Dr. Shaaff Jno. Thos. Clinical Cases [me] 1796      Index of Patients Names Diseases &c - in the Royal Infirmary of Edinr- 1788-89 - Lecture by Dr. Gregory On Continued Fevers. Part 2nd - Page. [illegible] On Intermittent Fevers - do - 45 On Dysenteria - 49 On Hydrothorax - 57 On Hyorops - 67 On Hysteria - 86 - Extracts from a Lecture on ? Cynanche Maligna - 114 - Ditto on the Case of Seith 192 - On Mania - 341 - On Erysipelas - 82 1st Part - Hume Names Page Disease Medicines Event - Gilmour 9 Cephalalgia Cucurbitata & Vesicatoria - Relieved Tait - 11 Erysipelas V.S & Infus: Tamarind: - Cured - McDonnald 13 Febris - Pulv. Jacob - Do - Sharp - 17 Diuresis & Tensio Abdom. Vesicat. & Diuret. - Do - McBean 20 Hysteritis Vesicat & Lotus - Do - Tait - 22 Variola - Do - Nisbet - 25 Typhus - Do - Ford 29 Do - Do - Clark 31 Hydrocephalus internus - Calome & Ung ☿ - said to be relieved - Smith 37 - Synochus - cured Innes - 39 Amenorrhea Rubia Tinct. Elect. Compress - not relieved McKenzie 45 Pneumonia - cured - Grindley 49 Typhus - death - Martin 53 Diarrhœa Extract Camphor & Sal. C. C. ℔ - not relieved Hargrove 57 Typhus - Death - Moir 63 Hyrops Ascites Crem Tart not reliev'd McDonald 69 Typhus - Death McDougal 73 Rheumatism Acutus - V.S &c - cured Names Page Disease Medicine Event Whatt - 78 Sepra Gonor - Pil. Plum: & Ung 5 - relieved - Paterson - 81 - ditto - Lot: Vitriol & Ung. Vit - cured - Tapp - 85 Rheumat. a. - cured - Cumming 89 - Lues Venerea Therc. Cinon - cured - Nicholson 93 - ditto - ditto - ditto - McLarne 90 Worms Pulv. Stanni - ditto - Anton - 108 Hæmorrhage from the nipple periodical - not relieved Seith - 107 Hæmatoma Extract. Hyosci. Sal. Plumb. nit - not relieved Ross - 121 Worms Pulv. Stan. cured Pond - 125 Diarrhœa Ext. Campuhor & sal. C.C. ℔ - not relieved Sutherland 129 Ascites - Digitalis - death Anott - 133 - none - dismissed Hutchinson 137 - Setons of diseased Liver - Mutta - death Wilson 145 Herminia - Rad. Valor. relieved Niven - 149 Paralysis - Plectricitat & Arnica Mont - relieved Smith - 155 Worms Ol. Ricin & Suc. Lemon Hy - cured Haislop - 157 - Paralysis dumb Bell &c - relieved Manson 161 Ascites digital - left [illegible] Grey - 163 C. Rheumatism Cicuta - cured McFarlin 169 - ditto - ditto - ditto - Meikle 173 Diabetes - mutta no relief Greig - 185 Cancer Cicuta - Ditto 2nd: Part Gregory Names Page Disease Medicines Event Kerr - 109 Typhus - Wine - cured - Boyd - 113 Cyanche Malig- Bark & Wine death MGregor 117 Typhus - Wine - cured Center - 119 Typhys & Gangrene Hips Tin. de Han - cured McDonnald 125 Scrofula - Issue. Electas - not relieved Watson 127 Synochus to Rheumatism Wine & V.S. &c - Abscesses - Henderson 133 Typhus - Wine - cure Mushart 137 Paralysis - - McLearne 138 aniora, Amenorrhea Pul Sabire Sub. Tinct. Pil. Gum. - not relievd Ditto - 141 Cyanche Maligna - Wine & Bark cured - Robinson 145 Synochus ditto - ditto Herriot 149 ditto - ditto - ditto Ross - 151 Hysteria Pil. Gum. relievd Walker 153 Typhus Wine - cure Urquhart 137 Anorexia &c - cure Scott - 159 Variola - cure Fisher 167 Apoplexy - V.S. &c - death - Pennyerick 173 Erysipelas Bark - cure Gaudy 177 Rheumatism V.S. &c - cure Anton 185 Hœmorrhagy from [illegible] taria - not relieve Seith 189 Hœmatemesis - - Brown 193 Cancer Arsenica - relieved Greig - 197 Ditto ditto - ditto - Names Page - Disease Medicine Event Dobbie 201 Mania Emet. & Sot frigid - improper McKay 208 Ischuria - cured Makew - 210 Diabetes Varia - not relievd Esther - 214 Dyspepsia - relievd Brown 218 Amaurosis Elec. as & ☿ - improper Geoffrey - 222 Paralysis - V.S. &c - death Cowley - 226 Pneumonia - death - Smith 230 ditto - V.S. in temp art. Laxant. Vesuit - Vomica Page - 238 Seus - & Hernia Humor Ung ☿. Bal. Tepid Decoct. Susit - cured - McDonnald 242 Diarrhœa Jalap List - death - Henderson 246 Mesthesica Electas. Thigil: Bal. Tepid - releivd - Williamson 250 Chronic Catarrh - Squills - ditto - Thompson 252 Typhus - Wine - death Yule - 254 Ascites - Ung ☿ & Squills - death - Monroe 269 - ditto - ditto - releivd - Hunter 277 ditto - ditto - cured - Enoch 291 - ditto ditto - ditto - Thompson 287 ditto Gin Punch & Brot death - Dick - 299 Hydrops Ovar. - death - Baron 307 Hysteria Æther Electos. Jalap fœtid - releivd McGregor 309 Chronic Opthalmia - Vani - releivd [illegible] 331 - Colic Violent - Nicotian Lavat. frigid cure McPhee 319 Hysteria - Penman Amaurosis  (1 Different diets used in the royal infirmary of Edinburgh - - Low diet - Foods - Boiled Barley, Bread Bury on Rice & milk if orderd sugar to each - Drink Barley water or Barley Gruel, Rice water if orderd - Middle Diet Breakfast & supper. Bread & Milk or Beer & pottage Dinner Broth in Milk with a Roll - Full Diet Breakfast and supper the same as Middle diet - Dinner, ℔ss of meat every other Day - Milk Diet Breakfast & supper Bread or Pottage With milk - Dinner the same or rice & milk if orderd -  (3 Pharmacopoeia Propria Dr. Horne - Pulv: Emetic: ꝶ: Pulv: Ipec: grs v. Tart: Emet grs. iij ♏ ƒ - Pulv: Laxans - ꝶ Pulv: Crem: Tart: ℈i - Rhei opt: grs. x ♏ ƒ - Potus Antiphlogisticus ꝶ Cryst: Tart: ʒij solve in Aqua font: ℔ ij dein adde Sach: alb: ℥ vj ℔ss pro potu com: - Jalap. Mucilaginos - ꝶ Gum Arab: ℥j solv: in Aqua fervent: ℥iv et cola dein adde syr: Althæ ℥ss ♏ ƒ - Dosis ℥ss 4ta quaque hora - Julap: Mucilag: acidulat: Fit addendo prioi Spa: Vitriol ten: gd C- 4) Pharmacopoeia propria Dr. Horne - Julap: Nitros: ꝶ: Sal: Nitri pur: ʒj Aqua font: ℥iij solve et adde Aceti puriss: Syr: com: āā ℥ss ♏ ƒ - Dosis ℥j 4ta: quaque hora - Julap: Salin: ꝶ: Sal: Tart: ʒj Succ: Simon ℥iss vel q: s ad sal: saturat- peracta effervescentia adde Aq: font: ℥iij Syr: commun: Aqua Cinnam sine v. āā ℥ss ♏ ƒ - Dosis ℥ss 4ta quaque hora - Julap: Effervescens - ꝶ Sal: Tart: ʒj solve in Aqua font ℥viij ♏ ƒ Capn: ℥j pro dosin et statin postea ℥ij misturæ sequentis - ꝶ succ: Simon ℥iss Aqua font: ℥vj ♏ ƒ repr: dos 4th: q: hora - (5 Pharmacopoeia propria Dr: Horne - Julap Scillit: - ꝶ: Aquæ Font ℥iij Acet: Sallit ℥j Aquæ piper: Jamaic: - Ammon s: v: āā ℥j ♏ ƒ - Dos: ℥j 6la quaque hora - Julap Camphorat: ꝶ Camph ℈i Mucil. Arab: ℥j solve et adde Aquæ Cimmam: s: v: ℥ss Aquæ font ℥iss ♏ ƒ - Dos ʒj ten in die - Julap Moschat - ꝶ: Mosch ʒj Mucil: Arab: ℥iss solve is adde Aquæ Cinnam: s.v: ℥ss Aquæ Font: ℥iss ♏ ƒ: Dos: ℥j ten in die - Mistura cort: peruv: - ꝶ: pulv: Cort: peruv: ℥ss. Mucil: Arab: ℥ij teramr. simul vene, dein: adde paulat: Aquæ. Font: - Cinnam s: v. āā ℥j ♏ ƒ Doc: ℥j tertia quaque hora - 6) Pharmacopoeia propria - Dr Horne - Solutio corros: merc: sublimi: ꝶ Merc: corros: sub: grs vj - Mucil: Arab: ℥iv. Aquæ font ℥vij adde Aquæ Cinnam: s. v: Syr: Althæ āā ℥ss ♏ ƒ - ft Solut: Dos: ℥ss ad ℥j bis in die - Solut: Argent: Viv: ꝶ Argent: Viv: ℥ss. Mucil: Arab: ℥ii teranr: simul donce globul: mere: pes nitus evanuerunt dein adde Aquæ fontis, ℥xij Cinnam s: v: Syr: alth: āā ℥ij ♏ ƒ - Dos ℥ss bis in die- Inject: Mercurial: Fit cum prior: sinc Aqua Cin: & syr alth: - Solut: Sacchar: Saturn: ꝶ Sacchan: Saturn: ʒss solve in Aquæ fontis ℥vij ♏ ƒ - (7 Pharmacopoeia propria Dr. Horne - Solutio Tart: Emet: - ꝶ: Tart: Emet: grs: ij solve in Aquæ font: ℥v et adde - Cinnam s: v: Syr: alth: āā ℥ss ♏ ƒ - Dos. ℥j tertia quaque Hora - Infus: Aman: cum Sena - ꝶ: Rad: Gent: Semen: fanic: d. āā ℥ss Tol: senæ ʒj Aquæ bullient: ℥iv - macera per horas quatuor & cola pro Dosin - fit quaque cum duplic: Senæ - Infus: Japon: ꝶ: Terra Japon ℥ij - Cort: Cin: ℥ss Aquæ font: bullient ℥viij macera per horas. 3s: et cola Dose ℥j sexta quaque hora - Decoct: Verbasci: - ꝶ Tol: Verbasci ℥iss Aquæ: fontis Bal: ℔iij coque ad ℔ij & cola - Dose ℥iv 4th: quaque hora - 8) Pharmacopoiea Propria Dr. Horne - Decoctum Dulcamaræ - ꝶ: Tol: Dulcamaræ ʒij Aquæ tepid ℔ ij coque parum et cola - Dos: ℥iij ter in die - Tinct: Carsutæ - ꝶ: Rad: Carsut: ℥iss Spir: Vin: tenuis Aquæ Font: āā ℔i Digere per dies quatuor & cola - Tinct: Digitalis ꝶ: Digitalis ʒvj Spir: Vin: ℥xvj- digere per dies quatuor & cola - (9 Jean Gilmour Œt: 19 - A Servant unmarried - Novr: 10th - Says that frequently during the course of the day & sometimes through the whole night; she is affected with severe pain in the back part of her head and temples [crossed out] which sometimes is so violent as entirely to prevent vision & sleep during the night - Pulse 80 - Tongue & Belly natural, appite: impared. Catamenia have not appeared these three Months - Complaints first appeared about a Month ago but have become more violent within this fortnight - can assign no Cause for her Complaints but a fall which she got down stairs, has used only some bitter drops which she supposed to be Laudanum with relief. 11th P - 68 & soft - Headch: during the Night & sleeps none, her vision is affected at times so much as not to be able to discover Objects applicr: Cucurbit: sine ferro posteriori parti Cervicis 10) Cervicus per quadrantim Horæ cras mane Middle Dech - 12th - From the Touch. Os uteri clausum & uteri impregnati suspicio - Rapelr: Cucmb: Dine Ferro - 13th - Pain of the hinder part of her Head easier pain of the Temples the same Apptr: Cucub: cum fine temporibus 14th - About 4 or 5 ozs Blood got from the Temples & pain there easier - 15th: Headach returned last night - Applir: Episfast 2o: temporibus - 16th P- nale: Blisters operd will Headch gone Dismissed restored - (11 Betty Tait Ot: 21st - Novr: 29th unmarried - Complains of Headach nausea Anorexia general pains & some Cough with pretty copius Expectoration; these pretty considerably attended with redness & swelling of the whole face to such a Degree as effectually to close up the Eyelids & the Cuticle in two or three places is raised up into vesicles that contain a thin watery fluid - p. 92. T. white & dry great thirst bad sleep & appetite; Skin hot & dry Belly & Catamenia regular; swelling of Face came on upon Tuesday last; febrile Compts: on Wednesday, knows no Cause nor has used any Medicine - Stat: Mittar: sang: e brachio ad ℥ix Incipiat quam peinum summare, Infus: Tamarind: ℥ij quaque hora ad alvi Sol: 30th: P - 96 & natl. Strength: on Tuesday Night had a cold fitts as which Time her Face was affected - Blood sizy; Face less swelld, 12) the Scalp is likewise painful; but does not appear red or swelld; Physic operated thrice after taking three doses Cap: Infus: Tamarind ℥ij 4ta q: hora - Complains of much thirst Capd: Potum Antiphlogist: pro potu communi - Decembr: 1st - P - 84 - two loose stools, swelling of the Face much diminishd, but the pain of the hinder part of the Head externally still continues, Repr: Infus: Tamarind: & potus Antiphlogist: - 2nd: p - 80 & soft, 2 loose stools pain & swelling much diminis'd - Repr: Infus: Tamar: et Ant - 3rd: p - natural swelling of the Face [illegible] diminihd but still complains of pain 1 loose stool, Repr: Infus: Tamarind: - 4th: Convalescent. Amittr Infus. - 5th: Convalescent - 6th: convalescent - 7th: ditto - 8th: convalescent - 9th: Dismissed cured - (13 Betty McDonald Œt 40 Married - Decr: 15th: is affected with severe headach Nausea Anorexia & debility attended by distressing Cough, difficult respiration, pain of the Breast & copius defluxion - P - 108 - T - white & parchd thirst urgent skin hot & dry Catamenia regular Belly very costive, she was attacked with these Complaints on the eighth Inst: & during the two preceding days had successive cold shiverings attributes her complaints to cold; about 3 weeks ago Fever was very general in the neighborhood where she lives had an Emetic on the 13th with no Relief stat injicn: Clyma Dom: - 16th: P. 116 & rather weak much expectoration, Glyster operated well, Tongue moist Capt: Solut: Tart: Emet: ℥j 4ta: quaque hora: Low Diet - 17th: P - 116 - & rather weak, after two doses vomited much & has purged 7 Times; Headch applict: Epispast: 2d: Temp: Capt: S.S. gxxv - forma Haust H: T: - 14) 18th: P. 112. Catamenia apparuère hod is rested better last night, Headach easier but the blisters have not yet operated. Repr. Haust: Anad. H: S: 19th: P. 108 - Menses evanuerunt post durationem unius horæ, Complains of Dyspnœa & pain of her side, Capt: Pulv: Jacob: ver grs: v form Bol: H: s & Mane Upr: Haust - u: a: - 20th: P 100; slight nausea after the Bol: last night & this morning & sweated much during the Night - 13th: day of the Disease, Belly costive Urine some Sedit: Injicr: Clyma domest Flat: Repr: Haust: H: T: Omittr Bol: - 21st: Had a plentiful sweat last Night & now easier, Urine with much sedt. - 14th: day - Repr: Haust: - 22nd p. 92: has been almost constantly sweating since the visit. Urine has much sedt. Repr: Haust: - 23rd: convalescent. 