DEP/DUA/1/19/08 (Transcript version)

John Auchinlech

(1778-1779)

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John [Auchinleek]

Cont his attend for so short time that reckon it unnecss. to say much respect his disease.

Affect to which he was subj evid complic & in some respects doubtful.

Here may consider pains of knees, & affect of abdom, as having no connect with each other.

And perhaps may view as an affect differ from both ulcer at upper part of sternum.

But while thus complic of diseases may farther remark that with regard to nature of every part some room for doubt.

Of all these sympt, set most dist. markd, is affect of knees.

And here many circum at least giving strong presumpt of Rheum.

Nature, situation & course of pain such as well known to occurr in that affec

While at same time age of patient 30 year & affect being in larger joints render it improbab. that of arthrit nature

While at same time To all this to be added that pain from motion of joint & from warmth in bed are at least very freq. sympt in Rheum

And while one shews that some degree of inflam still cont latter gives evid of progr from acute to chron state.

But notwith all these marks of Rheum one circum still giving doubt.

Well known that pains of bones from & indeed affect also in other respects often the conseq. of Vener. infect.

Of this cause some susp in pres case when consid that before commen of pres sympt. patient had been subj to the Vener. disease.

Was supposed indeed to have been cured of that affect, which is not improbab. was really the case

Well known however that this insid affect will [lurk] in constit for great length of time.

In so much that often extremly diffic in many cases, to persuade patients who have ever had vener sympt that are cured while slightest uneas of any kind remains.

And indeed this often supported by practit themselves.

For some who hold almost every symp with those who have ever been subj to to this disease to be latent pox.

This indeed is unquest pushing matter too far.

But yet in such cases as pres. from circum mentiond above cannot be entirly without suspicions.

And especially where as with our patient other sympt still remain having still more appear of being Vener.

For of this kind may I think consider ulcer on upper part of sternum to be

At least of this some probab. from long contin.

For at same time when Hist of case drawn up had subsisted for space of 2 years

Is indeed true that obstin ulcerat may arise from diff causes.

Yet none perhaps more freq than vener infect partic when has given [diseas] of bones.

And this seldom fails to be conseq of its being of long durat.

When all these circum then conjoind & when consid that patient some years ago certainly subj to a vener. compl. gives at least ground for suspit that whole sympt may be Vener.

May however be true with respect to neither

Partic with regard to pains of knees.

For these not seated as vener pains [commonly] are in middle of bones, but in joints which seat of Rheum.

And before any vener infect had been subj to rheum. a circum which seems afterwards to give praedisp to it.

But if thus doubts with respect to these diff parts of affect not less so with regard swelling of belly.

Wants those indicat of wind in alim canal which would lead us to suppose that depended on flatul or was of lymp kind.

At same time from hard & tense feel together with want of fluctuat cannot suppose it dropsic

While not of that circumscribd nature which could arise from an affect of any of the solids.

Of all these parts of his compl howevr this the most recent & least urgent.

And had patient contin under our care should probab. have done nothing with view to it till from farther progr better able to form determ judgem with regard to it.

Of this however had no opportun of making any farther observat as patient very soon left us.

And from this circum any [observa] with regard to prognos. in great meas precluded.

May only observe that although had contin under our care hopes of being of service to him by no means great.

And after affect of so long standing, whether vener. rheum, or of complic [natur] which of all perhaps the most to be dreaded could expect recov only from long contin course.

From circum of this case was disp. to think it no improp inst for trial of the Rhodod. a med of which have [alrea] oftener than once spoken.

Partic as Profess. according to accts of Prof. Koelpin at Stetin has prod complete cure in what he calls Arthrit. Venerea.

Must however own that expectat from it in pres case were not so high.

And had this provd unsuccess. should next have had recourse either to use of Mezer or of Mercury.

But from all these trials precluded by want of attendance on part of patient