DEP/DUA/1/33/40 (Transcript version)

Robert Drysdale

(1783-1784)

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Robt Drysdale Febr 7^th

Princip part of disease of this patient, consist in obv. enlargem of abdomen.

That this in part at least arises from water effused into cavit, is evid from manif fluctuat.

But sever circum from which led to concl that not entirely from this cause.

Partic tense feeling which has even at upper part of abdom.

And still more freq dich of wind by both mouth & anus.

From this I own disp. to consider pres affect as more of Tympan than of Ascit kind.

But at same time no doubt that must be viewd as a complic affect.

And with this idea opin of termin cannot be very fav.

For both diseases not only obst but also danger.

Must however be obs. that sever circum here much in fav of pat.

Disease compar. speaking but of short contin.

Even first sympt not more than of two months standing.

And before that had always enjoyd good health.

No reason to suspect any fixd cause inducing either compl.

And no distress affect of any import function.

With patient at early period of life distens of abdom from flatul no rare occurr.

And then for most part much less distress than with adults.

With regard to drop sympt also these at least limited

To except in abdom no sympt of watery depos else where

And lastly to be obs. that disch contin free

Urine at least little affected

And belly said to be rather loose

This indeed it must be allowed may have been effect of freq. cathart

But at least shewed that disch thus encreased without much diffic.

Upon whole then ground here for hoping for fav termin.

At same time can hardly expect that will be very speedily accompl.

For even allowing that dropsic sympt soon entirely removed yet recov. of tone of intest must be work of some time.

With a view however to remov. of both diff pract may be had recourse to

In dropsy though first obj the disch of water already effused yet of no less conseq to prev. return.

And this chiefly to be done by encreasing strength & tone of the syst.

An end from accompl of which will also be best able to prev disten from flatul.

For this very general conseq of want of due vigour in intest canal.

Hence then both disease in some respects at least to be combated by same remed.

And after remarks now offered objects in view from partic pract to which recourse here had will be better understood.

Began pract. by direct for this pat. an elect. the basis of which was Cream of Tart.

From this need hardly obs. that had in view the obt. an operat both as diuret & cathart

In both ways well known that influ very consid.

In so much that now very few artic more freq empl in hydrop cases

And from influ in this way, expected remov of water cont. in cav. of abdom.

From cream of Tart alone however consid quant requis for prod brisk cathar

And for prom absorp this at first at least seemd necess

Hence added as adjuv here added a small prop of Jallap.

But if adjuv here necess state of bowels seemd no less to require a corrig

And with view of prev. inconv from the refrig effect of the Crem of Tart as well as to prom expuls of wind had recourse to cort Cassiae one of most grateful of veget arom.

And although infer in price yet very little if at all infer in med virtues to Cinnam.

This elect. prod as was indeed expected freq watery stools

And with this also some encr. of disch by urine.

With these obv. disch. patient app to his mother to be upon whole somewhat relievd.

Gave reason therfore to hope that by contin cure might be obt.

But at same time to be observed that had prod very little [dimin] of [sweat]

This however was I own inclined to consid rather as effects of flatul than of water.

While therfore directed the contin of elect. had recourse also to anoth remed with a view of obt. effects of a carmin & tonic

As such here directed employm of mixt of Infus Amar with Tinct Aromat.

The former basis of which one of [purest] veget bitters the Gentian is unquest very useful in strength alim canal

While lattr cont. Cinnam, Cardom, Angelica & other grateful vegetab aroma has in most inst powerful effect as tending to immed expuls of wind.

By contin of this course under prop admin am hopeful that both hydrop & tympan sympt may be overcome.

If however in this disapp. have thoughts of next trying with this patient the use of Electr.

With a view to Drop. promise some advant as being means of prom absorp.

With view to Tympan may expect benef from influ as encr. nerv. energy of intest canal.

And from use in Palsy, may concl. also that may be prod of benef in this disease.

Shall here therfore wish to give it fair trial under form of sparks drawn from surface of abdom.

But if this also unsuccess. pract must afterwards be regul. by situat in which shall then find patient.