24th. convalescent: - Continues convalescent till 27th then dismissed Cured - 15) 16) 17) Mary Sharp Æt 26 A servt:t Married - Decr: 17th: complains of an acute pain attended by tension of the Hypogastric region with great difficulty in passing her urine & much flatulency - P - 104, Tongue & Belly natural Thirst urgent, appd: vad Compts: are of 6 weeks standing attributes them to cold when her Catama: were present, Has used several medicines with no advantages - 18th: P. 120 & rather weak; the Hypogastric region is tumified & sore to the touch, pain in the part when she walks; has neither pain nor difficulty in making her urine; Urine contains a quantity of mucus; the only Complaints she says is the pain in the lower part of the Belly which prevents her from lying on the right side; no pain down her Thighs nor Tenesmus nor Sollicitation to pass urine frequently - Low Diet - ꝶ: semen Sini ℥ss coque ex Aquæ Font: ℥xij ad ℥viij dein cola is adde Ol: Recin ℥j fiat Clysma Vespene injiciendum - Appr: Fotus Regioni hypogast: qua dolet. - 18) 19th: P 112: Kept the Clyster for some Homs os uteri non termet neque e, received much ease from these applications of Clyster & fotus tho pain has left the Hypogast: entirely & feels a pain at present under the short ribs of both sides which she thinks is owing to the preceding Vomiting - Urine much the same sediment as yesterday - Capt: S: S: ql: XXV former Haust H: T - repr: fotus - 20th: P. 100 no Complaints slept well Omittn: Repr: Haust: - 21st: P 104 pains under the short Ribbs on the right side which came on last Night & affects her breathing Applin: Emp: Epispast: part: dolent Omittn: Haust - 22nd: Pain gone Blister operatd well - no Complaint: - 23rd: convalescent 24th. convalescent: - 25th: continue 26 severe Diarrhœa since since our visit Capt: Slatim, Pulv. Rhei form. Boli - 19) 27th: Diarrhœa gone Cough with some Expectoration of thick Matter Capt: Julap: Scillit. ℥ss ter de die - 28th: continue 29th: P: 90 6 loose stools Omitt Julap: Scillit: Capt: Julap Mucil: ℥j 4ta: quaque hora. Capt: S. S: gr xxv for Haust H: S: 30th: P 120 & weak no diarrrhœa has nausea Capt Pulv: Emet: stat: Omittn: Haust: Anod. - January 1st: 1789 - P: 116 general pains Diarrhœa gone repr: Haust: Anod: & Julap: 2nd: P 116 pain under the short ribs of the left side the genl: pains gone repr: Haust: Anod & Julap: Mucil: 3rd: P 116 pain of left side continues; Appt: Emp: Epispast: part: dolent: Repr: Catua Remedia - Dismiss'd Cured - 20) Margaret McBean Œt 20 - A servt: unmarried - Decr: 16th: complains of headach great difficulty of passing urine; pain in the regi - of the Bladder with general soreness & debility; also distension of stomach at Times a sensation of Globis & frequent acid Eructations The Headach & dysuria occured on the 10th: Inst from cold whilst her Catama: were present - Complaints of her stomach are of considerable duration - P: 92 Tongue natl: Appetite bad; Belly loose has used a Draught & some aperient pills with Advantage - 17th. P: 92 & rather weak Urine with light sedt: had much vomiting the latter End of of last week, had a pain down the Thighs, in the uterine region, & in her Haunches since Monday & still feels pain, when the uterine region is press'd - appt: Fotus region: Uteri bis in dies, Capt: pulv: Rhei ʒss stat - Low Diet - 18th. P: 96 - Tumor Epigastric, Os Uteri tumor et dolet vomiting came on the 10th: & continued for 3 Days, much pain, in walking; the pain in the Hypogastric region was felt on the 15th: for the first Time; - 21 McBean - Physic did not operate, pain much easier Capt: Infus: Tamarind: ℥ij stat et Repr: 4ta: qq: hora, repr: Fotus Regioni Uteri u : a 19th. P:108 purged 5 Times pains much easier repr: Infus: Tamar: 6ta: qq: hora repr: Haust 20th P: 88 - Physic operated 4 Times Compts: almost gone Omittn: Remeda: 21st. P: 92: pain came on last night in the inferior part of the Abdomen & left side Inject: Clysma Domest: stat: Appr: Fotus parti affectæ - 22nd: pain continues the same Applir: Emp: Epispast: bene Camp: ponti Affectæ 23rd: P: 92 pain much easier, Blister not yet operated - 24th P: 112 & of natural strength, Blister Operated well; Belly Bound, some nausea Injecn: Clysma stat: Capt: Sol: Font: Emet ℥j emaquague hora usque ad Vomitum, 25th. P: 92 after 4 doses of the Sol: vomited - no Compt: but headach - Glyster operated well 5 loose stools after vomiting, Omitt Solut 26th. Convalesct: 27th. Dismissd Cured - 22) Betty Tait: Œt 14 Months - Januy: 9th: 1789 - was attacked on the 14th Current with the symptoms of fever; attended with some vomiting & diarrhœa which continued tice yesterday; On Tuesday there appeard a numerous Eruption of red spots on the face & all over the Body which at present are considerably raised above the skin & appear in some places to run into each other; Belly Natural takes the Breast well, bad sleep has used no Medicine Habeat Haust: Anod cum gr: is S:S: Hora Somni - 10th: P 101 face swelld, palpabræ likewise, pustules more protuberant & cohere, slept better, Belly bound - Injicn Clysma: - repr: Haust: Anod: - u: a - 11th: Face more swelld 8th: day pustules beginning to suppurate slept well Clyster operated well - Repr: Haust: Anod: u: a: 12th: Will not allow the pulse to be felt pustules contain Matter, but the Bases are not very florid; Spits more Belly bound; Injt: Clysma Stat: repr: Haust: Anod ꝶ: Ol: Recin Syr: Altha aa ʒj ♏ ƒ Capt: cras manæ - (23 13th: Pustules appear fully maturated slept well Belly not yet open, Si alvus non soluta sit repr: Ol: Recin: hora 3ta: P. M. ut antia Omittn: Haust: Anod & Enema -. 14th pustules drying breathes easily sucks well The Ol: Recin: operated once 15th Pustules more dry rested well, had a loose stool this Morning 12th: day Repr: Ol: Recin - 16th. 2 loose stools last night, pustules drying, physic has not operated to Day 17th: 14th: day - swelling of the palpatræ gone, physic operated thrice, pustules dry on the Face but contain fluid on the Extremities, Slept ill - 18th: Pustules drier; repr: Ol: Ricin 19th: repr: Ol: Ricin - u : a - 20th: Physic Operated twice continue 21st: Convalescent 22nd: Convalescent 23rd Convalescent - 24) 24th: convalescent - 25th: convalescent - 26th: Dismiss'd Cured - (25 Mary Nisbet Œt 17 - A Servant unmarried Jany: 1st: 1789- Has hedach, nausea, Anorexia pain of Arms & Back slight suffusion of Eyes some Deafness & much debility attended by Cough with rather difficult Expectoration; pulse 116 Tongue white & moist Thirst urgent, skin hot & dry, rests ill Belly costive, Catamenia regular, was attacked by these Complaints on the 27 rectt: & had cold shiverings on the two preceding days, says that about a fortnight ago she attended her sister pretty constantly who laboured under Fever; Has used an Emetic with no Advantage stat: Injn: Clysma Domest: - 2nd P: 120 and of natural strength; Glyster operated well, slept ill, pain of Head Shoulders & Back, Thirst Nausea at Times, Urine palv 7th: Day of fever. Capn: Julap: Camphor: ℥j 6ta: quaque hora. Injn: Aqua tepid: pro Clysmatæ - Appr: Epispast: ij Temporibus - 3rd: Pulse 120 & of nat Strength; Slept littæ Headch: easier & Blisters discharge well Glystr produced no Effect; much thirst, repn: Julap: Camphorat: repn: Enema ex aqua Tepid 26) statim et iterum vespere si alvus non prius soluta esset - Low diet - 4th: P: 112 & weak Delirium during the Night 9th: Day has had 4 loose stools tho she did not get the Clyster much Thirst, & very deaf. Urine high coloured & with a Cloud at Bottom, no sighing some slight Pelechia Eruption -. Omittn: Julap: Camph: - Capn: Mist: Cort: peruv: ℥ss 4a. qq. hora - Capt: Vin: Rub: port: dictum ℥q Aquæ Font: ℥j 4r: in Die Capt: L: L: q xxj Hora Tomni - 5th: P: 134 & weak has taken from Doses of the Bark mixture slept well; urine as yesterday Eruption disappearing Repn: Remed - u: a 6th: P: 136 & weak had a bad night & slight delirium; Belly bound; Capt: Vin: Rub: ℥iij cum ℥iss Aquæ quator in die - Repn: Mist: Cort: & Clysma in Aqua Tepia: Omittn: Haust: - 7th: Hora 7a: last Night, P: 120; Hodie P: 120 & weak; slept ill with slight Delex during the Night. Urine tumid 12th: Day (27 Tongue black & dry could not be prevailed on to take the Glyster & has not had a passage. repn: Med & Haust: Anod: 8th: Hora 8va: last Night Pulse 124 - hodie 116 & still weak; urine Turbid & has a very little sedt: at Bottom, slept much & was quiet during the Night; calls for small Beer to drink which is allowed her 13th. day Belly Bound has taken no Clyster repn: Omnia remeda: & Have at Cervisiam tenuem ad Libitum - 9th: P 116: Night quieter than usual has taken no Wine or Bark since last night Clyster operated well, much sediment in her urine, has drank 3 English pints of small Beer since last Night. repn: Haust & Clysma Hora Somni; Omittn: vinum & Mist: Corticis - 10th: P 108 & slept well 15th: day would not take the Clyster urine has no sedt: repn: Clysma & Haust: Anod: - 11th: Hora 7ma: last night; p: 96 to Day 108 slept well; symptoms all abated would not take the Clyster, repn: Clysma: 28) 12th: Convalescent. - 13th: P: 120 had a cold fit this Morning has a severe Cough & difficult Respiration slept ill. Capn: Julap: Mucil: ℥j 4ta: q: Hora Repn: Clysma Haust: Anod - 14th: Convalescent. Repn: Julap & Haust [illegible] 15th Continue - 16th: convalescent - 18th Had a voilent Fitt of vomitting during the Night Capn: Julap: Salin ℥ss 4ta: qq hora 19th: P 112 Headach: repn: Julap: Salin Abradatum Capiltitium - 20th Is a sleep but is said to be easier repn: Julap: u: a 21st: no sleep & very thirsty during the Night did not take her Draught repn: Haust. & Julap 22nd: no Complaints Omittn Remedia 23rd: Convalescent - 27th Let her have Meat for Dinner - 28th Dismiss'd cured - (29 Jane Ford Œt 16 - A Servt: unmarried - Decr: 22nd: complains of nausea headach anorexia, distension of the stomach at times, griping general soreness & debility, some Cough, pain of the Breast, difficult Expectoration & Dyspnœa Pulse 96, T white Thirst urgent, Skin hot & dry, sleeps ill Belly bound, Catamenia absent these 2 Months - was attacked with, these Complaints in their present form on the 18th: Cunt: & says she had frequent cold shivering during the three precedeing days, attributes her Complaints to cold - Has had an Emetic which did not operate - Stat: Infn: Clyma: domsest. - 23rd: P - 92: & weak Nausea and headach with pain of the Breast. Capt: solut: Tart: Emet: ℥j 4ta q. hora Low Diet - 24th: P: 96 some soreness which began before she took the solut: which produced no nausea; severe Headach, Cough & pain of the Breast - Omittn - solut: - 30) applicn: Epispast ij Temporibus Capt: S:S: gr xx from Haust: hora Somni nie non Capt: Julap Mucil: ℥j 4ta: quaque hora. - 25th: P: 88 No Compt: repn:n= Julap - Omittn: Haust: Anod- Blisters opd well 26th Convalescent - 27th: ditto - 28th: P: natural pain in her side applicn: Cucurbitt cum ferro - pont dolent: 30th: ℥iv Blood got by cupping - pain of her side gone 31st: Convalescent: - continues convalescent till Januy: 4th: then dismiss'd cured. - 31) Cullen Clark Œt 4 Decr: 20th: is affected with severe Headach which is attended by frequent Tremor vomiting emaciation & debility; has also some swelling of the upper Lip and is observed to pick his nose & grind his Teeth frequently - On both Legs & left arm are seated some soft tumors which are unattended by pain - at Times he is observed to be very [crossed out] cheerful but for the most part is dull & torpid. P. 100 Tongue natural, no increasd thirst, Appd: bad sleeps ill Belly costive urine diminished in quantity - Complaints of a fortnights standing & the Tumors on - the Extremites are of about 7 Months - Labourd under similar affections of the Head about 4 Months ago for which he took two Emetics & a purge & appeared to have been cured, had used at present an Emetic & a purgative without advantage no scrophulous symptoms appear in his parents - ꝶ Merc: dul: grs: iij Conserv: Rosar: q: L. [illegible]: Bol: Cap:n Hora Somni Middle Dick - 32) 21st: P: 96 and regular no squinting , no swelling nor pain of his Belly even on pressure - no pain in the middle part of his Neck, no dilation of the pupils no convulsive fitts - Vomitted at 2 different Times since he came In the House; [crossed out] The Headach appeared first & the vomiting about a week afterwards & about the same Time his Belly became costive , his nose appeared more dry than usual for 3 Days past - purged twice seems to have vomited some part of his Bolus - Apptn: Ung Merc: ℈i inferioribus ꝶ tremis: per frictionem Mane & vespene - ꝶ: Caloml: ppt: grs: ij Conserv: q: s ƒ Bol