DEP/DUA/1/43/60 (Transcript version)

James Short

(1787-1788)

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N^o34 James Short. at 9.

Case of this patient as well as former not without diffic.

Sympt however cannot be repres as numer.

And prob. that disease simple & uncomm. all arising from same cause.

Strong ground for presum [likew] that this cause in kidney.

This may inferr both from situat of pain & affect of urine.

But respect nature of diseased state in kidney more room for doubt.

For both pain & affect of secret of urine may arise from diff. caus.

Of all causes howevr prod these effects most common is calcul.

Well known to induce a disease both freq. danger & painful.

And besides circum already [men] in fits of pain to which this patien subj. at least some resemb. to it.

Here however must be allowed that other sympt of Nephrit. Calcul wanting.

Such for ex as affect of alim can stupor of thigh, retract of test &e.

From absence of these at least doub whethr any consid calcul. exist in kidney.

And am I own inclind rather to think there does not.

In these consid changes to which urine subj in point of colour, have rather evid of morbid affect in secret.

And from sand disch have evid of that condit of secret abounding with calcar matter

In this rather than any prop. calcul am inclind. to think that disease of pres. patient consist.

Even suppos this conj. however to be well founded, can hardly lead us to give fav. prognos.

At least to hope for speedy recov.

Not indeed any great reason for being appreh of fatal conseq.

At least if such should ultim occur will not prob. be a sudden even

But by no means an easy mattr to change condit of an organ so much out of reach as kidney.

And partic so, when morbid state in that organ, seems to have had foundat as it were in origin const.

For of this strong presumpt when consid long contin of disease, althou patient only at early period of life.

Upon whole therefore greater [reasn] to appreh [encrease] of affect. than ground for expect recov.

Yet at the same time something I appreh may be done with advan both with view of prev. conseq. most to be dreaded & of allev affect

First of these intent may exp. in some degree to accomp. by [more] free disch of urine.

As this calcar matter more diff & [illegible] carried off.

[These] [last] again may hope to obt. when pain most severe by occas use of opiates.

But besides these may also try artic. which have been supp at least to have effect on condit of secret organ.

Such for ex as Uv. Ursi. Vitriol Acid or Caust. Alk. lixiv.

But in pract here a good deal [regul] by circum

And obs. respect it reserve to future occas.