DEP/DUA/1/21/11 (Transcript version)

Robert Smith

(1779-1780)

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Robt Smith.

Need be subj of very few observ.

For soon after taken under care unexp went to country.

Hence could hardly be consid as having been obj of pract.

May however briefly state opin of disease & views of pract had he cont under our care.

When came under our treatm no doubt that most obv. sympt of disease affect of Eyes.

And from state of active inflam which then existed could have no hesitat in pron. him subj to ophthalm.

[At] same time also manif conseq. of former affect of this kind in film on cornea dimin vision.

But while Ophthal thus manif. equally evid. that not prin disease.

For here in glandul swellings manif proof of scroph habit.

And from this well known that most obstin Ophthal. have origine.

Accord in syst. of nosol. one spec markd by title of Ophth. Scroph.

This appel. then might with suff. prop. have given to dis of pres. pat.

Yet at same time must look on disease as being essent & in nature scrophul.

While ophthalm to be consid only as sympt of this affect.

And by remov of Scroph only that the disease to be overcome.

At same time during urgen of [oper.] meas necess. directed to mitig in first inst

But whatever name may with greatest prop obt. & whatever treatm to be first followed little doubt as to nature.

And from idea of nature progn. had patient cont. under care, could not be favourable.

Nothing indeed in state of his compl. threat. either immed or future dangr.

For danger of Scroph very much dep. on part of body attackd.

And when cheifly seated about eyes inconv much greater than hazard of fatal termin.

In every inst however both an obstin & troublesome affect.

And this partic to be dreaded with pres. patient as had already resisted sever. & these too powerf. mode of cure.

In place of allev of compl. from greater part even oppos effect.

Had he cont. therfore undr care might have been at some loss what to employ with prob. of success.

After failure of cold bath although fair trial given expect could not be sanguine

Yet vigour of patient such that might have at least been subj of experim.

And was prin with view of such that selected him as pat. for this place.

Here first obj would naturally have been mitig of Ophth

And this should have expectd more imm from topic bleeding or blisters than from any other pract.

But to both patient himself had some object.

Nor strange as on former trials not attended with des. success.

And some of them even appar. prod of bad effect.

While on other hand from cathart derivd at least tempor. benef.

Here therefore in attempts to allev. more directed by attent to [illegible] & [illegible] than by prin. reason or former observ.

From this led to prescr. Sal. Polych.

Which wishd to cont. regul. for some length of time to such extent only as gently to move belly.

As thus expected that should derive even greater benef. from it than from severe [illegible] which could not thus be contin

To aid operat directed solut in very consid prop of water.

For even pure water from dilut of cont. of alim canal & distens of intest in some hab. even of itself, oper as gentle cathart.

And in all inst. aids operat of those of saline tribe in partic.

Of this stricking inst in case of sea water.

Any determ quant oper. more power when prop of fresh water added than when taken alone.

But besides this water supp. farther of use merely as diluent

And indeed by some effic of min waters in gener. in Scroph ascribd to washing out Lymph syst.

This opin however can be no means entirely adopt.

Yet still disp to think that may have some influ.

And thus imag. that might be means at least of allev. of pres influ

Was however unwill to trust to this alone.

And notwith former opin of pat. wishd to have effects of issue again tried.

If by these mitig of pres [illegible] obt. should next have aimd at radic cure.

And with this view was intent here to have made trial of freq. rep. emet.

Of author on which led to this [pract] or ground on which exp. success. shall at pres. say noth.

Because hope that may yet have opport of treating of cases [where] may witness effect.

For offuscat. after inflam gone was intent to try the Pulv. [illegible] as it is calld lately introd by Dr Balding.

This formul. consists of equal parts of powd of Crem Tart & Sugar.

In sever other inst have empl. with great success.

But refer observ. [till] some case under care in which actually [illegible]