Capt: Hora Somni - 22nd P - 104 pupils dilated had some vomiting last Night did not take his Bolus Repn: Ung Merc: & Bol: ut antea - 23rd P: 124 Headach violent during the night; vomitted none has taken both Bol & purged thrice omittn: Bol: Appn: Ung: merc: ʒss hora somni & mane - Let him eat what he will (33 24th: PP: 116 No passage of his Belly, no affection of his Mouth from the Mercury no Vomitting; & Headach less severe. Repn: Ung Merc; ut a: repn: Bol: ex Merc: dul: H: L: & et Antea - 25th: P 116 pain in his teeth, no vomitting & headach easier two loose stools - Repn: Ung: Merc: Omittn: Bol: 26th: P 112: no vomiting headach easier & fitts of is less severe & frequent had a loose passage yesterday at Noon, Complains of pain in his Mouth & teeth pupils still dilated, breath has a bad smell repn: Ung: Merc: ℈i hora Somni & hume 27th: P 122 much headach during the Night spitta a little last night but none to day two loose stools repn: Ung: Merc: - 28th: P 112 Headach severe one loose stool Tongue swelld - Abradatur Capillitium, stat: Applicn: Emp: Epispast: bene Camph: Capiti. repn: Ung Merc: u: a - 29th: P: 120 Blister discharges well, has salivated since 6 p: m: yesterday Mouth very sore; no Vomiting nor Compts: of his 34) Head; purged twice Omittn: Ung Merc: 30th. P 132 much vomiting last Night pupils less dilated Heachach easier; Belly open Nose discharges naturally salivates much & mouth sore - 31st: P: 132 some headach but no vomitting Belly open; Mouth in the same state & but little spitting this Morning; pupils more dilated; Head still discharges - Januy: 1st: 1789 - P 134 pupils much dilated salivated none for these 24 Hours; purged 7 Times - Appn: Ungt: Merc: stat: & repn: ocas mane - 2nd: P 124 no spitting Headach less & no vomitting 3 loose stools. repr: Ung: Merc: u: a - 3rd: an Eruption like that of the Measles was observed last Night but no watering of his Eyes has been observed; only a slight Cough & sneezing Mouth sore spits none 2 stools - repn: Ungt: Merc: u: a - 4th: P: 124 Erupn: in the same state; Headch: a little easier some Cough & sneezing; Mouth waters & Tongue sore Capt: Julap: Mucil ʒij 4a: q: hora - 5th: Continue, 6th: ditto - 7th: Headch: much less pain of Belly - Repn: Ungt: (35 Clark - Jany: 8th: 1789 - Had some headach during the night, no spitting repn: Ung: & Julap Mucil: - 9th: continue. 10th: continue - 11th: Much headach & some vomiting; Belly open repn: Ung: & Julap Mucil: - 12th: Continue. 13th: Continue. - 14th: Continue 15th: Omittn: Ungt: 16th. Symptoms thus amœ 17th. P 110 had two convulsive fitts which lasted each about 5 Minutes, in which fitts his Head & Extremities were much agitated. Complains of his Head - repn: Emp. Epispast Capiti - 18th: Headach easier; Blister does not discharge has not yet been removed 19th: Continue - 20th: Blister does not discharge, Headach easier, no vomiting - 21st: Continue - 22nd: Eruption over his skin which was discovered only to day - P: 120 Capt: Julap: Salin ʒj 4th: qq hora 23rd: Eruption drier seems easier continue - 36) 24th: Convalescent - 25th: Symtoms as usual - 26th: continue - 27th : continue - 28th: Dr Horne dismisses this patient cured of Hydrocephalus - From the present state of this Child it - would appear that some of the most alarming symptoms are abated; the Dilatation of the pupils & dryness of the Nostrils are not so considerable, but he is not perfectly freed from the former & has frequent starting in his sleep with an extreme Emaciation of the Body - (37 Ann Smith Œt 23 Unmarried - Jany: 15th: Complains of severe headach nausea some vomiting & general pains, particularly in the lower part of the sternum increasd in Inspiration - some Cough P: 120 Tongue clean, some Thirst, bad sleep & appetite, Belly & Catamenia regular - was attached on the 8th: cont:, Attributes her Complaints to cold, Has used no Medicines - 16th: P: 128 & rather weak, nausea & vomiting, & Contents of her stomach Acid - Capr: Sol: Tart: Emet. ℥j - 4ta: qq: hora - Low: Diet - 17th: P: 124 & rather weak every dose produced nausea & vomiting & gave her 8 Stools ꝶ: pulv: Jacob grs: v - Opii grs: i Conserv: q: s ft Bol: Capt: H: L - Appn: Fotus inferior = extermitatibus stat & vespene per Semihor: - 18th. P. 128 & of nat: Strength; slept better, Belly very bound, Injicn: Clysma. Bolus had no sensible Effect - repn: Bol: H: L & Mane repn Fot: has some slight Eruption on the Skin, 38) 19th: P: 132 & of natural strength; Erupn: in the same state; Bolus produced no sensible Effect; 3 loose stools sweated a little after her Legs were fomented; Severe headach Apptn: Emp: Epispast Tempi; repn: Fotus & Bolus u: a. 20th: P 108 [crossed out] Eruption diminishing 13th: day, Urine turbid, Blisters discharged well, Headach easier coughs some slept better 3 loose stools Omittn: Bol: & Fot: Capn: S: S: gr xx form Haust: H: L - 21st: P 108 Two loose stools this Morning slept ill from the Cough Cap:n Julap: Mucil: ℥j 4ta: qq hora Cap:n S: S: gr: xxx H: L: u: a - 22nd: Slept some continue 23rd: P: 84 severe looseness - rep: Haust: - 24th: 3 loose stools P: 86 repn: Haust: - 25th: Continue - 26th: Convalescent - 27th: Convalescent - 28th: Dismiss'd Cured. - (39 Elizabeth Innes Œt 17 - unmarried Jany: 2nd: 1789 - Complains of Headach vomiting frequently the Contents of her stomach which are acid; occasional distension of the Epigastric region, Griping & much flatulency; Cough pain of Breast; Dyspœa & pain about the region of the Bladder at Time - Pulse 108 - Tongue white much thirst appetite bad, Belly regular Catamenia have been absent these 12 Months - Complaints have been present these 6 Months & much increasd within this Month; Knows no Cause has used no Medicines - 3rd: Pulse 120 & rather strong in the right Arm flushing in the Cheeks at Times & feels herself remarkably hot - Fiat V:S: ad ℥viij et Capt: picto: Emet: Vespene Applicn: Vapor Aquæ Tepid: naturalibus - Low Diet - 4th: Pulse 124 & of natl Strength about ℥iij of Blood only got from Both Arms - Blood in a natural State - Vomit operated well 40) stomach foul & has now less nausea no Complaints but swelling of her Stomach after Meals, Much Thirst - repn: Vapor Aquæ 5th: P: 110 and of natural Strength no Nausea to Day - Capt: Pulv: Rub: Tinct ʒss ter in dies - repn: Vapor Aquæ - Applicn: regioni Uteri Sinimt Simp: ℥ss Hora Somni - 6th. The powder produced no sensible Effect repn: pulv: Rub: Tinct: Ungt: & Vapor 7th. Vomitted her Medicines repn: Mede. 8th. P: 104 has not vomitted her Medicines Capt: pulv: Rubœ Tinct u: a. - 9th: Vomitted the powder. Capt: Pulv: Rub: Tinct ʒss forma Bol: ter de die 10th: Has no vomitted her Bolus repn: Bol: 11th: Pulse 96; Stomach swells every Night about 5' OClock & continues so for two Hours & then goes off without any appearance of flatulence: no vomiting & most of her other symptoms have disappeared; repn: pulv: Rub: Tinct. grs: XLV form Bol: ut antea - (41 12th: Complaints the same repn: Rub: Tinct: ut antea Omittn Vapor: - 13th: Complaints the same, no Effect from the Medicine, Capl: pulv: Rub: Tinct: ʒj form: Bol: u: a: - 14th: symptoms the same, no Effect from the Medicine repn: Rub: Tinct: u. a 15th: Examinatio per tactum prœbet nulrum signum uteri impregnati we learn Catamenia apparuerunt here vespere - ꝶ: Fol: pulegii ℥ss Aquæ Bullient: ℥viij infunde per horas octo Capt: ℥j quarter in die - 16 - It appears that the report of the Catamenia's appearing yesterday is groundless Omittn: Infus: puleg: repn: Rub: Tinct: u: a 17th: Medicine produces no Effect continue - 18th: Continue her Medicine 19th: No Complaints; But Amenorrhea not removed, omittn: Rub: Tincts - 9 ꝶ: Pulv: Savin ℈i Conserv: grs: ♏ ƒ st. Bol. Capt: H: L: & Mane - 42) 20th: Capt: Pulv: Sabin: grs: xxv. u. a 21st: Felt Nausea after the Medicine Capt: Pulv: Sabin grs: xxx u: a 22nd: Continue - 23rd: Vomited the Bolus this Morning repn: Bol: u: a - 24th Continue 24th Vomited twice repn: Bol: u: a - 26th: continue - 27th: Vomited her Bolus - Omittr Bolus ꝶ Mere: dul: grs: vij Conserv: q: s: ft: Bol Capt: Hora somni - 28th. Bolus had no sensible Effect - repn: Bol: H: L: - ꝶ: Die: Cocciœ ʒss divide in pie: e: Capt: cras mane - 29th: Pills have had no Effect yet Omittr Bolus - 30th: The pills purged her thrice yesterday but no appearance of Catamenia Flat: Compressio Arteriæ Cruralis per duem minuta vespene - (43 Innes - Jany 31: Complains that the Compression produces a numbness of the Leg compressd & some nausea & gripes afterwards repn: Compressio u: a - Feby. 1st Complains of a pain in her Back & Head - P. last Night before Compression 104 & continued the same tho a little weaker during the compression, in two Minutes after the compression was removed, P: was 140 - Omittr Compressio Eliciantur scintillæ Electric: ex Inferioribus Extremitatibus - 2nd. Catamenia have not appeard but her general Health much restored Dismiss'd - 44) (49 Henry Grindley Œt 22 - A Brewer - Novr: 17th. - On the 11th: Current was attacked with the Headach, Anorexia, general soreness with dry Cough & pain of Breast which continued untill the 15th: when he was seized with a cold shivering which has continued more or less ever since with the aggravation of all the other symptoms - P - 106 - T. white but moist much thirst bad sleep no appetite, B - bound skin hot great tremor of his Hands used no Medes. - Capt: Solut: Tart: Emet: ℥j 3tia quaque Hora usque ad Vomit: incipiens statim - 18th - P - 108 and weak, tremor of the Tongue as well as of the Arms, 8th: Day some delirium during the night & at present not quite distinct no Headach but pain in his chest when he 50) after the 1st: and second Dose he vomited & purged but no effect from the 3rd & 4th: no sweat nor signing, slept in the Night - ꝶ: Pulv: Jacob: ver: grs: v Conserv: q: s: ♏ ƒ et ft: Bol Capt: H: S: et repesr mane - Low Diet - Applicn: Fotus Inferioribus Extrumets: statim per semihor: et repesr: h. s & mane- 19th - P - 120 and weak not alterd during the fomentation delirious during the night, Urine thick, a small pale eruption over all his skin; Bolus produced no sensible Effect, severe Cough; Repesr: Pulv: Jacob: grs: viij in forma antea præscript - Capt: Julap: Mucilag: ℥j 4ta: quaque hora, repesr: Fotus ut antea 9th. Day - 20th - P - 120 & weak slept well sweated much during the Night & is still (51 sweating; got a Clyster which operated well, urine of a reddish Color - Repesr: Bolus ut ant: Capt: Vinum Domest: ℥ij 5ta: quaque hora. Repesr: Fotus - 21st - Pulse 130 & weak; 11th: Day difficult respiration this Morning; much thirst, Belly bound, slept much at Times during the night no visible effect from the Bolus; urine high colored, Eruption the same state; Injuir: Clysma domest: stat: applin: Epispast 20: Temporibus; Capt: Pulv: Jacob: ver: grs. xij form: Bol: H: S & mane. Repn: Fotus & Vinum ut antea - 22nd - P - 136 & weak, quite insensible, the white of his Eyes of a red Colour, very delirious during the Night, the Bolus produced no sensible Effect; the Glyster & Blisters operated well; urine of a natl: colour; Eruption less; Capt: Vin: Oporto ℥iv sine aqua stat & repesn: 4ta: quaque Hora - Appn: Epispast bene camphor: intra Scapulas stat: omittn: Bol: & Fotus - 52) 23rd: - P - 140 & very weak; has taken a Bottle & a quarter of pure port since the Visit much more distinct Respiratn: laborious, the Colour of his eyes the same; the Eruption never appeared above the skin are now of a pale being at first of a red colour; sleep much, urine & stools passed insensibly; Clyster & Blister operated well; stools not fœtid; tis of a pale colour; sweat over his Head & Feet dry - Repesr: Vin: ut Ant: Appn: Brach: 13th: Day: Capt: Mist: Cort: persv: ℥ss 4a: quaque Hora - 24th - P 150 & very weak nearly insensible since the visit; Blister operated well & has taken Mist, Cort: & wine, some degree of subsultus Tendinum, Repn: Vin: & Mist: cort: Capt: Julap: Mosch: ℥j ter in die - Died the 25th: 74 before 12 - a.m On openg. the Body a great deal of Blood effused between the Muscles presented itself & a good many spots which appeared to be the Effects of Inflamatn. appeard on the peritoneum & Intestines, nothing use preternatural in any Cavity - (45 Jas: McKenzie Œt 30 a Labourer - Decr: 12th: Complains of severe headach Anorexia, general pains & debility Accompanied by some Cough & rather difficult Expectoration: P. 120 Tongue white but moist, Skin hot & dry, increas'd thirst, Belly rather costive; these compts: supervened on the 8th: Currt: & were preceded by frequent cold shivering knows no cause: Laboured under similar Compts 3 Months ago, from which he perfectly recover'd; used