DEP/DUA/1/37/06 (Transcript version)

Jean Stalker

(1785)

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Jean Stalker Febr 5^th

Disease of this patient very distinct markd even from slightes exam of counten.

While at the same time from hist as introd into regist. had every reason to believe that simple & uncompl.

From yellowness of eyes, & indeed of skin in gener. as well as from state of urine had manif indic of pres of bile in blood.

While at same time from state of stools, had evid of absence in alim canal.

In these two however, have great charact, of obstr. to natural disch of bile, or in other [words] of Jaund.

Could have no doubt therfore in consid it as being a distinct marked inst of that affect.

And indeed in hist only one circum which can I think be consid as singul.

Regul. viz of disch by belly during course of affect.

In most cases of Jaund belly bound.

In many even to obstin degree

Probab. conseq of want of that stimul to intest canal which bile affords.

Hence foeces, while deprived of usual colour, want also accust. acrim

Thus obstipat, the usual state of this disease, easily expl.

But though thus readily acct for that occur, yet no reason why in every inst of Jaund, belly should necess be bound.

For besides bile, many other stim, by which peristal motion, even morb. encreased.

This partic case at early periods of life.

And then indeed dispos to encr. action in intest canal, seems to be very great.

Accord, with health stat of inf. belly comm loose.

From period of life therfore at which disease here occurred, viz third year, this singul. may seem less extraord.

And at any rate, easily expl. either from suppos. that some other stim here supp. place of bile, or that intest partic irrit.

But when take notice of age of patient, may perhaps seem to be a singul that occurd thus early.

And indeed in greater part of cases, jaund of any obstin at least, occurrs with those advan in life.

At least if except what calld Gum in infants & which some consid as jaund

But even early periods of life by no means altog exempted from it.

With them, may readily suppose, that ducts obstr. by vicid either of bile itself, or of secret in intest canal.

And when consider, that even in early periods of infan, very consid urin calcul are formd, may readily suppose that, may also be liab. to biliary ones.

With them indeed schirros of neigh viscera, perhaps a less freq. cause.

And accord in jaund, with young subj, progn very gener. more fav.

In pres inst then, from this circ as well as from short durat of dises had reason to entert fav. hopes.

As when applied for our assist, had not been of above ten days durat.

At same time during that period had resist use of these emet.

Could not therfore view it as of slight or transit nature which [aris] from spasm or viscid sordes.

And was disp. to consid it as an example of Jaund from calcul.

On this idea of disease, notwith want of success from formr emet. thought that still best chance of remov by repetit

Directed therfore that during course of following week should at prop intervals take these.

And as most certain means of excit full vomiting had recourse to powder of Ipecac.

While ordered these directed also a mixt of Bitter infus with elix of aloes & rhub.

Which in such cases often service as counteract indigest which occurs with Jaund.

But while here prin exhib that might not seem to be inactive.

What has been effects of these med have not learnd.

For since were prescr. have seen nothing more of pat. at this place.

And from what dissert. has proceeded cannot pretend to say.

May have been conseq of her not [choosing] to follow our direct. as having prescribd emet which had already empl. without success.

But reckon it more prob. that it proceeded from having empl them with success. & thus having no farther occas for assist.

And this indeed as have often [illegible] opport of learning, a freq occurr in Disp pract.