DEP/DUA/1/25/01 (Transcript version)

Jean McKenzie

(1780-1781)

---

Jean McKenzie.

With regard to disease little ambig.

Consists in severe pains.

And these too chief. seated in joints.

Obs. also partic to affect larger joints

Espec. knees & shoulders.

From nature as well as situat pron Rhm

In this disease indeed in some inst diagn diff.

Partic in disting from Gout & Venr pain

Here however many circum remov ambiguity

That Rheum rather than Gout conf. both by age & sex.

A female & in prime of life.

Still farther demonst by situat in large joints.

And perhaps most of all by affect sever at same time

Equally clear that not Vener.

Situat also, not middle of bones.

No topical affection

No other vener. sympt.

Farther evid of Rheum in progr.

Began with febrile affects.

And from thence transit to pres cond.

Then also attend with swellin

In this common course of affect.

May then pron. Rheum.

But Rheum a disease which has diff states

These require diff. treatm.

Becomes therefore obj of conseq. to [deter]

Common diseasevision acute & chronic.

Though founded in nature yet too gener.

With view to treatm in pract course [illegible] distinct

Inflam. Irritab. Atonia. Paralysis.

Descript of these not pres. busin.

Reasons of divis more fully elsewhere

Here only, pres. case 2^d [State]. Irrit.

Disting by absence of charact of [act.] Inf.

Heat. redness – swelling – Fever.

Yet freq. recur of pain – Quick of Pulse.

Evid of dispos to renew of inflam.

And prob. not a little dep on Irritab.

In this then suppose essent. to consist

On this ground prognos.

When began treatm not unfav.

Still more so at pres.

Rheum in any form not danger.

Sometimes indeed when degn to Paral. incur

But then only fatal by ind other affec

And of this no appear at pres.

In acute sometimes fatal from fever

And sometimes from seat, vital organ

But in pres inst no appear of this kind.

And of all states Irritab. least dang

In some inst indeed tedious.

But more under power than Paral or Aton

And when obs. moder. less dang of [trans] than in viol acute

All these circum then at comm fav.

Now still more ground.

For under treatm consid dimin.

And unless from [accur.] soon dissm.

Return of pain howevr not surp.

Season appr. when most likely.

From occas. causes then again with viol in acute state.

Rather however new attack than cont

And of pres. most probab. that [illegible] fav. termin.

If prog contin shall be disp to attrib to med empl.

Indeed whatever termin look upon case as already consid advan.

And this consid as affect of treatm if not altog at least in good meas

Hitherto will observe patient unif course of one med.

In this stage of Rheum gen. inten diff from what to be foll. in others.

Not encr. action of vessels in act. inf.

Hence no necess for power dim of [impet].

Still however tend to renew of inflam.

Hence powerf. tonics neither req. nor safe

Req. as it were interm course.

And prin obj to remove disp to encr. action.

Chief to be expected on two prin.

1 Altering condit of nerv. power.

2. Supp determ from dis to sound parts

These cheifly by med comb. Stim & eva [illegible]

And of this kind sev in use in [this] state of Rheum.

Among others, volat. Elix of [Guaiac]

At least is to these prin disp. to attrib success.

At same time used in some meas on empyr footing.

Long indeed empl. in pract.

And that too in this affect.

But of late more comm or [recom] of Dr [Daw]

And empl. in larger doses.

Formerly drops now drams.

To extent even of half an ounce.

For full act treat of Rheum & Gout.

Of cases no reason to doubt author.

Demonst. influence.

Since that public freq. used.

And in many inst with des. effect.

Have tried Guaiac in diff forms.

Partic as acted upon by diff menst

And in this way gen. more effect than in solid state.

Though cannot be dissolvd yet may be diffused in water.

But at least more eleg. from spirit

In Ednr Pharm two introd

viz Simple & Volatile Elix.

Of these former with [Rectif.] spt.

And cont. large prop. of Guaiac.

Latter with Spt. Sal. Ammon. Vinos.

Little more than half the Guaic.

But addit of volat. arom oil. Sassaf.

Last formul. appr. nearly to that empl. by Dr Dawson. Tinct. Volat of Lond.

Formd by Spt. Volat Aromat as menst

Since his public have freq. empl. both

And of two disp. to preferr former.

Both as cont. larger propor of Gua.

And likewise as not restr by menst.

Farther advant as more easily taken

But exper. have had incl. to give pref to latter

And inclind to think that power of Guaiac augm from Vol. Alk & oils.

From these consid then here empl.

In Dr Dawson cases often exhib by [illegible]

But in this state few capab of swallowing it.

And besides draught of water [illegible] after have always found necss. to dil & cov taste

With this intent have tried various artic

Simple syrup Extr. of Liquor &e.

But found nothing bettr than [Med.] G. [Ar]

Here Elix & Mucil. equal part.

Taken to extent of ℥p m. & v.

That is ℥p of Elix in day.

To this quant in gener obv operat.

Partic moving belly but still more inducing sweat.

And then cheifly benef.

Here neither effect.

Seemd however to have some infl. on disease

For pains somewhat allev.

In this situat thoughts of augm.

But restr. by sickness at stomach & even vomit from first doses.

Besides often more operat afterwards than at first.

Directed cont. therefore for 2^d week.

And from this still farther allev.

Still howevr no sweating or loosenss.

And as no uneas. at stom. ord. augm

This rather at night as then best chance of [illegible] as in bed.

Directd therfore ℥i of mixt ℥p of Guc at bed time.

Still however only [sense] of heat without sweating.

But very consid allev of pains.

Contin therfore in same state.

At succeeding report howevr pains somewhat augm.

Probab. effect of some accid.

Led howevr to farther augm of dose of med.

For to this no object.

Now taken to extent of ℥i of Elix in course of day.

In this extent has freq. sweated

And with such allev. of pains as gives hopes of cure.

Expect that patient soon in situ to be dismissd

And that without other med or farth augm of dose.

If this case addit [exampl] of effic of M. Elix of Guaiac

And farthr confirm of opin long enter.

At same time recurr of disease would not argue want of effic.

For in variab & cold weather a very prob. event.

In that case howevr meas to be accomod to circum then occurring.