no medicines - 13th: - P - 100 & rather strong Urine natl: pain of the breast increasd, & much worse when he Coughs a natural stool during the Night, Fiat: V: S ad ℥ix Capt: Julap: Mucil: ℥j 4a: q hora - Low Diet - 14th: - P. 100 & of natural strength blood natural, urine made last night has some sedt: general pains easier but not his headach. Belly bound slept little cough the same: Injicn: Clysma Donust slat - 46) Capt: Sol: Tart: Emet: ℥j 4ta q hora - Omittn. Jalap: Mucil: - 15th: No Effect from the Solutn: but two loose stools - P - 84 slept tolerable no Compts: urine with sediment - Omittn: Solut: - 16th: P: 84 - pain of his Breast & Cough with very little Defluxion - Repn: [crossed out] Julap: ♏︎ - 17th: P - natural no Compts: continue 18th: Convalescent - 19th: Convalescent - 20th: convalescent allow him some meat 21st: convalescent: 22nd: no Complaints - 26th: P: 104 pain of breast sides & Bones with Headach: p 104 - & strong. Fiat V: S: ad ℥vij Repn: Julap Mucil: 27th. p 92 & of natl: strength, Blood in a natl: state Headch: easier pain in his side the same Cough no better Repn: Julap Mucil: Applicn: Emp: Epispast intra scapulas - 28th: pains except those in his right Side easier Blister operated well repn: Julap: a. a (47 29th: P: natural convalescent - 30th dismissd Cured - 48) (33 Archibald Martin Œt: 63 a painter - Novr: 13th - Has frequent dejections of a whitish & sometimes yellowish matter without any mixture of Blood; accompanied with Borborygmi Gripes & slight Tenesmus at Times; says that he sometimes passes the contents of his stomach quite unchanged; complains also of frequent Cough with copius Expectoration, P - 80 - T - clean little Thirst good appetite rests ill from the Diarrhœa which is worse during the Night - Diarrhœa of 4 Months Standing, Cough only of one; knows no Cause; has used some Medicines both in a liquid & a solid form without benefit - Capt: stat: pulv: Emet: et cras mane Pulv: Rhei ʒss - 19th - Pulse 100, vomit operated well; Rhub: had no Effect but stools loose & yellow - 20th Pulse 140 & weak was seized this Morning with a fluttering about his Heart 54) which he has had before, 3 loose Stools this Morning - ꝶ: Extract: Campechens ʒ ss Sal: C: C: grs: iij ♏ ƒ ft. Bol: Capt: Statim & repesr: H: S & mane - 21st No purging pulse 86. Cough continues, Repin: Bolus ut ant- Capt: Julap: Mucil ℥j 4ta: quaque Hora - 23rd. Diarrhœa gone pulse 90, cough continues; Repn: Julap: Mucil: Omittn Bolus - 24th: Looseness returned; Repn: Bol: ut ant: & Julap: Mucilag: 25th - Pulse 100 - 5 loose stools, before & during which he feels some pain in the abdomen but without Tenesmus Repn: Bol: quater in die & Julap Mucil: ut ant: - 26th - P - 100 - 6 stools, Omittn: Bol: Capt: Mist: peruv: ℥ss 4er: in dies; Steak for Dinner Daily & a Bolus Porter - (55 27th: 7 loose stools, Repn: Catex - ut Ant - 28th - Purging same Repn: Cort: ut ant - 29th - 5 loose stools - Repn: Medical - 30th 6 loose stools - Repn: Cortex - Decembr: 1st. 5 loose stools; Repn: Cortex - 2nd: 4 loose stools; continue - 3rd: 3 loose stools, continue. - 4th: 3 loose stools; continue. - 5th: - Pulse 96 - 13 loose stools, Omittn: Cortex. w: Pulv: Columb: ℈i Capt: pro dosi et Repesn: quarter in dies - 6th: no purging - 7th: continue 8th: 1 loose stool continue; 9th: Only one stool; Repn: Medica: 10th: 5 loose stools Omittn: pulv: - 11th - no Diarrhœa - 12th: 5 loose stools Repn: Columbo u: a: - 13th: 3 lose stools; has taken but two doses of his Medicine Repn: Columb: u: a: - 14th - P - 96 & weak 6 loose stools - Repn: Columb: quater in dies u: a: a Bottle of porter a Day & ℔ij Beef Tea. 56) 15th: P 100. 4 loose stools & sometimes attended by pain - Repn: pulv: Columb: u: a et alia Remedia - 16th: 2 loose stools continue - 17th: P - 104 - 4 loose stools. Repn: Pulv: Colum 18th: P. 108 - 4 loose stools; omittn: pulv: Columb: & Haust: ꝶ: Confect: Japon: ʒij solve in Aquæ Font: ℥vj deinde adde S: S: gr: LX Syr: Althæ: ℥ss ♏ ƒ Capt: ℥ Coch: mag: post un am quamgue Dejectionem - 19th: P 108 Diarrhœa gone Repn: Remeda: 20th: P 112 - only one stool - Repn: Remeda: 21st: 4 loose stools contue. 22nd 2 loose Stools 23rd: - Had 1 loose stool & deserted the House (57 Wm: Hargrove, Œt: 24 a sevt: - Novr. 10th - Complains of Headach, Nausea Anorexia general debility & great oppression has also frequent Cough - Pulse 90 T - white but moist, appetite impared, B - regular sleeps ill complaints of 3 days standing & attributes them to drinking porter when in a great Heat, from Exercise has had 3 Emetics - 11th - P - 96 & soft is not sensible of having received any infection sleeps little complains for 2 Days of a pain in his Throat no headach, Delirium through the night. Capt Julap: Mucilag: ℥j 4ta quaque hora - 12th - Four stools since the Glyseter, slept since 7 oclock a.m. Capt: Mist: Cort: peruv: ℥ss 4ta quaque Hora, Repitn: Julap: Mucilag: - 58) 13th - P - 90 and weak 2 loose stools, delirious during the Night but slept calm this Morning 7th: Day of the Fever, urine pale - Repetn: Medicamenta 14th - P - 90 & weak 5 loose stools delirious during the Night, but upon the whole slept better - 8th: Day - Repesn: Mist: Cort: peruv & mist mucil. - 15th P - 84 - 3 loose stools sleeps much, Urine pale - Omittn: Mist: Cort: peruv - 16th P - 106 - seized yesterday with violent pain in the region of his stomach for which he got directly 20 Drops of Laudanum which relieved the pain immediately, but it recurr'd again about 4 oclock this Morning for which the part was fomented and he was eas'd (59 The pain he feels in round the Umbilicus and is increas'd on pressure - Two loose stools, much thirst & heat of his Mouth, urine of a light straw colour with some Clouds among it Applicn stat: Emplast: Epispast vene comp: parti dolenti Capt: Statim: pulv: Rhei ʒss - 17th - P - 104 and weak 11th: Day, Delirium during the Night, Urine pale much thirst, pain of the Abdomen diminishd & the parts rather softer; Blister operated well, 2 loose stools, one yesterday another to day; no sighing, hands tremble much, takes no food, has desire for Porter, let him have a Bottle daily - ꝶ: pulv: Jacob: grs v Conserv: rosar: q: s ft: Bol Capt: H. S a Bread Berry with 2 ozs: Wine & sweetened with sugar for Dinner - 60) 18th: P - 90 & weak slept but little, had delirium through the Night; 1 loose stool since visit sweated on his Body but not in legs for 2 Hours after the Bolus - Let him have 2 Bottles of Porter daily; Repetn: Bol ex pulv: Jacob: vero: H: S: ut antea - Capt: Vin: Domest: ℥ij quater in dies 19th - Pulse last night 120 the same to Day & weak, but cold during the Night a moisture on the Head & Breast: a Hicup & Bilious vomiting almost constantly since the visit; Delirium during the Night Bolus produced no Effect; Glyster orderd last Night had good Effect - Abdomen Tense; complains of pain in the stomachic region; passes much flatus with the Glyster - Capt: Julap: Sal in ℥ss S: S: gr: x - 5ta: quaque hora, donce vomitus cessat: Applicn: Epispast (61 19th: William Hargrove Applicn: Epispast: regioni Ventriculi, ꝶ: Flor: Chamomil: ¤ss coque in Aquæ fort: ℥xij ad ℥ viij cola et adde ol: Oliv: ℥j - f: Enema stat. injicund - Habeat: Vin: Rub: ℥j cum Aqua ℥ss 4ta: quaque Hora - 20th - Pulse last Night 130 - to Day 126 & very weak; vomiting continued till Evening of yesterday before which he had taken 3 Doses of his Draughts; Delirium during the night Clyster came away without fæaculent Matter & brot: off much wind; Blister open = well & pain easier; frequent Hicup, takes no food & but little Wine - Repn: Clysma & flor Cham: Repn: Julap: Salin: ut ant & Vinum - 21st - P - 120 - & somewhat stronger slept well B - still tense, 3 loose stools & of a dark brown colour; retaind the Clyster for an Heron & pass'd it without much flatulence 62) ꝶ: pulv: Rhei: - Semen: Cordiand: āā ʒss ♏ ƒ Capt: stat - Repetn: Vin: ut ant: & omittn Julap: Salin & Clysma - Capt: S: S: gr: xxx forma Haust H. S - Died this Evening 63) Alexr: Moir Œt: 58 - A Mason - Novr: 9th - The whole Abdomen is occupied wt: a colourless & somewhat elastic swelling but attended with rather indistinct Fluctuation - The lower extremities are affected with a considerable degree of Œdema; the upper extremities& face are much emaciated, with general debility & the skin is tinged of a yellow color the appearance of which last he cannot asscertain - Pe. natural, Tue. foul & Black with increas'd thirst, appcn: little impaired; Belly slow fæces whitish urine high coloured & scanty rests tolerably - The abdominal swelling came on about [crossed out] 9 weeks ago that of the extremities three weeks after Has used Cremor Tartari: scilla & Digitalis before admission & got a dose of ol: Recini. without benefit - 10th - Pulse 60 & weak has taken of the 64) Crem: Tart for two weeks before admission a Tea spoon ful three Times a Day in Treacle, three doses of squills & as many of Digitalis - an evident fluctuation felt in the abdomen & the right Hypochondrium appears somewhat tumified but no pain felt on pressure; Tongue foul urine very turbid of slight red colour & not above an english pint a Day. - lies with most ease on his left side - ꝶ: Cryst: Tart: ¤ss solve in aqua tepid ℥xij - Capt: Cras summo Manln Nu non Capt: Pot: Antiphlogist: pro porti communi - Middle Diet - 11th P -68 - has had 3 loose stools - says he thinks his Compts: arose from laying down on the cold ground on his Belly at different Times - Repesn: Solut: Cyst: Tart: cras mame ut antea, & potum Atiphlogist: Steak for Dinner - (65 12th - Pulse 66 - Urine very turbid, measures half an inch less round the Abdomen Medicine operated twice Repetn: Medicamenta - 13th: 3 loose stools, urine in the same Quantity - Repetn: Cryst: Tart: ut antea Capt: gin punch ℥viij in dies - 14th - 2 loose stools urine the same size of the Belly fall'n an Inch more Continn: Cryst: Tart: ut ant - 15th: One loose stool - Repetn: Cryst: Tart: ut ant 16th - Belly increasd an inch: urine ℔iiss 2 loose stools - Repetn: Cryst: Tart: ut ant - 66) 17th - Main sleeps none on acct: of severe Cough 2 loose stools Repetn: Cryst: Tartar - Capt: S: S: gt: xx H: S: forma Haust Take Broth for Dinner - 18th - Purged 5 Times yesterday - Repn: Cryst: Tart: & Haust: Anod - 19th & 20th: symptoms same 21st - Purged 7 times- Repn: Crystal: Tart: - 22nd - purged 9 times repn: Cryst: Tart: - urine ℔ij & ℥ij - 23rd - Purged twice; size of the Belly & Legs increas'd; urine reddish & amounts to ℥ij a day Omittn: Cryst: Tart: - 24th: 4 loose stools after the visit yesterday Urine ℥ij 74 & lets fall much Sedt: - (67 25th. - Marr. No purging complains much of Debility & pains over the abdomen: sleeps but little Continue the Anod Drat: - 26th - Dismiss'd by his own desire 68) (69 David McDonnald Œt 42 Jany 21: 1789 - Complains of severe Headach Anorexia, General pains & great debility with much oppressions & Cough with copious Expectoration; has also sinnitus aurium & great Tremor of his Hands - Pulse so quick & fluttering that it cannot be counted; Belly very Bound, Tongue white great Thirst, sleeps none; was taken ill on the 14th Currt: knows no Cause, Has had an Emetic with some Relief & a Blister to his Belly for pain there Injicn: Clysma Domest: vespene & Capt: ꝶ: Pulv: Jacob: grs: v Opii grs: i Conserv: q: s ♏ ƒ ft. Bol - 22nd: P: 160 & very weak, sleeps tolerably well urine turbid & has deposited much sedt: no pain of Belly for a Clyster last night which operated well, had a sweat which was general through the Night, but mostly on his Head - complains most of weakness has some desire for Wine Capt: Vin: Rub: Port ℥ij cum Aqua ℥j 4ta: quaque hora, 70) Capt: Mist: Cort: peruv: ℥ss 4ta: quaque hora Nu Non Habeat Jusculi tenuon: ℥iv ter de die - Hora 3ta: P: M: pulse scarcely perceptible ꝶ: Tinct: Serpent: Virg: ℥ss Aquæ Cinnamom: simp ℥j Syr: Simp: ʒij ♏ ƒ ft: Haust Capt:n Stat: & repn: H: S: addendo S: S: g xxv 23rd. Pulse felt at the Heart sometimes 184 & at others 200 but so weak in the Arm that it cannot be felt; slept none the draught produced a great Heat in his stomach, gentle delirium all Night & at present, Clyster operated well, Urine turbid 10th: day complains of general pain reaching over all his Body - Capt: Vin: Rub: ℥ij 2die: q hora repn: Mist: Cort: peruv: Applicn: Emp: Epispast inter scapulas stat - Omittn: Haust; ex serpent: Ung: 24th: Pulse cannot be felt - slept 4 Hours, delirious during the Night, 11 day sweats much Blister operated well, Eruption in, (71 Eruption in the same state, Urine turbid & with some sediment but has pass'd none since 6 neri p: M, has taken but two doses of the Bark