DEP/DUA/1/31/04 (Transcript version)

Jean Stuart

(1782-1783)

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Jean Stuart.

In hist of this patients case a variety of diff sympt.

Some as cough, pain of breast & affect of breathing indic a pectoral compl.

Others again as pains of belly grinding of teeth, picking of nose and lips, sympt of an affect of alim canal

Often indeed more especially consid as indic of worms.

But although may certainly proceed from worms as cause yet no doubt that may be effect of any irritat in alim canal.

When reflect however that affect now of two years standing & that no worms passd can hardly susp. these to have here any influ.

Would rather therfore view this part of affect as conseq of pecul. irrit of intest

But while thus evid of affect both of lungs & alim canal in pres as well as last case have also [mark] of affect of bones.

From distors of bones & enlargem partic at joints can have little doubt in consid this affect as being Rachitis.

And with this patient age, in place of afford any obj. tends to corrob. the suppos.

For is at that period of life when rachitis most common.

Disease also took origin from a cause to which that affect not unfreq. traced viz Measles.

Must indeed be admitted that some even of most common sympt in Rach here wanting.

Partic no [encrease] of head no distors of chest.

And although abdomen swelled yet neither app. that this dropsic. nor any marks of Anasarc. swellings of legs.

But although dropsic affect. as well as affect of head & chest comm in this affect yet not necess.

And in diff cases has commen in diff. ways.

Partic where occurs not in most simple state but with any compl.

And here when consid origin of affect, as well as other sympt to which she has subj. can have no doubt in consid this to be the case.

When consider that gladul. swelling have app. extern reason to conclude that an affect of this kind still subsists in Lymph. glands both of mysent & lungs.

And therfore consid her compl. as an example of Rachitis [illegible].

From this view of affect must be doubtful as to termin.

And would not be surpriz if should fall a victim either to Phthis or to Tabes Mysenter.

Must however observe that affect although of a danger. nature has made no great progr.

That many cases where even without the aid of remed patients have grad recovery.

And that since treatm of pres. case begun whether from operat of syst. or remed which have been empl. affect app. dimin.

This however shall have occas more partic to mention in speaking of pract. which have here been used.

First prescript for this patient [then] use of two vomits at short intervals.

These chiefly intended with view to affect of breast.

And while not disapp. in operat. that had in this way good effect, may be inferrd from relief of cough which soon followed.

No doubt that emetics the most immed & most powerful expect which we possess.

And here prob. good effect prin to be attrib to mucus disch. by means of them.

But besides cough had here also in view the unload stom.

For no doubt that sordes collectd there, a very common & uneasy occurr in Rachitis.

And therefore that Emetics a necess prelude to any other pract.

But while expected these conseq from Emet. still more immed with view to affect of alim canal had recourse to anoth remed

Combinat viz of Magnes. with Rhubarb.

This naturally indicated by marks of acidity.

As destroying this removes a cause by which tone of alim canal very much weakned.

While at the same time the Rhub. both tends to prev. constip & to brace intest canal.

Hence look upon it as one of best remed with which am acquainted agains such affect of alim canal as are the attend of Rachitis.

In pres. case appears to have had good effect.

For since she began use these very consid dimin.

With regard to affect of bones could not expect so sudden a change

This as observd with regard to case of former patient chiefly to be brought about by operat of syst. itself.

By absorpt. of watery & [incoherr.] matter & by fresh depos of earth in more firm & compact state.

With a view however to forwarding this process have here also directed friction with camph oil.

Imagin that both from frict itself & from the Camph. some thing may be expected.

And that has had good effects is at least presum from dimin of affect since began use.

If therfore matters contin to go on as have hitherto done shall not think of altering course.

Under med at pres. empl. with operat of syst. itself, may I think hope for recov.

And indeed patient at pres in such a situat that more to be expected, from air, exercise & regim than any thing else

With these would prob. indeed [form] recov. if cold bathing could be conven. conj.

But both situat of patient & season of year at pres. obj. to this.

Besides till farther evid that no danger of return of affect of lungs, would even be inadvis

Hence then if no new app. or change of affect to the worse shall probab. persist in pres course till patient in condit to be dismissd.

But if these shall take place future pract. must be accomod to occurrences.