DEP/DUA/1/28/04 (Transcript version)

Adam Whitehead

(1781-1782)

---

Adam Whitehead

When this patient came under our care must own very much at loss what opin to form of case.

And during short period of attend doubts in no degree removed.

Hence almost unnecess. to offer many obs. respect.

For with regard to pract. had no opport of trial of med intended

And with regard to nature of diseas all that can offer mere conject.

From sympt related in hist. if dep to be put on acct given many diff conj may be formd.

From cough, affect of breathing & state of expector. had reason to concl. exist of pect compl.

From pain of back conj. with colour & scarcity of urine has reason to inferr affect of kidney

From sickness, vomiting, soreness at stomach, oppress, headach &e reason to infer exist of stom ailm.

Besides these many othr conject might also be mentiond.

And must own that although inclined to think repres. of affect. somewhat exagger. yet had little doubt in consid patient as sub to compl. of ailm.

At same time probab that these origin from some one comm. cause.

And here I own disp to conject that this cause affect of liver.

To this cheifly led from two circum. seat of pain viz in [right] hypochond.

But still more the obv. enlargm which took place there as discov. both by feel & sight.

For affect of this viscus, a cause adequate to, effect of [illegible] it assignd

Severe blow viz from fall.

And on affect of viscus so import am inclind to think that [most] at least of sympt may be expl.

From local affect. of liver would acct for pain enlargem &e.

From vitiated secretion would expl. affect both of stom & urin organ.

And to this also think it not improb. that pneum affect also to be in some degree referrd.

At same time as prob. in great meas inconnectd with other, & was effect of cold to which exposed.

This idea of affect however though out as mere conject which had no opport. of having conf. or [illegible] by farther observat of progr of affect.

With these sentim of compl. howevr could form no fav opin of termin.

And although might not prove suddenly fatal, yet little xpect of recov.

Was not much displ. therefore at dissert.

Esp as plan of cure which said to promise greatest benef. could not in our mode of pract have fair trial.

Here will obs. that for short time that patient remaind with us two diff pract. empl.

First of these frict viz with mere ointm conj with small prop of Camp. intended with view to radic cure

That is to remov as far as could effect it, of cause of compl.

While latter the Spt. Nit. dulc. intend to obv. compl. consid as merly sympt.

And still more to prev conseq. which imag. would otherwise arise.

From great scarcity of urine [app] the occurr of drops sympt.

While be encrease that disch expected that vitiated bilious matter introd into blood [thrown] off.

Empl. therfore Spt Nitr. dulc. as one of easiest & best diuret with which am acquainted.

Mercur. ointm. intended to act as deobs. in remov. gland obst.

And in this perhaps as effect as any remedy yet introd into pract.

Is however cheifly to be expected as entering circul. mass. of fluids.

At least if except cases where acts immed on affected glands from reach. these in course of absorb.

May occur therefore as quest why here directed to be [rubd] on side

As absorb arising from [thence] no conn with liver.

But by these at least as well as any others may entr syst.

And to this pract led not from any theory, but from being well [assurd] that often empl with advant in warm clim where liver compl most common.

Here But however from patient leaving us had no opp. for trial.

And concr. case of which saw so little & with regard to which so uncert. have already perhaps said more than enough unnecss to say more