Mixture, Has taken 3 ozs: of wine every two Hours repn: Vin & Mist: Cort - Applicn: Sinapismi pedibus - 25th: Hora 8va: last Night pulse as in the Morning ꝶ: S: S: g: xxx Aquæ Cin: ℥j ♏ ƒ & fiat Haust: Capt: H: S - Hodie P: 140 & intermits some Times & is as strong as when he came in, slept much during the Night & had some delirium the sinapisms becoming uneasy were removed in an Hour & his Feet were a little inflamed; Clyster of ℔i of water & ℥ij of oil operated last night well; the urine was obliged to be drawn off by the Catheter & amounted to near ℔ij & contained a little sediment. Got a Bottle of wince since the [crossed out] visit; Abradatum Capillitum & Appn: Empt: Visic: Amp: & bene Camphorat: Capiti - 72) repn: Vinum ad libitum & mist: Cort: peruv: 12th: day repn: Haust Anod Eruption gone - 26th: P: 124 & little below the natural Strength much delirium during the Night has been in a comatose state since 4 a: M: Belly bound ℔ij of urine drawn off by the catheter yesterday & appears natural Blister discharges well has taken ℥ xxxiv of Wine since the Visit & 4 doses of Bark Injicn: stat: Clysma Domest: repn: Remedia. Educatum Urina stat: 27th: after the Visit ℔ij of urine was drawn off - the rattles which he had in a small degree increas'd & at of past 3 oclock He died - (73 Abigail McDougal Œt 32 married - Novr: 11 - Complains of violent acute pains in all the joints of the upper & lower Extremeis: shooting down along the course of the muscles & sometimes to the small of the Back - some swellings of boths Knees & left ankle - P - 100 skin Hot but moist T - clean, some thirst, no sleep appd: impared - B - very costive supposes herself with Child, as Catamenia stopd 9 weeks ago - was first siezd on the 5th. Cents. - Attributes her compts. to cold has used no medicines - stat. Injicn. Clysma Domest: - 12th - Pulse 90 natl Strength swelling has left the left ankle, Back of the left hand a little red & swell'd - 74) pains more severe when not in Bed - 8th: day of disease, pain of shoulder much worse, sleept none for four Nights, sweats always during the Night; very thirsty Fiat. V: S: ad ℥x ꝶ: sal: Sedat: stomberg ℥ss Syr. sacchar: q: s - ut f: Bol H: S. sumend - Capt. Potusn: Antiphlogist: pro potu commence -Low Diet - 13th Pulse 90 - same strength as yesterday Blood very sizy: pains easier some sediment in urine, slept better, B - bound, Injn: Clysma domest: stat: Repr: Bol & pot: Antiphlogist. 14th. Pulse 96 & rather strong urine turbid pains easier but attacked no Knees last (75 14th last Night which are not swelld the swelling & reds Hand diminishd Repr: v: s: ad ℥ix - Conts: Bolus - 15th Pulse 96 & rather strong, Blood very sizy pain in her Knees & Ankles, as likewise in the muscles of the intervening parts; the urine made last night with some sedt: that of this morng: turbid - Belly Bound - Injicn: Enema Domest - Repetn: Medicamenta - 16th - P: 92 & rather strong, complains of pain in both shoulders, Glyster operd: well Repr: v. s ad ℥ix et antea præscript: Medical - 76) 17th - P - 82 & of natural strength, urine turbid, Blood very sizy, pains all gone as likewise the swellings; sweats frequently during the Night. Omittn: Bol: sal: sedat: Hombag: 18th - P - 90 - was attacked during the night with severe pains in the Knee & Elbow joints but the pains are gone off after sweating plentifully; Urine deposits much sedt: ꝶ: pulv: Dov: ℈i Syr: q: s. f Bol: H: S sumend - 19th - Pulse natural, a sweat appeard half an Hour after she took the Bol: & has continued general till this Time; no pains complains of weakness. a little, Table Broth & steak for Dinner, Omittn: pulv: Dov: - 20th - The sweat contind: all Day yesterday & all Night; feels still some pain in (77 20th: McDougal - Knees; Urine turbid & has little Sediment. Repn: Bolus: H: S - 21st: Had nausea after the Bolus & sweated much all night no Complaints but weakness Urine turbid - 22nd- Pulse 80; pain in her left wrist; Urine with sediment - 23rd Convalescent - 24th: the same 25th: ditto - 26th: Do - 27th- some pains in her Knees & left arm during the Night - 28th- Convalescent - 29th: ditto - 30th- ditto - Decr: 1st- continues convalescent & dismissd cured the 5th. - 78) Catharine Wyatt Œt 17 - Unmarried a Servt: & pretty Girl Decr: 11th on several parts of the superior & inferior Extremities & small of the Back is scated a dry scaly Eruption which is not scaly or itchy at present; but says at Times it is very much so, it frequently falls off & soon again assumes its former appearance, Functions natural, this Complaint is of 2 Months duration, it first attacked the right Elbow & continues to spread used no Medicines - 12th: - ꝶ: Merc: Dulcis Sulph: Antim: præcip āā grs ij Conserv: Rosar: q: s: ft: Bol - Capt: Hora somni - milk Diet 13th: Medicine produced no Effect Repn: Bol: H: S: & Mane - 14th No Effect from the Medicine Continn: - Remed: 15th: Eruption less & drying Continr Remedo 16th- continue (79 17th: continue - 18th: has a brassy taste in her Mouth spitts a little & Teeth a little loose sweats none, Eruption better Omittn: Bol: - 19th. the Effects from the Medicine continue. the Eruption better - 20th: no Spitting Eruption disappearing Repr: Bol: u: a: - 21st: Repr: Bolus u: a: - 22nd: Erupn. going away repr: Bol: u: a 23rd: continue. 24th: Catama: adsunt Omittn Bolus - 26th: Catamenia adhere remanent - 27th: The scent has left her Arms & in some degree continues in her Legs Catamaia: disparuerunt - repr: Bol: u: a - 28th: Bol: produced no sensible Effect repr: Bol et Applicn: part: affect: Ung Saturn 29th: The Eruptn: looks better - repr: Bol & Ung: - 30th: & 31st: continue - 80) January 1st: 1789 - Complaints in the same state Appln: Ungt: Nutriti q: s vis in die partibus affectis: Habeat Balneum Tepidum vespene per 5 Minutes - omittn: ing: Sat: - 2nd. Much scaly Matter has come off some the bath - repr: Baln: Tepid & ung Nutrit: u: a - 3rd: much scaly Matter came off repr: Balneum & Ung. - 4th: Compts: better - 5th: omittn: Bal & ung - 7th: Dismissd relieved - (81 Catarine Paterson Œ 19 - A Servant unmarried - Decr: 11th: both wrists hands & left Arm are affected with a painful scabby & itchy Eruption discharging an ichorous Matter accompanied with some swelling & Inflamation; Functions natural says she had laboured under an Eruption of the dry kind on the right arm about two [crossed out] Years ago, this Eruption is of a Months duration attacked the left hand first used some solutions & Ointments without benefit - 12th: - ꝶ: spirt: vit: ten: ℥ss Aquæ Font: ℔j. ♏ et Applicetur partibus affectis - Middle Diet - 13th. Complaints the same - Repr: Aqua Vitriol - 14th: 1 Eruption drying & parts affected less swelld - Repr: Aqua Vitriol: - 15th Eruption better, continue. - 16th: Continue 17th: Continue - 18th: Eruption better continue - 19th: Continue - 20th: disease abating Contine: 21st: continue 22nd: continue. - 82) Decr: 23rd & 24th: continue - 25th: Eruption almost gone but the parts very dry. ꝶ: Sinims: simp ℥j spin: Vitrio: tenuis ʒj ♏ ƒ ft: Sint: applicand: part: affect: vis in dies 26 parts affected seem soften, Ungt: is not attended with so much smarting as the Aqua Vitriol - repr: Ung: - 27th some fresh Eruptions have appeard repr: Ung: - u: a 28th: Eruption continues - repr: Ung: - 29th: Eruption has increasd - Omittn ung: Vitriol et Appls: Ung: Antipsorici q: s: part: Affect: omni noctre: - 30th: continue 31st: Eruptn: mostly gone Cones: - January 1st: Arm rough & scurfy - Omittn Ung: Antips: - Habt: Bal: Tepid - 2nd: much thin watery Liquor oozes from the parts affected - repr: Balna: Tepid & Ung - u: a (83 3rd: Continue: 4th. continue - 5th: The affected parts very red & painful Omittn: Ung: & Balm: - 6th: Arms turning worse Appn: Ung: Nutrit. partibus affect: vis in dies 7th: & 8th. Continue - 9th continue - 10th: Eruption drying - 12th: dismissd cured - 84) (85 Janet Tapp: Œt: 26th: Decr: 4th: is affected with violent acute pains in all her Joints of the upper and lower Extremities & shooting along the Course of the Muscles, also affecting the Back & lions with considerable tumefaction of the great & small joints - These are attended with Anorexia rigors at Times and some Cough P. 120, T - white & dry, urgent thirst, Belly round, rests ill, skin hot; These Complaints supervened on the 25th Ulto: immediately after exposure to cold during her Menses, The pains of her joints are much aggravated when warm in bed; had a whitish powder yesterday and some Physic today which she says procured 4 loose stools without relief - Fiat: Win: Sect: ad ℥ix - 5th: P: 112 & of natural strength, Blood very sizy only ℥v got; Urine turbid; sweated much during the night; much thirst; Repr: Sal: Nit: Crem: Tart: āā grs: x ♏ ƒ pro dosi. Capt: 4ter: in die - Low diet 86) 6th: P. 112 but soft, Blood sizy; Urine turbid; swellings subsided much & no pain but in the uppwer part of the right Foot severe Cough; Repr: pulv: u: a - Capt: Julap Mucill: ℥j 4ta: q. hora - 7th: P: 100 & soft wrists of both Arms attacked with pain & some swelling but no redness Tongue white, pain in the small of her Back; sweats sometimes during the Night; Urine turbid; Cough still continues; Capt: solut: Tart: Emet ℥ss 5ta: quague hora, Omittn: Pulv: Repr: Julap Mucillag: - 8th: P. 104 - the pain of the wrist better but that of the back still continues; Urine turbid nausea after the first Dose but none after the second; A loose stools sweats during the Night. - Repr: Remedia - 9th: P: 116 pains much better; no Diarrhœa but sweatd much during the Night; slept well Omittn: Solut: Tart: Emet - 10th: P - 100 & soft pains of her Limbs ꝶ Pulv: Jacob: ver: grs: v Conserv: q: s Capt: H: S; - Contint: Julap: Mucl - (87 11th: P - 100 pain along the Muscles of the right Leg & Thigh sweated some during the Night but no Nausea nor loose Belly - Capt: pulv: Jacob: grs: x fornea Bol: H: S: u: a: - 13th: P: 104 pain of her right Leg & Back Bolus produced no sensible Effect: Repr: pulv: Jacob: grs: xv - form: Bol H: S: u: a: 14th: P: 96 - pain seems to descend from the Thigh joint along the out side of her Thigh & leg a little below the knee which turns severe during the Night: Medicnes: operated yesterday - Omittn: pulv: Jacob: ꝶ: pulv: Dovr: ℈i syr. q. s: fiat Bol Capt: Hora somni - to have a flannel shift & take a large Draught of warm Liquor afer her Bolus - 15th: P 88 - had a general sweat during most part of the Night; pains in the same state Repetn: Bol: u: a: - 17th: P - 104 - sweated much, pain in the same place - Omittn: Bol 18th: pain in the Thigh joint; Appt: Cucurb: Ceuent: part: affect: - 88) 19th: was not cupped, pain left the hannd joint much easier in other parts - 20th: P: 88 - pains almost gone; Cough during the Night - Capt: Julap: Mucil: ℥j 4ta: quaque hora - 21st. Complaints the same continue 22nd free from Complaints: - 23rd & 24th: convalescent - Continues convalescent till 29th: then Dismissd Cured - (89 John Cumming Œt: 26 - a servant - Decr: 12th is affected with Ulceration of the extremity of the prepuce some phymosis soreness of the internal Fauces with slight ulceration of the left side & some Tubercles on the scrotum; some of which are raw; has also severe headach with difficulty of deglutition grea pain of left shoulde, increas'd discharge of saliva with Cough - Functions natl: was attacked with these Complaints about 3 weeks ago which appeard in the fern of Gonorrhœa first; used some pills 1 Lotions with some benefits. - 13th: P - 80 & rather weak; pain in the left side of the Testicle: Applcn: Peni fot: mane & vespene & postea Calaplasma expane & lactia coctis; Habt: partium suspensorium; ꝶ Muc: Cinerci præcip: grs. ij: Conserv: V: S; ƒ Bol. Capt: H: S - 14th: P - 100 - some slight Ulceration still appears in the Throat purged once Capt Bol: u: a: H. S: & Mane & antrea prescrp: Med: 90) 15th: P - 100 Belly loose Repr: Med: - 16th: 2 loose stools continue - 17th: P. 100 Belly loose Applict: Hirud: ij ad penis preputium - Repr: Remed: - 18th: P. 100 ℥iijss Blood got by the leeches, phymosis diminished spitts a little mouth sore omittn: Bol: - 19th: Continue - 20th: 21st: 22nd: ditto - 23rd: Mouth very sore spitts ℔ ij 24th spitts about ℔j. - repr: Bol: 25th: spitts ℔j repr: Bol: u: a 26th: spitts ℔iss Mouth a little some Belly open Omittn: Bolus: - 28th. repr: Bolus & let him have Meat for Dinner - 29th. repr: Bolus. 