during night as then from horiz posture would as readily remain in bladder as any where else.

And then of red colour as by absorp watery parts carried off.

This here traced to partic cause.

And one too with regard to which can be no doubt.

That is operat of Lithotom.

About 11 years ago patient had a very large stone extracted from bladder

And since that has been const [affect] with this compl.

When this the case large stone to be extracted pres. affection will occur without any fault on part of operator.

And evid to be ascribd to injury to bladder & muscles which is in conseq. of size of hard body to be removed.

Such then had been case with pres patient.

And in [conseq.] find him subj to this disease which had cont with him for space already ment viz 11 year

During this period various remed tried under direct of able practit.

And when consider that is a disease in many cases incurab. must own that did not entert favour expectat.

Took it for granted that should dismiss patient no better than when came under care.

Yet imagind that without prejud some trials might be made not commonly put in pract.

And was merely wish to have opport of observing whether these would have any effect that thought of taking this pat. under care

Now must own have changed sentim respecting prognos.

And at pres. flatter myself with hopes that shall be able to bring about if not complete cure at least very consid relief.

Such indeed patient has already recievd.

And do not see any partic reason for dreading that will not be perman

If this the case have at least freed patient from a very great inconv.

And have suggested introd a practice, which have never seen tried & which although may possib have been used by others have never heard of.

In all such affect great obj in cure must be restore proper power to [Spth] vesicae

And where does not arise from actual destruct of organ may be attempt on two princip.

By encreasing vigour either as simple or as animatd solid.

And that either by immed action on affected part or by action on system in general.

May readily suppose that diff mean of obt these ends had been tried by practit under whose care patient bef. [was].

And partic that had employd the various astring & tonics commonly in use against such affect.

In this situat then had nothing to expect from remed in common use practice

By this determind to try what could here reap from electricit as a tonic.

Of action of this remedy which with me I own a fav. one shall have occas to speak in next case that viz of John Lenin.

May here only observe that hopes of success founded on princip which have elsewhere endeav to estab.

That tonic power viz the effect of irritab. in conseq of which from ordin stim causes to which muscles subj const tend to contract.

By augm this dispos then expected addit force of contract.

Irritab. again unless in as far as is affect of struct consid immed to depend on nerv powers.

And know nothing more effect encreasing nervous influence than electricit.

This does as augm general mobilit from general action on secret. organ [illegible] of nervous fluid

But more especially effect at partic parts when sparks drawn from thence.

As by action on extrem of nerves inf. commun to partic part of brain

And thus probab. change in secret. from thence indep of whole.

For hold brain to be not merely one but a collect of secret. organs.

Thus then expected that by means of it might perhaps encrease vital powr in sphincter vesicae

How far this reasoning well founded may with many be mattr of doubt.

Is not however to be denied that has been attended with desired effect.

And unless from return of compl. shall not think either of altering pres. plan of cure or of having recourse to any other remed

If patient gets entirely rid of his compl. may perhaps soon dismiss him.

But if cont to have any remain shall still persist in use of electric.

Unless perhaps may think it advis to omit all remed for short time that may see how does without them.

If obliged to have recourse to any other remed will probab be trial of cold bath.

But shall I own be much better pleased if can dismiss patient without it & would fain hope may be the case.