DEP/DUA/1/21/12 (Transcript version)

William Campbell

(1779-1780)

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Wm. Campbell.

With regard to no part of disease of this patient much room for doubt.

Yet case by no means of simple nature

And probab. not impossib even that greater complic than obvious.

Or at least that some parts of affect extend farther than should infer merely from app.

Most obvious and at pres most distr. compl. is evid what arises from [water]

And this evid [effused] in cellul [memb] rather than in any partic cavity.

Can therefore have no doubt in bestowing upon it name of Anas.

Although to consid extent yet of such standing only that may be consid in incip state.

And notwith great affect both of legs & scrotum yet when came under care had not extended very far in syst.

Abdom indeed manif swelled.

But not to such degree as to give any diffic of breathing

And from freedom of respirat had reason to conclude that anas. had not extended to lungs.

While at same time neither in appear nor state of upper part of body any indic of it there.

Here also with respect to this part of compl. another circum in fav of patient.

Though more than ordin degree of thirst yet urine cont. free.

Thus not only less chance that swelling would encrease but opport even for more safe & speedy remov.

If these however fav. circum with regard to this part of disease some others of contr. nature.

And partic prev constit of pat before commen of any hydrop. sympt.

Now appear manif affectd with scrophula.

And this affect we are informd in hist begining at very early period of life has already cont. for 10 years

Occurs therfore as quest of some import. whether now to look upon dropsy as a conseq. from that cause.

That from gland swellings, dropsy in diff forms does arise, cannot be matter of doubt.

And should as natur suppose this effect of indurat & tum of Lym glands as of any other.

For by this means progr of fluid through lymph vessels most effect retarded & dimin.

Notwith this however must be adm that from Scroph dropsy not freq. cons.

And in pres. case no partic gland swellings to which can attrib it

Besides this disease in most gener form & as app. in legs collected from cellul memb in every part of syst.

But indep. of gland swellings scroph may here by supp to indu dropsy in anoth way.

Well known that dropsy in form of anasarc. freq conseq. of obstr. or dimin of accust. disch.

And with pres patient after being subj. to very consid runnings for space alm of near 10 years disch now alm stopt.

From this then not improbab. that dropsy has arisen.

If however in any way connectd with scroph as cause, may concl. that shall find it obstin.

And even on suppos. that totally unconnected yet from occurr in such habit reason to appreh. that will be more obstin than should otherwise suspect.

From these circum then cannot here look upon drop. affect. as of little import. or free from danger

And although success. in evac water yet not free from danger of return

Would hope however, that may be able if not radic to remove dis. at least to keep it mod.

And if could empl. any meas. success. comb Scroph, might in the end be overcome

Of this however am affraid can have very little expect, unless from operat of syst. itself.

By this means it is true, recov as age advan not unfreq. brought about.

And may even be aided by some measures.

If therfore pres case does not afford examp of effic, may at least give opport of trial.

But in treatm first obj to be aimd at the evac of water.

This in such a case in partic should attempt to accompl. by those means which have least tend to debilit.

And such the less necess. as no dysp. or any other very urg. sympt req. immed disch.

From these circum then determ to use of Crem of Tart & that too in but small doses.

Of late this subst. very much used in drop compl

When wish for brisk cathart few answer the purp. better.

Esp. if operat quickd by small addit of Jallap. [illegible] Gamb. or like

When thus exhib not only operates without excit thirst, but has tend even to abate it.

And while prod disch of [watr] by intest canal has also powerful influ on prod same affect as augm urin

This conseq. of copious diuresis often success. obt when given to infer [quan]

And was with this intent that empl. in pres. case

As did not wish for any thing farth than at utmost slight catharsis here added nothing to quicken operat.

Small addit of Cinnam meant merly as corrig that might sit more eas. on stom

And as acting on this visc no [illegible] obs. to result from it.

While at same time disch by urine consid augmented

Under this operat swellings already very much abated.

And am hopeful that no farther meas will be requis for entire remove

If this effected, will be next obj. as far at least as we can, to prev. ret, & to remove Scroph.

For this purp. have some thoug of putting this pat. as have suggs in other cases last case on course of Emet.

Rep. dose at interval of 8 or 10 days

These of late by some pract much extolld in Scroph.

And from effic in other gland tum am inclind to think not without found.

Well known often success in removl. of swelld testic.

Here the rather ind to use as while tends to comb. scroph may prev return of dropsy.

For few means more powerf. as encr. action of absorb.

But while pros. this course shall endeav also to strength tone of syst.

And for this purp mean to employ Peruv Bark.

If these meas unsuccess. what others will be adopted must be determ by state of compl at the time.