30th: repr: Bol: u: a 31st. repr: Bol: Jany: 1st: 1789 - Spits ℔iss Omittn: Bol: Appr: Ung: Merc: q: S: præpuce better spitts (91 about ℔j repr: Ung: u: a. - 3rd: Mouth still sore Contn: Ung: u. a 4th: Vertigo last night has been taking Mecury - i: e: Merc: præcip: Ciner: for 25 Days spits ℔iss - repr: Ung: u: a: 5th: Continue - Continues under a Ptyalism of about ℔iss a day till 12th: ꝶ: Flor: Sulph ʒij Capt: H: S: & Mane - 13th: repr: Flor: Sulph: u: a - 16th: dismissd Cured - 92) (93 James Nicholson - Œt: 55 - Novr: 24th: - Has a considerable degree of pyrexia and a discharge of a whitish matter from the urethra, with slight Ardor urinæ & chordee; also a large ulcer on each Tonsil & scabby Eruption on the Hands Legs & face particularly - Belly Pulse & appetite natural; great thirst ulcers of the Tonsils & Phymosis of a Mouth standing which last appeard with Warts on the Glans penis immediately after the Healing of an ulcer in the left groin: Eruption of a Fortnights duration; says he believes it is a Mouth since he received the Infection; has used Merc: pills & a Dose of salts without Effect - Capt: Pulv: Merc: Cinerci: grs. i forma Boli: H: S: & Mane: - 25th - P - 74 & rather weak; had chancres symptom appeard a mouth after infection has had one stool since he took the Medicine. Repn. Bol: ut antea Milk Diet 94) 26th - Bolus produced no Effect; Phymosis easier Repeln: Bol: applicn: Fotus & Cataplasma emoll: peni vis in die - 27th - Phymosis easier & swelling less Bolus produced no Effect: thinks his Gums are sore - Repeln: Bol: Cataplas: et fotus. u: a - 28th: Gums sore, ulcers of Tonsils & phymosis took better; continue - 29th: Eruption on his skin drying & much lighter in colour; Medicine produces no Effect mouth less sore - Repn: Medica: - 30th: Mouth painful & affected with copper Taste, Teeth loose, spitts a little Repn: Bolus - Decr: 1st - Headach & Chilliness with thirst he spitts about 72 pints; ulcers of the Tonsils took cleaner - Omittn: Bol: 2nd: p - 86 - pain of the throat easier continue - 3rd: p: 80 - some Cough & headach, Nose sweld & red, mouth sore & has spitt about 70 on english pint. Capt: Julap: Mucil: ℥j 4ta: q: hora - (95 Decr: 4th: - P. 104 & rather strong, the swelling & redness has spread over the Cheeks & Eyelids so that his Eyes are strict & attended with some pain & vesicles - Fiat V: S: ad ℥x stat Capt: Infus: Tamarind: ℥ij, 3 āā: q hora Repr: Julap Mucil: u. a. - 5th: p. 96 and of natural strength Blood sizy: Tumefaction of the Face in the same state & some vesicles appear, 4 loose stools - Fauces inflamed & a little swell'd Repr: Infus: Tamarind: & Julap mucil. - 6th: P. 100 & soft, sleeps ill swellings of fallen but still continues in his Ears 4 loose stools, Repr: Remed: - 7th: P - 88 & soft the swellings has left the face much & attacked the scalp & back of the neck; 4 loose stools repr: Remedia - 8th: - swelling diminishing; Belly loose Repr: Remed: - 9th: - P: 88 - the redness has spread over his Shoulders and Back but complains of no pain 2 loose stools, Repr: Remed: - 10th: P - natural 4 loose stools no Compts: of his Head; Omittn. Infus: Tamarind: - Repr: Jul: Muc: 11th: Eryspelas gone Repr: Julap: Mucil: 96) 12th: Convalescent: 13th - Phymosis almost gone but still no retraction of the prepuce, no matter appears on that part - Omittn: Cataplasm: - 14th Broth & Beef steak for Dinner 15th: Convalescent - 16th: convalescent - 17th: 18th: Convalescent: 19th: Repr: Bolus ex Merc: præcip: Ciner: u: a: - 20th: no ulceration in the Throat Rep Bol: 21st: has a swelling below the Ears on the night side which appeared first 3 days ago applr: Fotus tumori vis in dies Repr: Bol: - u. a - 22nd: swelling more painful & red, 2 loose stools & mouth has a bad taste appr stirred: ij tumori cervicis - Repr: Bol: & omittn: fotus: - 23rd. Tumor larger & reder - 8 loose stools Mouth sore & teeth loose; Appn: Cataplasm: emoll: ex pane & lacte coctes tumori & repr: vis in dies ℥iiss Blood got by the leeches repr: Bol: addendo Opii grs: ss - 24th. Bolus did not purge him repr: Cataplasm: & Bol: u: a (97 Decr: 25th: Nicholson purged 8 Times repr: Cataplam Omittn: Bolus - 26th: Tumor less - 27th: Diarrhœa gone Tumor diminishd spitts a thin water repr: Bolus - 29th. spitts ℔iss Bolus has been attended with no sensible Effect repr: Bolus - 30th: Continue - 31st: Eruption like Psora has appeard these 8 Days - Tumor almost disappeard - Spitts ℔ij - Omittn Jany: 1st: 1789 - spitts above a ℔ a Day 2nd: Tumor of the Neck almost gone - spotting disappeard - Continr: Catplasa: 4th: Has been under the Effects of Mercury for 26 Days and 22 Days under Erysepelas; put of which Time he was taking the Infus: Tamaind: no Compts: spitts none - Applicn: spin: Minder: Tumori Colic - 5th: Continues to mend - 8th: Dimissd cured. - 98) Charles McLeane Œt 15 Jany 14th: 1789 - was attacked on the 12th Curd with severe headach & soreness of Belly which still continues, P: 120 Tongue clean, great thirst & good sleep appetite bad Belly very Bound has used no Medicines, vespene Injicn: Clysma Domest: - 15th: P 112 & weak grinds his Teeth but no picking of his close, Clyster operated well & pain of Belly easier, complain of headach & nausea - Capt: Solut: Tart: Emet: ℥ss 4ta qq: hora - Low Diet - 16 P: 126 & rather weak pass'd a Sum bricus about a year ago, vomitted after every Dose of this Belly & Head easier, 5th: Day - repr. Solut: Tart: Emet: u: a - 17th: P: 100 vomited twice & has had 2 loose stools complains of severe pains of his Belly, Coughs much, 6th: day - ꝶ: Pulv: Stanni ℈ij Conserv: Rosar: q: s: ft: Bol: Capt stat repr: quater in dies - omitt Solut - (99 18th: P: 84 pain something Better, vomited the first Bolus. repr: Bolus 19th: No Complaints pulse natl. repr: pulv: Stanni 20th: Convalscent. 21st: 21st: Omittn: Bol: de pulvore stanni - 22nd: convalescent. - 23rd: Dismissd cured - 100) (101 Belly Anton Œt 22 - A Servant unmarried Decr: 16th: the left hand and Arm are affected with a considerable degree of swelling with some Edema has also slight swelling of the lower Extremities towards high with weakness of the left Arm & obtuse pain ij of the Cartilage Ensiformis, Appæ: bad some thirst other Functions natural she was attacked by this affection about 4 Months ago & says it first appeard in the palm of her Hand; attributes her complaints to cold bathing when her Catamenia were present, labored under a similar affection of the Arm about a year ago, has had 2 Blisters on the left Arm 2 Issues on the left leg & has taken Bark & Crem: Tart with no Advantage - 17th. P - 80 & of natural stregth was cured formerly of the same complaints Elician: Scint: Elect ex Beachio Ful Diet - 102) 18th: Compts: the same Repr: Elects: - 19th: P. 80 had a Hæmorrhagy from the left Breast to the Amt: of ℔ij - repr: Electas: 20th: Not Electrifd. to day Repr: Elects: - 22nd: swelling of the Arm in the same situation nausea for 2 days Capt: pulv: Emet: Vespene & repr: Electas: - 23rd: vomit operated well & stomach not foul a little after the operation had a Hæmorrhagia from her Breast to the Amount of ℔ij P. 108 pain in her sides - Capt: Julap Nitros: ℥j 4ta: quaque hora Omittn: Electricias: - 24th. P: 92 pain in her Breast sides & back repr: Julap: Nitros: u: a: - 25th: P: 92: & weak Ischuria these two days, feels no tumefaction of the Hypogastric region has felt pain in the left part of the Thorax for a considerable Time & cannot lie on that side; Capt: Cryst: Tart ʒij ex Aquæ: font: ℥vj cras mane Omittn: Jul: Nit: Slat: Introduction Cathatm. (103 26th: P: 94. ℔ivss of Urine drawn off by the Catheter, passes none naturally, as yet the the Crystalls of Tartar have had no sensible Effect - repr: Solut: Cryst: Tart: u: a - 27th: Complains of pain in her left Breast: Medicine has produced no sensible Effect; Capt Cryst: Tart: ℥ss in Aqua Font ℥xij cras mane - 28th: Ischuria continues; Medicine has had no Effect - repr: Cryst: Tart: draw off her water by the Catheter - 29 Ischuria continues, One loose stool neri, no pain in the region of the Bladder nor when then Catheter was introduced repr: Cryst: Tart: u: a - 30th: P 88 - the Salts have had no Effect pain at Times especially [crossed out] when she attempts to make Water about the region of the pubes - Applicn: Emp: Epispast. bene camphor regioni inferiori Sumborum repr: Cryst: Tart: - u: a: - 31st: symptoms the same Blister operated well repn: Cryst: Tart: u: a: - 104) Jany: 1st: 1789 - Ischuria continues Belly natural - Continue - 2nd: Has a prolapsus Uteri; The affected Arm is much diminish'd in size & softer, the Tartar has had no sensible effect except increasing the urine; Ischuria continues - Habiat pessarium repr: Cryst: Tart: - 3rd: symptoms easier Ischuria continues repr: Cryst: Tart: - 4th: P: 104 size of the affected Arm much diminishd. Medl: has had no sensible Effect except that of increaseing the Quantity of her Urine which now comes off naturally repr: Cryst: Tart: - 5th: Pulse 86 - has had an Hœmorrhagy from the Breast to the Amt. of ℔ ij - 6th: P: 100 pain in the left Mamma, Had some vomiting last Night repr: Cryst: Tart: - 7th. P: 88 - pain still continues in her Breast Medl: produces no sensible Effect Arm much diminishd - 8th: Catamenia adscent: - 9th: Catama: adhere Tent: 10th: swelling of her arm much better: Catamenia adhere remanent: - (105 Anton 11th: Catamenia disparuerunt; some Schinous Tubercles in the left Mamma; Appn: Spir: Minder: q: s: quater in die repr: Clysma - 12th Continue - 13th: Continue - 16th: swelling of Arm diminishd that of the Breast increas'd, Appn: Spir: Minder: Broct. Contn: Cryst: Tart: - 18th swelling of Arm almost entirely gone; Heat of Arm after the application of the Spir: Minder: which was constantly cold before - Continue - 19th: Sch her have Beef Tea - 20th: Continue. 21st: Continue - 22nd: Continue. 23rd: Continue. - 24th: Continue - 25th: Continue - 26th The affected arm almost as small as the other, & no pitting is observed in it - The Medicine operates by increase of urine only - repn: Cryst: Tart: some Blood & what she thinks pus came from her Breast yesterday - 106) 28th: Arm less swell'd repr: Cryst: Tartari - 29th - Affected with 5 or 6 Hysteric paroxysms on seeing a patient seized with on e Omittn: Cryst: Tart. - Capt: Œther: Vitriol: cochlear parvem unum ex Aquæ font: ℥j quater dedic 30th: No Fits repr: Œther: - 31st: Dismissd cured of the Complaint in her Arm - (107 JAne Seith Œt 18 - A Servant unmarried Decr: 22nd: is affected with pain of the back & both sides which prevents her from setting erect & much impedes respiration; has also occasional pain under the sternum, distension about the Region of the stomach, severe griping which is sometimes relieved by a discharge of flatus, with frequent vomiting of Blood which t times is to great extent & had an attack of Epistaxis last night & this Morning which she imagines was occasion'd by Efforts to vomit: great headach, nausea Anorexia & debility. The Blood is for the most part of a Black & grumous nature; some Cough, Expectoration rather difficult & the Sputa are generally streaked with Blood, & at Times the Cough is accompanied with some discharge of Blood - P - 96 Tongue natural, Thirst urgent rests 108) ill - Belly costive Catamenia absent these 2 Months - She says she was attacked by these Complaints on the 1816: Purst: 1 attributes them to a fall she received the same day in coming down a stain - was blooded once, & used a Linimn for the back some pills & a mixture with no benefit - has a severe pain in the left side of the hypogastric region - Fiat: V: S ad ℥ix - Injuicn Clyma vespesene - 23rd: P: 96 & of natul: strength, Blood in a natural state, vomits blood without coughing & coughs up some Blood without vomiting, she fell on the small of her Back & the pain, she complains is under short ribs of the left side; which pain is increasd when she coughs or lies on her right side; food always & drinks sometimes make her vomit; no Blood ever appeard in her stools; some Nausea (109 applicn: Cucurb: Auent: part: dolent: in smistro lative - Capt: Infus Tamarind: ℥ij 4ta: q: hora - Low Diet & let her a Heat & drink be cold - 24th: P: 96 & of natl: Strength, 4 ozs Blood got by cupping [crossed out] the pain is easier in the part, part cupped but not much easier in the right side; purged 3 Times but no Blood appeard in the Stools, vomitted last night & this Morning some black clotted blood without coughing, has also cough'd up a little florid Blood without vomiting, much nausea; has vomitted sometimes her food & Drink & was very sick after each dose of the purgative, slept none - omittn: Infus: Tamarind - Repr: V: S ad ℥iij 4ta: quaque Hora nes non Sumat S: S: gr: xxx forma Haust hora Somni - 25th: P. 100 & of the same strength, blood of a natural state vomits every thing she takes & some Blood cause up with the 110) with