DEP/DUA/1/37/48 (Transcript version)

William Campbell

1785

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Wm Campbell. 12^th April. 1785

Respect compl. of this patient was by no means without doubts when came under our care.

And these during short time of attend here not altog removed.

Disease however in some respect a manif one.

For chiefly consisted in obvious & consid swelling of abdom.

While this may arise from diff causes, had here little hesit in attrib it to wind.

For was not of that fixd kind or circums. feel at partic part which could give reason to believe, that depend on local affect of any visc.

Must therefore necess referr it to some [effused] fluid

And here could have no susp. of its depend on fat.

For to this tense feel, appear of patient in other respects, & general state of health unsurmount obj.

While want of fluctuat, condition of urine, which abund & natural, as well as state of disch by the belly, obj to idea of water.

Hardly therefore any other cause to which could referr it than wind.

And this confirmd both by tense feel & by relief afforded in conseq of disch.

Although however prin from this cause, could not inferr that was entirely so.

And one circum at least, which viewing it as a tympan affect was singul.

State viz of disch by belly

Very gener. one of disting sympt of Tympan. bound state of belly.

And in proport as disease advan obstip becomes greater.

With our patient however belly on contrary loose.

And as far as had opport of obs. progr. when looseness most severe swelling most consid.

A circum from which might inferr that if were not to each other as cause & affect, that yet causes at least were connected.

And although conjunct uncomm, yet not inconsist with idea, of affect being of tympan kind.

In tympan swelling arises, not from any uncomm cause of extric of air, but from want of resist to that fluid.

And in worst cases, musc fibres of intest canal even in paralyt. state

Hence peristalt motion almost totally susp. a circum necess & unavoidably induc costiv.

But consid distens from flatul, may arise, where without paralysis, mere dim of tone.

And there, but reason to supp. that this distens would even encr tend to action.

For unless where sensib defic distens operates as stim to musc action.

This then, take to have been [cause] in pres inst.

And while think it probab. that distens is cause of looseness here, is no less so, that is cause of pain.

For of distens of a sensib part, pain necess & unavoid conseq.

And this, only other sympt in pres case, which could be consid as deserv. notice

With this idea of patients disease could not at least view it as being danger.

And when consider that only of a months contin, during which had not been unif or stat, had even reason to hope, that would not be of long contin.

For swellings of belly, at early period of life, every day over come or even disapp of themselves, after much long contin.

At same time could not here speak, with very great confid.

For Tympan. in not a few inst nay when distinct. markd in every inst. turns out a very obstin disease.

This even the case where at the begining app. very slight.

And though not fatal yet in end incurab.

That is contin till patient cutt off by some other affect.

Reckond it however more probab. that here fav. termin would occurr

But whether fav or otherwise from late irregul attend of patient now doubtful whether shall know what it is

And for same reason also depr. of opport of knowing affect of med.

During time for which did attend us, cannot say, that any consid benef derived from them.

Began you will obs. by directing for him the Peruv. Bark mixd with powder of Cassia.

To first had recourse on idea that swelling effect of dimin tone.

And that by restor due vigour, might prev occurr, both of future flatul, & of looseness.

But for immed expuls of flatul, to be affected by some stronger stim to alim canal

And was with this view, that conj with bark a prop of powder of Cass

In which, an equally grateful, & much less expens. aromat, than the Cinnam.

Under use of this med, sympt seemd at first, to be consid dimin

While swelling much fallen was also less affected with pain.

And what somewhat at least in fav of idea as to cause of looseness this sympt also dimin.

In this situat nothing seemed farther necess than contin.

And by this hoped that would be overcome.

App. however not so favour at succeeding report.

For now found that with recurr. of swelling, pain, & looseness, had also less free disch of wind

On this acct. in conj with Peruv Bark, some stronger carmin seemd necess

And as such had here recourse to mixt of bitter & aromat Tinct.

From which in gener. at least very consid effects as tend to immed expuls of flatus is obt.

What however, has been effect with pres patient, have not yet learnt

For though now more than forthnig since prescr. yet have seen nothing of him since.

And after such absence doubtful whether shall see him again.

If however does return, must be determ by effects which med has had & by state in which find him, whether shall repeat use or have recourse to any othr pract.