DEP/DUA/1/18/12 (Transcript version)

Walter McFarlane

(1778-1779)

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Walter McFarlane.

Symptoms in case of this patient but few in Number.

Yet perhaps some room for doubt as to nature.

Am however disp to consider it as affording ex of an affect which has not freq. occurrd to me.

Patient compl. of some pain in throat

And on inspect of fauces slight marks of disease discov.

But notwith inflam & pain can by no means hold it to be a case of Cynan

Here nothing of febrile affect. which attends that compl.

Besides which long contin & slow progr. of compl. by no means corresp with history of that affect.

To all this may be added that diffic of deglut much greater than from can arise from any inflam here taking place.

And indeed diffic deglut may be consid as here constit greatest part of [aff]

This sympt however in syst of Mr Sauv. & others consid as great charact of a partic Genus of disease.

Disting by title of Dysphagia.

Defind as consist of pain & diffic attend & freq. prev. deglut.

Disting from Angina by want of fever or affect of respirat.

To this genus then have little diffic in referring pres. case.

And not only inst of this compl. which have had occas to trial.

In vol of cases selected from records of Dispens. will find sentim deliv at consid length on very remark inst of this affect.

To that public then referr you for opin as to disease of pres. patient.

May however observe that to genus of Dysphag. various species referrd.

In syst of Sauv about 20 diff [spec]

To case mentiond above gave denom of Dysphag. dolerifica.

And may I think bestow same nam on pres. case.

Here also probab. that affect depn rather on pecul. sensib than on any local topic affect such as tumour or like.

But of latter suppos. some probab. from what happened to patient two years ago.

Then are told deglut affected in simil manner from tumour on uvul.

And that had fav. termin in [suppur]

At pres. know for certain that no tumour situat in that part.

May however be effect of tumour lower seated.

And in that case will belong to the Dyspn. [Pharyng.] of Mr Sauv.

Here however must still observe that no evid of tumour.

And upon whole rather disposed to latter formr opin.

On this ground inclind to give more favour prognos. than if suspected tumour

And upon whole disp to hope disposed to hope that shall be able to remove patients compl. & in no long time dismiss him free from affect.

This if conject right to be affectd by restoring proper condit of sensib to affected diseased parts.

If howevr depends on tumour by obtaining removal of it either by resol or suppurat.

With hopes of answering any one of these intent. had here recourse to use of Electric.

For mixt at first prescr. given prin with intent of not neglecting patient till machine in order

Electric when duly employd hold to be one of most powerful agents in pract of med.

By this remed obtaind complete cure in case of Dysphag already [attend] to

And am in hopes same may be [case] in pres. inst.

Of affects of electric & modes of admin it much has been said.

For very distinct view may referr you to Will find very distinct view in an inaug dissertat by Dr Stevenson lately publishd at this place.

May not howevr be out of place briefly to deliv sentim respecting it

Modes of exhib of great variety

Especially if attend to distinct between pos & negat. elect.

But not at least ascert by exper. how far any real diff in effect between negat & pos.

And many circum in mode of exhibit which certainly prod no change in affect.

May I appreh. referr mode of employm to these heads.

From this acct will readily understand foundat of expect from it in pres. case.

And as consider affect to be local have cheifly directed it in way of spark

Am in hopes that whether depends merely on pecul state of sensib or even on tumour may have affect of curing compl.

And indeed has already been prod of very consid benef.

At pres. therfore no thoughts of any other meas but contin of it.

May obserrve that few remed in which more regul persev necess.

Even therfore, if should not speedily yeild, unless from circum, will not soon alter plan.

And if obliged to have recourse to other meas. must be determ by circum in which shall then find patient.