the Contents of her stomach yesterday afternoon has likewise some Blood this Morninhg by coughing; pain of her Stomach the same, Vomited the Drat & slept none, & vomits her Medicine severe Headach - Repr: Tinct: Rosar: et Haust: Anod: Injicn Clyma Domest: u: a: - 26th: P: 100 & soft, vomits all her meat drink & Medicine: no Blood by Coughing pain of her stomach severe; had a natural stool & did not take the Clyma Capt: Julap: Acid: Mucil: ℥ss cum S: S: gr: vj statim repr: 5ta: quaque hora repr: Clysma domest: Omittn: Infus Rosar. Beef Tea - 27th: P: 96 & soft; vomits constantly the Blood in less quantity; some Blood come off by coughing last night, had a scanty stool by the Clyster pain continues the same. reprL Julap: Murie: Acid addend. S: S; gr x Appln: Cucurb: sici: stomachi regioni affect: - (111 28th: P: 92 & soft continues to vomit all she takes but without an ad mixture of Blood the first dose of the Medicine yesterday staid 1/2 an Hour on her stomach after the Visit but all the following came up directly; the Cupping Glasses have been applied thrice each Time five Minutes; they were attended with no sensible effect nor was the pain any easier, the Clyster operated but little Applicn: Cucurbit: sicca per semi horam stat: et repr: vespere & Mane - repr: Clyma: it Julap: Mucil: Acid cum: S: S: ut antea - 29th. P: 84 has vomitted sometimes & last night a little Blood but has been easier since she was cupped, vomits her medicine but Clyster operated well - ꝶ. pulv: Rhei grs: ie Syr. q: s: ft Bol. Capt: stat: et repr: 4er: in dies repr: Clysma stat: omittn: Julap - e S: S: Applin: Cucurb: u: a: - 112) 30th: Has vomited every thing she has swallowed but without Blood; severe pain of her Head; the Clyster operated but little repr: Bol addendo S: S: gr xv repr: 5ta: quague hora repr: Clysma; much thirst let her have 2 oranges - repr: Cucurb: siccœ u. a - 31st: p: 96 vomitting continues & some Blood came up last Night & to Day; pain the same - vomits the Medicine - Capt: S: S; gr xv forma Haust. stat. & panto post repr: Bol: ut antea, repr: Haust Anod semper ante Bolum - repr. Clysma vespere & continn: Cucurb siccœ - Jany: 1st. 1789. P: 102 & soft; Hœmatemesis during the Night kept her Medicines to Day glyster had no Effect & never has had a natural stool; repr: Cucurb: u: a & Haust: Bol & Clysma - 2nd. P: 88 vomiting abated & kept the Drat: & sometimes the Bolus - repr: remeda: - 3rd: P: 104 Vomiting returned pass'd a little Blood with her stools on the 1st: Instant the pain of her stomach is so severe that she cannot lie on her right side Appn: Cucurb: c: ferro regioni (113 stomachi. repr: medica: alia: u: a - 4th: P: 90 & soft arms & legs often very cold vomiting still continues throws up the Bolus always but keeps some of the Drat.; pain eased by cupping but the vomitting brings it back again: got a Blow on the Back part of her Head when she fell which was very sore at first but the pain of her Head at present is in the fore part - Applicn: Statim regioni stomachi S: L: ʒij & repr: Cras mane. repr Bol: & Haust u: a: - 5th. P. 84. Vomiting the same & threw up some Blood last Night; pain of the Stomach easier since the Application of the Laudanum repr: applicatio S: S: u: a repr: Atia remed: & Clysma - 6th: P: 80 less vomiting & sometimes retains her Bolus & Drat: pain easier since the application of the Laudanum. ꝶ: Theraic: Androm: ℥j extende super Serteum, et Applicn: Regioni stomach: repr: Bol: Haust: Anod: & Clyma: Omittn: Laud: Liquid: - 7th: P: 84 and of natl Strength severe dry Cough & pain, of right side increasd on inspiration vomiting less - Fiat: V: S: ad ℥ viij repr: Remeda. - 114) 8th: P: 84 & nearly of natural Strength vomitted less frequently; pain of the right side much diminish'd; Blood in natural state; Vomits the Bolus but retains part of the Drauts: Omittn: Bol: repr: Clysma & Haust Anod u: a - 9th: P: 96 & strong severe pain especially in inspiration & great heat below the Cartilage Ensiformis; some Vomiting & Cough with the latter of which some Blood came up; a scanty stool with the Clyster - Fiat V: S stat ad ℥x repr: Clysma Vespene & Haust: Anod: - 10th: P: 100 & not weaker Blood in a natl state vomitted much Blood this Morning, tho the vomitting has not been so frequent; Breathing easier but the pain of her Breast still continues; applicn: Cinimm: Anod: phar. Edins: regioni stomachi ter de die q: s: Capt: Infus: Tamarind: ℥ij 2da: quaque hoa ad alvi Solutionem, repr: Haust: Anod: H: S. - Omitt Clysma - 11th: P: 96 vomitted both food & Medicine since the visit so that the physic has had no Effect capt: stat S: S; gr: XL - Hora 2da: P: M: repetatur (115 Seith repetatur Infus: Tamarind ut antea Injicn: Haust: Anod Hora Somni & Lin: Anod: u: a - 12th: P: 90 kept the fish Anod Drat: but did not the second retaind some of the Physic which operated once; stomach much swelld last Night, has retaind none of the Physic since 2 yesterday P: M: Vomitting continues; appn: Emp: Epispast bene Camph. regioni stomachi stat, repn: Haust: Anod H: S: Omittn: Infus: Tamarind: - 13th: P: 90 & of natural strength purged twice since the visit; retaind her Drat: Blister discharged well vomiting but little diminished by the Blister & some Blood still discharged with the Contents of her stomach, repn: Haust: Anod H: S: & Mane - 14th: P: 96 & of natural strength less vomitting threw up about ℥iv of Blood this Morning ꝶ: Extract: Hyosicam grs: i Conserv: q: s. ƒ Bol: Capn: H: S & repn: mane - omittn: Haust - repn Clysma 116) 15th: More Blood than usual vomitted this morning; Bolus produced no sensible Effect - Capt: Extract: Hyosciam grs: ij for Bol: u: a Repn: Clysma - 16th. P 84 & of natural strength, Nausea vomiting & pain worse; has vomited blood twice, retains her food better than she did Clyster operated well, feels nausea after the Medicine, repn: Remed: u: a - 17th: vomited twice & threw up much Blood each Time, sick after the Bolus - Caph: Extract Hyosciam grs iij. u: a repn: V: S: ad ℥ix - repn: Clysma - 18th: P: 80 & weaken, Blood natural less vomiting & less Blood with it, Clyster operated well more nausea after the Blus repn: Clyma & Bol: - 19th: P: 84 vomited some Blood last night but vomited without Blood to Day, complains of pain in her Breast much nausea & vertigo from the Boluses Clyster operated wel; repn: remedia - (117 20th. P. 112 nausea vertigo & Headach always after both doses, Clyster operated well & had a natural passage this Morning much vomiting & Blood with its pain severe, Omittn Extract: Hyos: ꝶ: Sal: Nit: grs: x Conserv: g: s: ♏ ƒ ft: Bol - Capt: Stat & repr: 4ta: qq: hora. Omits Clysma 21st. slight nausea after the Bolus vomiting diminished, says a little Blood came up yesterday from Cough alone before she began to vomit - repr: Remedia - 22nd: Vomited much Blood last Night pain of left side severe Capt: Salis Nit: grs xv forma Bol: u. a repr: Clysma - applicn: Naturalibus vapor aquæ Tepid: vis in dies - 23rd: P: 100 vomited Blood to Day pain severe, breathing difficult, repr: Remed: u: a Wishes for an Egg let her have one, - 24th: P: 100 vomited less & a smaller Quantity 118) of Blood - repr: Remed: & Ovum - 25th: P: 100 & of natural strength vomited Blood twice to day Omittn: Bol ꝶ: S: S: gr xv syr: althæ ʒij Aqua Font: ℥ss ♏ ƒ ft: Haust Capt: 4ta: qq: hora - Appn: Fotus Aquæ frigodæ. regioni stomachi vis in die repr: Clysma - Omittn vapor Aquæ tepid - 26th: P: 86 and of natural strength, retains her victuals but has vomited blood once thinks her stomach swells after the Application of cold water repn: Remedia - 27th: vomited Blod last night & some this morning retains the Drat: ꝶ: Sacchar: Saturn grs iij Conserv: q: s: ft: Bol - Capt: stat: & repr: crus mane - repr: Haust: H: S & mane Omittn: Fotus: Aquæ Frigid - 28th: P: 104 & soft less vomiting & less Blood pain in the same state griped after the Bolus & purged twice. repn: Bol. & Haust: Omittn Clysma - (119 Seith - 29th: less Blood but the vomiting continues the same purging repr: Bol: Haust & Clysma 30th: as much vomiting but less Blood Belly round - ꝶ: Ol: Resin ℥ss Capt: cras mane - Omittn Bol - 31st: The Medicine operated thrice has had an increase of vomiting & of Blood with it - Capt: Julap Mucic: Acid ℥ss 4ta: qq hora - Capt. S: S: gr xxx H: S: & mane - Feby: 1st: Less vomiting & less Blood repr: Medicamanta - vit pag: 189 - 120) (121 Henrietta Ross Œt: 12 - Decr: 2nd: - Is frequently during the night attacked with Fitts in which her upper & lower extremities are much convulsed, her head is generally drawn back & in a state of suffocation about the Trachea; these fitts continue usually for about ten minutes; she foams at the mouth and grinds her teeth in them but has no warning of their approach, nor does she know what passes during the paroxysm, they leave her in a state of languor on her recovery. Is also affected during the day with an uncommon distension about the region of the stomach which comes on suddenly and disappears in a short time; but she says that this is not commonly followed by a paroxysm. B - costive, P - 80 & soft, appete: good, sleeps tolerably but cannot lye on her left side; Catamenia have never appeard; these fitts came on about a fortnight ago; but her stomachic have been of a years standg. says that she discharged by stool a few days ago great numbers of small worms which by description appear to be of the Ascarides kind; her upper lip seems to be 122) a great deal swelld & she says that it has been in that state about a year - Has used Medicines - ꝶ: Tart: Emet: grs: i pulv: Ipec grs. v. ♏ ƒ pro Emet: vespene = Capt: pulv: Rhei g xxv Caloml: grs: v. Conserv: Rosar: q. s. ƒ Bol cras mane - 3rd: - P 100 & of natural strength; pain & swelling about the apperture of the nostrils pain of the abdomen at different times especially when press'd; not observed to pick her nose, but grinds her teeth in the fitt, headach at times; vomit operated well & stomach foul, physic has had no effect yet; had a short fitt yesterday; ꝶ: Pulv: Starmi ℈ij: Pulv: Rhei grs: iij. Sal Martis gr: i. Conserv: q: s: ƒ Bol. Capt: quater in die. Middle Diet 4th: P - 100 passed a lumbriens Worm about a year ago, no scrophulous symptoms cannot lye on her left side on acct: of pain which she then feels about the region of the Liver; had by the physic 4 loose stools highly putrid had 5 Fitts yesterday of the convulsive kind during which (123 which she was insensible; the suffocation about the throat does not seem to arise from Globus Hystericus Repelr: Bol: u: a 5th: - P. 100 no fitts, B - open lies with more ease on her left side; no pain in her Belly even on pressure Repr: Bol: u: a: 6th. - P: 84 had one fitt of 5 Minutes during on & with slighter Convulsions during the Night, 2 loose stools; sweated much during the Night, swelling of the lip less - Continue - 7th: P. natural - Repr: Bol: u. a - 8th: No fitt, complains in her [crossed out] right side of a pain & says that it is lower than before - Repr: Bol: 9th: no fitt; some headach; 5 loose stools, Repr: Bol: 10th: 3 loose stools; Headach complains of pain in the right side: Appen: Emp: Catid: phar: pauperum parti dolent - Repr: Bol: u: a: 11th: No fitt pain of the side the same Continun: Bol: - 124) 12:: Still compains of pain in her side 3 loose stools & of natural appearance Continun: Bol: u: a - 13th convalescent: 14th: Convalescent - 15th: Dismiss'd cured - (125 Abraham Pond Œ: 53 - Novr: 21st: - For 3 weeks or a Month has labored under a severe Diarrhœa attended with some Flatulence without gripes, Tenesmus or any admixture of Blood in his stools which are of a natural Colour P - 80 - T - foul & dry, thirst sleep & appd: natural, attributes his Complaints to poor living & cold has used no remedies - 22nd - P - 60 & weak 2 loose stools since admission, Vomitting this Morning, Capt: Pulv: Emet: vespere & pulv: Rhei ʒss cras mane: Ful Diet - 23rd: - Pulse 58 & weak Emetic operated well stomach foul; Rhubarb has had no Effect - Capt: Mist: Cort: Peruv: ℥ss 4ta q: hora - 24th - P - 62. - only one stool Repn- Mist: Corticis - 25th 2 loose stools only - Repn: Cortex 126) 26th - Purged 5 Times - Repr: Cortex - 27th yesterday purged only Twice pains easier - Repr: Cortex - 28th - purged 6 Times, continue - 29th: purged 3 Times; continue - 30th: purged 3 Times; continue - December 1st: continue, 2nd: continue - 3rd - 4 loose stools, headach; continue - 4th: continue, 5th - Nausea after eating; 5 loose stools; Capt: Pulv: Emet: u. a: vespere Omittn: Cortex - 6th: Vomiting copious from the Emetic 5 loose stools - ꝶ: Extract: Campechen ʒss Sal: C: C grs: iij Syr: q: s ft: