DEP/DUA/1/39/12 (Transcript version)

Edward Ross

1786

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Edward Ross. Febr. 25 1786.

Of disease of [this] pat opin I confess somewhat changed since last spoke of case.

At least with respect to termin.

For now inclind to consider it in more serious light than form.

When came under care chief affect pain of stom.

And this not const. but chiefly after taking food.

While at same time attend with sickness nausea acid eruct & great disten.

In these have comm marks of dyspep.

And here no reason to believe any fixd affect.

For at that time no local [hardnss] to be discov. at any partic part from exam of stom.

No constant pain.

And no vomiting which very com. attended of shirros or local affect of stom whether at Card or Pylor

Hence then disp. to view it as being affect merely of aton state of that viscus.

And what prob. a very common conseq of that condit. a morbid affect. of fluid secret. by stom on which digest very much depends.

This opin as to cause nature of affect corrob. also by acct which gave of cause.

Ascrib. disease to [drinking] spirit liquors of bad qualit.

Well known however that by abun of spirits whether good [or] bad stom affect [induced]

And such abuse was I confess disp to think had been case in pres. inst.

Much more freq. however induc weakened tone than any local affect.

Which again very gener conseq of [storkes], preced inflam or some simil accid.

Hence then inclind to view disease as being merely inst of Dysp.

An affect which though often obst. & troublesome yet in gener. not danger.

And often where to greater highs & of longer contin than pres, yet fav termin.

In pres case consid short durat as somewhat in fav of pat.

Had only been of four months stand.

Which though long period for some diseases yet cannot be consid as such for dyspep.

Besides then that sympt far from very urgent consid us as having here opport of treat affect in incip state.

To this also to be added as anoth fav circum. that had once before been subj. to simil compl.

And on that occas had even spont. termin in recov.

On these grounds then, hoped that by aid of prop. regim & med in no long time affect if not entirely removed might at least be allev.

And for some time change which took place in compl. seemd to fav this idea.

But since pat. came under our care, a circum ment of which [were] not before informed, giving much more serious aspect to compl.

Report of 4^th Febr last in our regist in following terms.

Is entirely free from the cardialgia & acid eructations but complains of a sense of stoppage at his stomach so that can swallow nothing excepting in fluid state & small quant at a time.

Such tempor. diffic of swallowin often at times merely conseq of spasm.

And not unfreq. such spasm induced by flatul.

But here [repres]. as having been so const. with pat. & with so little pain, that could hardly attrib to that cause.

And was I own inclined to susp. some local strict at cardia

Such however often conseq of [schiros]

And where this occurs disease very gener. in end fatal.

On this ground then now disp to view disease in much more [serios] light than before.

With regard however to termin of affect. now unnecss for us to offer any conject.

For since last report urgen of compl. has led him to apply for admiss into infirm. where at pres. under care of anoth phys.

And for same reason also hold it necess to say but little with resp to pract.

At commen of treatment, though consid prin morbid affect as [consist] in dimin tone of stom yet before empl. remed to restore it seemd necess to do somethin for obv. urg. sympt.

And here, consid sickness nausea & [ven] pain as a good deal affect of acid as indic by eruct. seemd to be obj of conseq. to destroy it.

With this intent had recourse to Pulv. Cretac, the basis of which need hardly obs. one of most powerf. of absorb. [earths].

But which in that formula united with two of most powerful active & grateful of veget aromat. Nutm & Cinnam.

From these hoped that same affect as remov flatul & thus allev. disten

In this however cannot say that expect were answ.

For after empl for space of week acid eruct as severe as before.

While no allev of other compl.

From this then thought of conj use with some med for strength stom

And thus remov. in some degree at least cause of acid

As such had here recourse to the Tinct Absinth the basis of which one of strong of veget bitters.

And which indeed, long empl. against stom ailm.

With view to flat was given in combin with Pepp. mint water.

Which as means of expelling wind from stom has very imm & powerful affect.

From use of this Tinct very consid relief.

Was not only less affected with nausea & pain but entirely free from acid

In this situat reckond farther contin of Pulv. Cretac unnecess.

And directed that should go on with Mixt of Tinct. Absinth alone

At succeeding report affect in some respects still cont. to be easier

And in partic no return of acid.

Now however were informed of a partic which had never before been ment.

Obstr. viz to passage of food into stom.

In conseq of this could swallow nothing but in fluid state, & small quant. at a time.

Of this have already in some degree expressd doubts.

But consid it as most probab. suppos. that the affect of strict from schirros. directed for him use of Cicuta.

If entirely mist as to affect was at least a remed from which no reas to fear bad conseq.

And if schirros Cicuta one of very few artic from which could look for any benef.

Here indeed am very far from repres. it as what under even best managm. will be prod of cure.

Great maj. of cases I have seen where schirr. either at Pylor or Cardia have term fatally.

But one case com to [me] by Dr Odier of [Geneva] where strong evid that success remov. schir. at cardia

Wished therefore here to give it trial.

Was only however from contin for consid length of time that could form any judgem.

And from such trial entirely precluded from pat. being now under care of anoth pract.