DEP/DUA/1/37/54 (Transcript version)

John Stuart

(1785)

---

John Stuart.

Of case of this patient have not I own been able to form any decided opin.

But can have little doubt in consid his affect as being of compl. nature.

And probab. diff parts of it little connected with each other.

When first applied for our assistance chief compl an affect in disch of urine & pain of back.

From situat of pain, from [scanty] disch, & from app of urine had reason to concl. that this affect of Nephrit kind.

And that depend on Calcul. or at least sand of which a consid disch take place with his urine.

Besides this had also an evid & consid disease of right test.

This swelld to very consid magn near four times size of left, while at same time was of hard & indur feel.

In gener. had but little pain from it & had also been for very long time in what might be calld [stat]. state.

Hence notwith shooting pains at times, might justly be consid as schirruous testic.

Besides these had at times also pains along right thigh, termin in knee where most severe.

These may have been of Rheum kind.

But consid it as more probab. that connected either with affect of testic or nephrit compl.

And partic with former for of Neph. a very common sympt

Besides these affect to which was subj when came under our care since treatm here another also has superveend.

Has been attackd with severe catarrhal affect partic indic by cough & dyspn.

And to all this to be added that gener app of habit exhib a very [exhau] figure.

With this idea of disease progn you may readily suppose cannot be very fav.

Would be by no means surpr. if in no long time, patient falls vict to affect.

And if this not the case, can hardly expect recov from at least greatest part of them.

In nephrit, where stone of kidney of any consid size, utmost to be lookd for is mitig.

And where schirros of testic, so consid as in pres inst. rarely to be removed but by oper.

For which, hardly to be doubted that our patient a very unfit subject.

Of catarhall affect, a compl. but of recent date might indeed look for compl. removal.

But at same time, as occurring with an exhaust. & debilit habit, death may readily be conseq of cough dyspn. & diffic expect.

Upon whole then, little more here to be aimd at, than mitig.

And is solely with this view, since patient came under our care, that pract here empl. have been directed.

Began you will observe, by directing for him, use of Cream of Tart adding as corrigens, small prop of powder of Cassia.

This directed with view of gently prom disch of urine, & by this means removal of sand.

Under use, affect in this respect was for some time allev.

But became affected with very violent cough, attended with [distin] dyspnoea.

And by this, other sympt, partic pain of back, were much aggrav.

With view to this affect, had recourse to applic of a blister.

And from this also, tempor benef at least seemd to be obt.

But on mitig of these sympt. whether from viol of cough, or any other cause, tumour of test we were informed was encreased.

And this also attended with more than ordin pain.

Viewing this as effect, of accid superveening inflamm. have directed saturn poultices.

And am in hopes, that in no long time, may again be brought to former state.

Still however, diseased state, & that too, to very consid degree, will remain.

If fav circum occurd might with view to removal, try a course of Merc & Cicuta.

From which in some cases of this kind, have known consid & even surpriz. benef. obt.

But in pres. state of our patient, very doubtful indeed, whether for such a trial, any prop opport will occur.

And as have already said, probab. that pract. must entirely be directed, merely with view to mitig of sympt.