DEP/DUA/1/47/21 (Transcript version)

Alexander Glasgow

(1789)

---

N33. Alexr Glasgow at 32.

In case of this patient, a distinct, markd inst of Rheum.

And although in some cases diff to disting that disease from gout yet here could be no doubt.

Pains indeed at time when came under our care, chiefly in infer extr.

And if not in feet at least in ancle

But here, without any of those affect of alim canal which const attend of Gout.

And during whole course of disease for three years, pains had never once affected toes.

Had never once been obs. to altern with affections of stom.

Had occurd in most joints of body & partic in large ones.

Had affected with consid sever. many joints at same time.

And what perhaps no less desir. than any other circum, had deriv origin from an obv. cause, action viz of cold & wet.

To all these might were it necess add, that if not sex, at least age & condit of pat. in fav of Rheum.

For only in 32^d year, & a labour mechan by his condit in life totally removed from lux.

While however thus clearly of Rheum kind, must be allowed that a diffic in diagnos still [great] occurs.

For with a view to most success pract. must determ, not the spec. but partic modif of the disease [when] exists.

Rheum a disease which when long contin runs through very diff stages.

And in these very diff morb. cond. may be consid as immed giving rise to most urgent sympt.

Hence for remov. diff intent of cure to be fulfilled.

Accordingly by greatest part of writer divided into acute & chron.

But for distinct view should I appreh consider it as admitting of four states.

And these would disting as states of Inflam. Irritab. Atonia & Paralysis.

Diff sympt & charact of each of these endeav to state at some length in pract. course.

Here may only obs. that from freq. shift of pain, from obv. swellg with which often attended, & from aggrav by cold, while at same time no marks of fever, view it as in state of irritab.

And in this condit prognos. perhaps no less fav than any other.

Or at least admits more readily of cure than either aton or paral.

Though perhaps less readily yields to active remed, than the [Infam].

And may remark that in all its stages, a more painful than a danger affect.

For even where proves incur. is yet seldom fatal.

In pres inst must be allowed that contin of the disease somewhat against pat.

But notwith this am here hopefu. that if cannot altog remove may yet at least be able to mitig aff.

This at first here thought of attemp by intern use of opium.

And by an active topic app. having for its basis the essent oil of Turp.

Soon after these med begun howev pains, prob. from some accid circum became much more severe than before.

While at same time, belly very bound.

This last might I thought [or] have some influ at least as augm pains.

And could be little doubt, of its being encr by pills, if not origin from that cause.

Hence then, to these have now subst., Pulv. Guaiac comp.

And from this conj. with [ointmen] hopeful may derive benef.

But of pract reserve obs. till agn speak of case.