DEP/DUA/1/35/04 (Transcript version)

Charles Campbell

(1784)

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Chas Campbell May 28^th

In case of this patient sever obvious & distress sympt.

And with regard to nature of affect in some respects at least am inclind to think but little doubt

But name with prop. to be given it more a matter of controv.

Here three morbid condit from each of which might be disp. to seek for name of disease.

First freq. inclin to disch urine.

2^dly Pain & diffic with which that disch attended.

And 3^dly The condit of the urine as disch. partic as uniform cont. a large prop of white viscid mucus

Were we to name affect from first of these would naturally give it appellat of Stranguria.

If from 2^d again, pain vizr with which disch attended, would give it appellat of Dysuria.

And this latter appellat given to the affect to which our patient subj. here in syst. of Dr Cullen.

For I think no doubt that it exhib to us an ex of that affect which in his syst. disting by title of Dysuria mucosa.

At least have no doubt that it afford us an example of that Gen to which Linnaeus in his syst has given name of Glus. or of what Mr [Lieutaud] has describd under title of Catarrhus Vesicae.

These however ment. by Dr Cullen as synon. With his Dysur. Muc.

But in my opin he has done wrong in consid this affect as a species of Dysur.

And neither with prop to be [named] from pain & diffic of disch, nor from freq inclin.

These indeed intim connected with the disease.

But both of them in my opin merely symptom of state of disch.

And if wish to give the disease a name in any degree conveying idea of its nature, must derive it from that source

Here however simil disch takes place from bladder, as in Leucorrh. from the uterine vessels.

And hence has I think with great prop been named Cystrrhoea

This appellat will find given to it in an inaug. dissertat lately pub. on this subj by Dr [Parnham] which cont. many excell obs. both with respect to Hist & Cure

This appellat then consid as [prefer] either to Catarrhus vesicae of Sauv or Dysuria mucos. of Cullen.

That case before us an example of that affect evinced by all sympt.

But partic as have already obs. by large white mucous sedim which the urine cont.

Where this comb with pain & freq inclin to disch of urine, no other affect from which can suppose it to arise but actual ulcerat.

And indeed same app in some degree given by purul matter.

But where this takes place, const heat & sense of [burning] at partic part.

While at same time, pres [diffus] in urine much less viscid & glut. than mucus.

From these partic then all doubt respect pres case in my opin was removed.

The matter diffused in the urine nothing more than morb. secret of mucus separ from folicles within bladder partic about its neck.

And in conseq of this vitiated secret. though quant. encr. yet prop lining & defence to bladder wanting.

Hence arises pain as well as freq inclin to disch.

From this view of nature of affect might be concl. that should not be expected to be a very obstin disease

At least encr. mucus disch from other parts as for ex. Gonorrh, Catarrh &e often even spont. termin.

From [fact] howevr app. that in [Cysterh]. case by no means so fav.

For when once induced very gener. obs. to prove both an obstin, & troublesome disease.

Probab. the conseq of being encreasd & aggrav. by contin stim of saline impreg in urine.

Partic liab. to be an obstin disease when occurs at late period of life.

And especially if at early period prop remed be not empl. to comb. it.

When all circum then taken togeth. obstin viz of disease, age of patient already past 70^th year, its contin for space of sev weeks, & during that time its encr in viol. have I think reason to believe that will prove obstin.

Shall not therefore be surp. to find that all our efforts ineffect.

At same time differ. modes of cure which may at least be tried with some prop of success

Here no doubt that disease very much encr. by stimul of [urine]

And although in any state will have some effect in that way yet this very much encr augm by prop of saline matter to watery part.

Hence then by means augm the disch affect often very consid allev.

And thus opport. at least afford for most advant use of those remed by which chance of comb.

This circum therefore led me in entering upon treatm, to have recourse to powder of Crem of Tart.

Given however to quant. only, of Tea spoonful twice a day.

To this extent, could expect from it, but little influ in moving belly.

But when thus grad introd has best chance of operating as diur.

And although here wishd, that belly should be kept gently open yet influ in way of diur. was what chiefly wanted.

This effect however did not at first prod.

Or at least if any [increase], so inconsid as to escape observ.

While at same time no change in state of inclin to disch, & in pain with which attended.

And quant of viscid mucus cont nearly as before

Notwith want of success howevr did not think of entirely desert. plan.

But while cont Crem of Tart, wishd also to employ anoth med. more partic calcul for [counteractin] cause of affect.

As such had recourse to Uv. Ursi

This med need hardly observe first introd on recomm of Dr [D Ha] of Vienna as a remed in Calc. cases.

And although in these, by no means found to answ expect entert, yet from repeated expr, observed prod of good effects, in cases of affect of urin organs.

Often prod of advant. even where reason for susp ulcert in these

But partic have found in some other inst. of this disease very consid benef from use.

This therefore has led me on pres occas to think of empl.

On what princip indeed here operates must own am very much at a loss to say.

In way of sensib qualit shews very consid degree of bitterness & [astr].

And with this would seem also to contain a prop of vegetab [mattr].

But from all these comb. activ cannot be inferrd

Or at least from other artic possess them to equal or even greater degree, have never been able to obs. same effects.

Till therefore farther light thrown upon it, must consider it, as operat, in manner which [cannot] expl.

But if realy prod effect, of dimin disch, & allev. sympt, this at least a matter of [illegible] conseq.

And here must confess that had recourse to it on empyr footing, or rather that of former exper. than any other.

Only form under which have for my own part empl. this artic is that of powder of dried leaves.

And indeed am acq with no [other] under which has been used by any pract.

While at same time from powder, which very gener. at least sits easily on stom, may expect all affects which is capab of prod.

Here empl at first to extent only of ℥p taken in the morning.

But with intent of encr. quant if found that born with ease.

Accord. now you will obs. taken to same quant. thrice a day.

While at the same time as belly rather loose Crem of Tart entirely omitted.

Cannot say that from this artic more than former, patient has [yet] derived any consid advant.

But this not to be expected in very short time.

And for fair trial will require still longer cont.

Mean therefore to persist in empl. & if not prod of inconv. even encr. quant. used.

If however in the end disapp, which from what already said of progn. by no means an [improb] event have next thoughts of trying anothr active veget. viz Hyosciam.

And if this also shall fail may have recourse in success to Bals Copaiba, Vitriol Acid, or to Elect.

In all these howevr must be regulat by circum at the time & by situat in which shall find patient after trial already begun