DEP/DUA/1/40/68 (Transcript version)

David Smith

1787

---

David Smith. Febr 3^d 87.

In history many symptoms.

But no doubt that most matter affect of disch of urine.

And reason to presume that from this most if not all others arise.

Formerly obs. some doubt as to name.

Would seem entit to appell both of ischuria & dysuria.

For from dimin of disch evid of affect of secret.

Hence great charact of Ischur. Ren.

While again from pain & diff of disch. may pron. Dysuria pres.

But these am inclind to think merely conseq of state in which [ser]

For will obs. often even with mixt of blood.

And prob. from small quantity of watery part always very consid imp of saline matter.

To this would ascribe great [sense] of heat in urethra.

For here no evid that sever. less than natural.

Hence to be ascribed to encr. stimul.

To which probab. also to referr great degree of pain.

A conseq of action of urine [thus] acrid on sensib parts at neck of blad.

Here then though sympt from action on bladder yet would consider disease as origin in kidney.

And to this, cause to which ascribd gives addit probab.

For affect referrd to injury done to [trunk] of body, by which told sever ribs fractured.

And which prob. prod injury of kidney itself.

To local disease in this [then] am inclind chiefly to referr pres. affect.

At same time would by no means assert that kidney only organ dis.

Or that bladder entirely [sound].

Yet think that sympt. may be exp without this.

And relief derivd from [pract] empl. renders it more prob. that no [affect] of [blad]

While without suppos of affect of kidney phaenom not to be [expl.]

For this equal cause of scarcity & of bloody disch.

But suppos. kidney alone in morbid state, yet disease to be consid both as import & alarm.

For well known that in many inst ischur. a fatal affect.

While at same time almost every local disease of kidney obstin

For organ very much out of reach.

Hence when formerly spoke of case repres as one where little hope of compl. recov.

And that the rather to be feard as of sever. years standing

While occurd in man of very adv. age already in 72^d year.

Would however app. that this progn at least so far contrad by event

For patient already dismissd if not free from affect at least with all sympt consid relievd.

And enjoying at least that state of health which did before app. for ass.

This however I own consider only as effect of tempor encr. of quant of Ur.

Not of remov. of disease in kidn.

Hence I own inclind to look upon it rather as tempor than radic cure.

Yet dispos. to look upon it, as to consid degree at least, effect of med empl. with this pat.

Here from idea of disease [concern] great means of immed relief to dep. on encr of secret of urine.

And with this view it was that prescr. Vin. Nicot.

An artic formd by infus. Fol. Nicot Viz. ℥ i in Vin Alb. Hisp lb.i.

A menst. by which activ of this powerful artic fully extracted.

Nicot long known to be a subst possess very active powers.

And these depen both on Phlog or oily & Saline impreg.

Hence requis for extract a menst in which both ardent spt & water united

Nicot in diff forms long empl. in med & with various intent.

But of its diuret powers very little or rather no ment made by [pract.] med. writers.

For discov of these consid [us] as indebted to that ingen. &dilig obs of nature Dr Fowler of Staff.

Recom with this view to atent of [pract] in late public. Med. Reports.

[There] many stricking ex of benef in diff cases of Drop & Dysur.

Since that as Diur. a good deal empl. by other pract.

And many satisf that justly merits very high charact.

For my own part have not befor empl. it in cases of Dysur or Ischur

But have freq used it as diur in other affect.

Partic in Drop. & Chron Catarh.

From exper I have had conv. that often does oper as powerf. diur

At same time like all other [diseas] its operat uncert.

And indeed this not wonderful when consid situat of secr. organ.

For matter can only reach it in course of circul.

Hence liab. to [such] changes [are] on many occas to be rend altog. effete before reach kidney.

And this depend on infin numb of accid circum.

Hence what succeeds in one case will often fail in anoth.

And what esteemd weaker, freq. prod of desird effect where stronger empl. in vain.

As far as my obs. goes Nicot subj to same uncert. with others

But from having found it often a powerful diuret. had here recourse to use.

And in affects not disapp.

For from time that began empl. urine at least somewhat encr.

And all sympt partic heat in disch it consid dimin

This however must ackn. could not entirely ascribe to Nicot.

For at same time directed anoth diuret. viz Infus. Junip.

Made by extr. active parts of Junip partic essent oil by water.

Diuret power of this artic long known.

And under form of water infus effects encr. also by diluent.

Hence consider it as one of best drinks to be [empl] with other diuret

To this therfore not improb. that part at least of good effects here obt. to be ascr.

Although however under these consid relief yet urine still scant.

And at same time Nicot as not unfreq case had effect of excit consid sickness at stom

Omit therfore Nicot. had recourse to powders of Crem of Tart with Mixt of Nitre & Cassia.

From this soon still farther aug.

And was now free from all other sympt.

And finding himself in as good health as had been at any time for some years before desired to be dismissd.

To which I own not [averse] since now as well as ever exp. him to be.