DEP/DUA/1/24/01 (Transcript version)

Robert Hamilton

(1780-1781)

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Gentlemen.

Have already deliv two lect introd to this course.

In these have endeav to state & explain nature of busin both with respect to Pract & Lect.

Shall not now occupy any part of time by resum observ then offered.

May referr those who had not oppor of hearing them to general view of business of Col. Cas. subj to H. of Lect. on Theory & Pract.

From that view will at least form some idea of plan on which busin to be cond.

With respect to utilit of course may only obs. that shall be much disapp. if do not derive [such] inst.

And to those who honour me with attend hope also may be of prod [some] advant.

Without farther prelim then shall begin gen view of some of first cases.

Speaking of each in order in [which] stand in register.

First in order of list Rob Hamilton

Respect. disease to which subj littl room for doubt.

Is suff. marked in state both of obv swellings & ulcerat.

May with out hesit pron affect [Scrop] Swellings seated in those glands which of all others Scroph most freq attacks.

Slow prog. to ulcerat, length of time for which cont. in ulcer. state, & cond. of disch from them, leaves no room to doubt that of this nature.

With these sympt. at any age & with any habit should pron this to be the disease.

But in pres case still [farth] corrob evid.

Patient at that early stage of life when appear of Scroph in this form most freq.

And has those extern marks in habit, with which most freq. occurrs Fine Florid complex & soft smooth skin.

Here may observe that besides most consid swelling & ulcerat, upper lip & sept [mid] of nose also affected.

In these at least when case came under our care consid swelling.

This appear the rather notice as by some held diagn of a very diff disease.

Pres. viz of worms in alim canal.

In inst before us however no other sympt from which should susp this.

Appetit nothing pecul.

Neither affect with gripes glairy stools nor any other of common sympt.

Or even that worms may not sometimes induce it.

And must own this a diagn in which for my own part disp to put very little confid.

Would be far indeed from denying that where takes place worms are never pres.

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But in greatest part of worm cases which have had occas to treat no such app.

And on other hand have freq seen it pres where no worms.

Partic so in inst of Scroph.

And where pres with worms is [most] commonly where they affect Scroph habits

Even in such cases then still inclind to look upon it as Scroph sym

And as having connex with worms in no other way than accid combin.

Here howevr as already remarked no reason for pres such combin.

And therefore notwith pres, view [case] as simple inst of Scroph.

Or even that worms may not sometimes induce it.

With respect to what shall be term very great uncert.

No reason indeed to appreh fatal conseq.

At least with disease in pres form.

But scroph an affect in which, have it not in power to do great deal by aid of med.

And often when appear slight, of great obstin

Freq even happens that where least appear most danger of fatal termin.

Partic observed that in cases, where scroph in family, in those with least extern appear. most apt to affect lungs.

And in this way more freq fatal than any other.

To period of life at which this most freq happens, patient not yet arrivd.

Hence then can neither venture to say that shall be able to cure diseas nor to speak with any confid of durat or [term]

Yet in as far as judgem can be given case rather fav as otherwise

And age as well as constit of patien affords opport for trial of diff pract.

As affording such have selected case as subj of treatm in this place

Here however must set out with observ that very much at loss to say on what gen prin cure to be cond.

But without pretend. to thorough knowledge of nature, certain morb. condit which may be cons. as indic.

These partic are the tumors esp of glands.

The ulcerat in which tumour often termin.

And the general state of system, as well that which preceds disease, as which accomp or is induced by it.

Here though some ulceration at pres at least by no means [const]

And whatever may have been orig faculty in state of syst. has not at least suffered in any consid degr from effects of disease.

Consid removal of [tumours] then in first inst at least, as prin obj of attent.

Where such swelling & hardness take place natur size to be recov only by remov of that matter prod enlarge.

And this princip effected by restor of free circulat through part.

Or by [abstract] of matter, through channell of Lymph vessels.

These princip will in some meas explain to you intent in pract already princip employd here.

Mean with view of affecting [these] ends, or at least of attempt. [remov] of swellings, to try patient with course of Emet & Cicuta in conjunct.

Use of course of Emet in scroph is as far as I know but late introd.

Have indeed in gener been advised in this affect, by pract. where disease accomp with viscid sordes in stomach as means of obv. sympt

But not with view to radic cure.

Of late however have been informed by a corresp in London that very much used with that intent, by some of pract. there.

And partic with view of obt resolut of indol. swellings.

By whom first introd do not know.

But I think, some princip on which benef to be expected from

Especially from influ which have on circulat from agitat induced by action

And from affect as augm action of absorb syst.

But indep of doubtful princip supported by analog in pract.

At least one kind of gland [swel] in which often used with affect of discussing with great advant.

That is swelld testic.

After active inflam over in cases where their remains indol. enlarge. often of great service.

On these footings then some ground for hope in scroph.

And cannot help consid this pract as rational & meriting trial.

At same time cannot yet say any thing in support of it on more certain footing of exper.

In cases in which have hitherto directed such a course did not find benefite looked for.

This however inclind in some meas to attrib to want of fair trial

And not improb that disappoint in pres inst may origin from same cause.

For must be allowed that a course of emet by no means a pleas. mode of cure

And less chance of being persistd in, with scroph, as in this affect mankind in gener not yet taught by exper to place confid in them.

Is partly at least on this acct that here conj. with Cicuta

For from obvious operat at least not same distress or inconven.

But besides this am inclind also to think that from conjunct benef may be derivd.

Of introd of this remed into mod pract need say nothing.

May only observe that since first recomm by Dr Stork succeeding pract. succeeding pract have formd most oppos opin

By some extolld, by others consid as totally ineffic

For my own part in as far as can judge from own exper. I have had disp. to think fav of it.

Not indeed as a remedy capab of prod cure in every case of cancr.

But as often attended with good affects both in this, & other compl.

In none have I obs. it more so than in Scroph.

And although unquest essent diff in some partic yet perhaps betwen cancer & Scroph greater analog than is in gener imagind.

From this analogy & from exper. which have had of affects rather than any theory as to mode of operation had here recourse to it.

And not without hopes that prop contin may be prod of good affect.

In prod this emetic repeated every eight or ten days may I think cooperate

On this course therefore, unless some reason shall occurr for altering is intent to contin patient for some length of time.

And thus at least shall be able to judge whether adeq to cure in pres. inst.

If swellings dimin or removed may yet reckon it necess. to put patient on course of Peruv. Bark with view of strength syst, & prev return.

If fails, may have yet recourse to trial of some other of those med lately celeb.

Such for example as Sal. Soda Burnt Sponge, or Burnt [leather]

But probab. with no better [success]

Still however may afford us opport for such trials.

And if none effic patient may again in spring season resume pract more to be depended on than either Sea Bathing.