DEP/DUA/1/26/11 (Transcript version)

Robert Wilson

(1780)

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At same time thought it more advis that when upon tolerab interim, med should be interm given up than contin.

For nothing of more conseq to Hys patient than remov of every circum which can lead to suppos. that consid by others as in bad health.

On this acct. therfore rather than as having obt. compl. cure have was dismissd from farther attend at pres that time.

May at least say however that had obt. mitig of stomach compl.

And in hopes that from engage in usual mechan. empl. if return of affect. not entirely prev. may at least be mitig.

For after certain mitig of symp this more to be expected from engag both of mind & body, than from any other cause.

After these remarks on prognos. next to inquire how far mitig obt by practic employd.

In this expect. however now app. that have been disapp.

And perhaps even more truth in conject that patient will even for life cont subj to returns of same affect.

That as formerly obs. not cured although tempor remov of compl; appears from situat in which has now returnd to us.

Case as now introd into our regis in following terms.

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And after view just given of sentim of this case when began treatm need now add nothing of nature of disease

Still more than before disp. to consid it in light of a hypochond affectn

And although may again obt temporary yet do not expect rad cure

At least removal of morbid state on which depends more to be affected by [regim] & course of life than by partic med.

In this way best chance both of restor. due mobilit & counteract occas. causes.

In as far as med empl. is more with intent of obv. urgent sympt than any thing else

When regard however paid to most urgent sympt when patient came at pres under care, will perhaps be thought, that only med now emp not suited for that purpose.

Put patient on use of crude Antim to extent of ℥p every morn & evening.

And without any other med has been contin regul. on use of it ever since came under care.

May at first be thought very ill suited for obv. urgent sympt of which the most distress. stomach compl. partic vomiting.

Well known that Antim in gener. a tendency even to excite vomiting

But to this pract was here lead from former hist of affect.

Will obs. that while consid both stomach compl. & cutan affect as belonging to same disease, yet on occurr of latter, very consid mitig of former took place.

This, which by the way, often [remarkd] in such affect, was disp to attrib to change in mode of circulat, & greater determ to surface.

And somewhat in fav. of this [susp] that after last dismissd, pres return of stomach compl. took place, on cutan affect, being entirely remov.

Relief therefore again to be expected either from return of cutan erupt or from some meas. hav. simil [eff]

And was as a means of [support] equab. circul, & due disch by surface, that had here recourse to crude antim.

In this form it must be allowd action very precar.

For activ of the [metalline] part very consid reduced by the Sulph.

But besides this in order to action pres of prop of acid in stomach is probab. necess.

And accord effects it must be allowed are precar.

Sometimes both vomiting & loosen from small doses, in other large ones without any effect.

Notwith these object howevr must own that think very fav of this med.

And this not from any precon opin of powers which ought to have from princip it contains but from what have seen in pract.

Of all the antim have found no one to which more certainly oper. as prod disch by surface & of as support free circul. there.

Accordingly here hoped that it might afford some relief to stom compl as cutan erupt, while would also prev return & save inconven. result from that affect

In these views am inclind to think that have not been altog disapp.

At least as giving disch. by surface has had obv. operat even more than expected or wishd.

For space of forthnight after began use had effect even of inducing pretty prof. sweat.

From this however patient felt no inconven.

While at same time without return of erupt. his compl. were consid relievd.

This therefore suffic inducement for persist in use

And after contin for some time ceased to have former effect of ind. sweat

In this way contin for forthnigh longer.

And during whole course compl became grad easier.

In this situat then for [reason] formerly given have thought it better to omit all med.

And especially as patient at pres in country at some dist from Ednr.

From which as changing scene may derive more real benef. than from any thing we could do for [him]

Hope therefore that will not now be necess. for us to do any thing farther at pres.

At same time far from consid patient as cured.

And if again returns meas to be employd must be entirely accord to sympt at the time.