Bol. Capt: hora somni & mane - 7th: 3 loose stools, Repr: Bol: u. a - 8th: 5 loose stools; Repr: Bol: ter in die 9th: 3 loose stools; Repr: Bol: u: a: 10th:: no purging belly rather costive Omittn: Bol: - (127 11th: Convalescent: 12th: ditto - 13th: do - 14th: Convalescent. - 15th: ditto. - 16th: do: - 17th: Continue - 18th - continue Convalest: till 25th Diarrhœa returnd repn: Bol: ut antea prœscripta - 26th: 7 loose stools repn: Bol: u: a 27th: five stools only repn: Bol: u: a 29th: seven loose stools repn: Bol 4n: in die 30th: five stools repn: Bol: 31st: Complaints better continue - January 1st. 1789 - Continues better - 2nd: dismissd much relieved - 128) (129 Margaret Sutherland Œt 31 married but never had Children Novr: 12th The upper & lower extremities, the Abdomen as also the face & lumber region with the pudenda are occupied with a considerable Œdematous swelling but no fluctuation can be felt in the Abdomen; has likewise frequent Cough wt- copious mucous expectoration & Dyspnœa Pulse 90 - T - clean, much thirst, rests ill, appd: bad - B - regular, Catamenia have not appeard these 18 Months - says she is frequently disturb'd in her sleep by frightful Dreams & has great palpitation of the Heart - Her Compts are of about 15 Months duration & she attributes them to wet feet when her Catamenia were present, but they have assumed them present violence within, these 4 Months, was in the House last winter & used variety of medicines both these & abd = with very little benefit - 130) 13th - Pulse 90 & weak complains that Catamenia cessaverunt for 18 Months, easier when she lies on her right side as to her breathing - ꝶ: pulv: Digital: grs: i Conserv: rosar. q: s. ut ƒ Boll H: S sumend & repetr: mane - Middle Diet - 14th Pulse 96 - Medn: prduced no effect Capt: pul: Digit grs: ij forma Boli H: S: & repetr: mane - 15th - Pulse 96 - about 3 Hours after taking the Bolus last night felt severe nausea which continued for 2 Hours but the morng: Dose produced no Effect; Vomits generally after taking food especy: Broth & the contents of stomach always acid difficult Respiration Capt: Magnes: Alb. ʒss ter in dies (131 15th Reptr: Bol: H. S & Mane ut ant Beef steak for Dinner Day 16th Pulse 96 fill a nausea after the Dose last night - HAd nausea some vomiting & vertigo after the Dose this Morg: 2 loose stools but no increase of urine yet Capt: Sesqugran: Digital: for: Bol ut ant H: S: & Mane ꝶ: Tinct: Tamarind ℥j. capt: ad Libitum - 17th - P - 96 - still complains of pain in the Hepat: Region, nausea after the Bolus last night but none after the dose this morning purged twice & as she says shew was blood mixd with the stools & mere time of Blood in the Expectoration - Repr: Bol: ut ant - appen: regioni: Hepatis Epispast bene Camphor - 132) 18th - P - 96 - vomits every thing she takes Blister operd: well but the pain not easier. Repr: Bol: addends opii gr. i Capt: ut ant: - 19th - still vomits as formerly swellings in the same state urine not above ten Ounces Omitts Bolus - 20th: Pulse 90 & weak no vomiting - 21st: - Pulse 90 & very weak no vomiting takes no food & appears indistinct; 4 loose stools since the visit swellings in the same state - Capt: Vin: Rub: ℥viij in dies; Capt S: S: gt: xxv forma Haust: stat & H. S - Died the 22nd: - Dissection On openg: the Thorax the Lungs were found adhereing firmly to the back, with induration of the upper & back part of each lobe and about two Ounces of water were found extravasted in the Cavity of the Thorax; the Heart & its Vessells were perfectly sound no water in the pericardium; On Opening the abdomen the Liver was found perfectly sound; the [crossed out] Spleen very hard & much enlarged both Kidneys enlarged & rather setinous, no water in the abdomen (133 Elizabth Arrott Œt 20 - Unmarried a Servt: - Novr: 27th: - A large colorless unelastic swelling occupies the Region of the Abdomen but larger on the right side of it with very indistinct Fluctuation, complains of great pain accross the shoulders & at Night of coldness of her Feet, which sometimes used to swell towards Morning as she says, but no is entirely free from it: P. 100, T - clean, great thirst, Appetite & sleep Natural, Urine in the usual quantity Catamenia for these 19 weeks flowed every 3 weeks & for 5 weeks before that appeared every week or sometimes oftener - says the left side was first more swelld than the right; used some Mercury at that Time with little success but says she has been better since at Times - About 19 weeks ago she first perceived a small round swelling in the lower part of the right side which was soon after more swelld than the other & since that took some (132 Infus: Digitalis: & two Emetics which last viot: up a good Quantity of clean watry fluid & as she says renderd the swelling much softer but not less can assign no Cause for her Complaints - 28th - P - 76 & natural strength; complains of pain in the right & bottom of the Abdomen which is of 7 weeks standing - much Flatulence, T - whitish - ꝶ: Tol: Digit: ʒiss Aquæ font: bullient ℥viij ƒ: Infus per horas quatuon dein cola et adde Aquæ Nuc: Mosch: ℥j Capt: cujus Infus: ℥ss Hora somni & cras mane - Full Diet - 29thth: - P - regular pain of the [crossed out] stomach after the Medicines last Night Reprtn: Infus Digitalis - 30th: no fluctuation can be felt across the Abdomen, but is sensibly felt on each side separately & much pain excited on pressure on both sides of the Abdomen; Headach after the Medicine but most after the Morning Dose which continues about 72 an Hour. Capt: Infus: Digit: ʒvj. u. a - (135 Decr: 1st: - Much nausea after the dose this Morng: urine ℔iij - Repr: Infus: Digit: - 2nd: Belly increasd about 72 an Inch in size Urine ℔iiiss - Nausea after Mede - Repr - 3rd: - Continue - 4th: swelling of the Abdomen increasd 3/4 of an inch: Urine ℔ij ʒx Capt: Infus Digit: ℥j ut antea - 5th: p: 96 - swelling of the Abdomen increasd Urine ℔iij - Nausea & vomitting after the Dose this Morning, but none of these Effects after the dose last Night - Contiue. - 6th: much vomiting after the Infusn: this Morng: but none last Night; urine ℔iiss - Capt: Infus: Digit: ʒvj pro dosi u: a: 7th: Symptoms the same; continue - 8th: Had much vomitting yesterday & took none of her Medicine. Capt: Infus: Digit ℥ss u. a. 7th: No Fluctuation can be felt by the surgeon - Omittr: Infus: Digit: - 10th: dismissd as having no disease the increas'd size of her Belly supposed to be natural - 136) (137 Jean Hutcheson - Œt - 30 unmarried - Novr: 9th. - Has a general yellow tinge over the surface of the Body but particularly observable on the tunicæ adnata of both Eyes with flying pains in both shoulders & sides and a fixed pain about the Scorbiculus Cordis. - There is some degree of tension and fullness in the right Hypochondrium attended with pain & pressure - Pulse 100, appte: gone, Tongue white, some thirst with Cough increasing the pain f shoulders & sides, Headch:, Catama: have not appeard these two months but once for a Day - Belly regr: Stools white Urine high color'd, legs Œdematous towards Night - Has been in the House since the 15th: of Octr. has been blooded & blisterd on one side - Got Emetics opiates - solution of salt of Tart & Gum Kino, & Gum Arabic with potio Cretacia, without Relief - Novr 10th: Pulse 108 & weak, her colour was observ'd 138) to become yellow before she had any Compts: - she observ'd her legs to swell & the pain in her right side a fortnight before she came into the House - Can give no Cause for her Compts: Has less pain in her right side when she lies upon it & feels a Weight on dul pain when she turns up on the left side & lies upon it Took no Medicine before admission into the House - ꝶ: Cryst: Tart: ℥ss solve in Aqua: font: tepid ℥xij - Capt: cr: summo mane - Middle Diet - Novr: 11th: Pulse 96 - less pain in the hepatic Region - Medicine operated six Times urine not increas'd - Repetn: Soult - Crys: Tart: cr: Mane et Mind. - (139 Novr: 13th Pain of the side less troublesome did not take the Medicine she purged frequently yesterday - Repetr: Sol: Cryst: Tart: cras mane - 13th - ' Capt: Gin punch ad ℥viij - Medicine operated twice, pains easier but complains of weakness - Urine 3 ℔ which she thinks is more than usual Table Broth & steak for Dinner Repn: Cryst: Tart: ut ant - 14th - Pulse 100 & weak 2 ℔ss Urine Salts have had no sensible Operation Repr: Cryst: Tart: ut ant - 15th P. 100 & weak. medce: operated often during the night so she did not take it this morng: complains of weakness - Capt: S: S: gt: xxx in for: Haust 140) 16th Novr - P: 108 - yellow colour deminishd Pain in the hepatic Region less & can lay on that side with more ease, swelling of Legs gone even when sitting up Urine in the same state - Let her have porter a Bottle a Day in place of Gin punch - 17th - P. 120 - seizd last Night with a pain under the short Ribs of the left side for which the Haust. Anod: was repd which gave her Ease; stills complains of pain espey: upon strong Inspiration Apply - Emp: Calid: phar: paup: Sateri dolent. statim. 18th P: 106 - & weak; the plaister gives her no pain but keeps the parts below hotter; the pain has left the left side & settled in the right; 5 loose stools Repr: Haust: Anod - 19th - P - 140 - & weak pain the same as yesterday Cough & Dyspenœa (141 19th - Novr - J. Hutcheson 3 loose stools; applicr: Emp: Calid regioni Hepatis dolenti, Repetr: Haust. anod stat: & H: S - 20th - P - 114 - & weak, some Dyspnœa, 3 loose stools pain easier - Capt: Infus: Japon: ℥j 6ta: quaque Hora - Repr: Haust: Anod: H: S - 21st - Purging continues - repetantur Medicamenta - 22nd - P - 100; taken no medicines since last Night thinks they make her sick - ꝶ: Extract: Campechen: ʒss - Capt: stat: Hora somni & mane. Omittn. Haust & Infus: Japonic: - 23rd P - 102 & weak no looseness - Repr: Bol: H: S: & mane - 24th P - 100, no pain nor tumefaction under the short ribs took no Bolus, Repr: Haust: Anod: H: S: omittn: Bol. - 142) 25th: Pulse 100 no particular complaint Repr: Haust: Anod: - 26th: Continues the same repr: Haust 27th - P - 100 - no Compts: but weakness repr: Haust: Capt: Mist: Cort: peruv: ℥ss ter in die : - 28th no Complaints but weakness Continuation Mist: Cort: peruv: - 29th: continue - 30th: continue - December 1st: - continue, 2nd: continue - 3rd: - continue - 4th: P. - 104 & weak complains of pain in the left side. - 5th: P: 104 - & very weak, no particular complaints - Capt: Vin: Domest: ℥iij quater in dies - repr: Haust. & omittr: cortex - 6th: - P - 104 & weak; Continn: Remed: u. a 7th: P - 104 very weak, purging severe - Capt: Vini Rub: Port decti ℥ij quater in die - Repr: Haust: Anod: H. S & Mane Omittn: Vin: Domest: - 8th: continue - 9th - Died this Morning 6 oclock - (143 144) (145 Robert Wilson Œt: 53 - Novr: 25 - Has pretty constant severe headach with Tinnitus aurium and some degree of Anesthesia of the left side of the Head, & considerable Ptyalism; pulse 62 - Tongue clean, belly round, sleeps ill, appete: bad, Headch: of 4 - Months standing but has become severe within these three Days; numbness of the left side of the Head came on in April last; he attributes it & Headach to a deafness which came on in January last; has used Bark & Wine without relief, & has used Blisters with the same Effect - 26th - Pulse 60 & weak much affected with noise & beating in his left Ear; start much during the night & when the Door opens suddenly: all Noise hurts his Head much, thinks he makes more Urine than he used to do & both pupils contract well but sees best with the right Eye - applicn: Emp: Epispast: pone Auren sinist: & postea fiat ulcus perpetuerm Ope Ung: Epispast: Capt: Pulv: Valer: Sylvest: ʒss quater in dies - 146) 27th: Has been affected at times with flatulency & Acidity of stomach & nausea; Headch: a little easier Blister operated well; Repr: Pulv: Valer: Sylvest: ut antea 28th - Headach worse; Belly round, Urine pale; Injicn: Clyma domest: Capt: Pulv: Valer: Syl: ℈ij - ut antea - 29th - Headach easier, Glyster operated well last nights Urine has sedt: this Mornings clean. Continue - 30th: - Urine pale; the pain made two attacks on the right side of his Head & is now settled about the right Eye; Belly costive: Injicr: Clysma. stat & Repr: Pulv: Valer: Syl: ʒj ut antea - Decr: 1st: Complaints easier; continue - 2nd: Headach much easier; continue - 3rd: some Headach to day continue - 4th: Compts: the same continue - 5th: P - 80 Headach much easier - continue - (147 6th: Decr: P: 92. had a Suppression of Urine last Night but it has gone off to Day, tho is yet attended with some degree of pain, Repetn: Remedia - 7th: Urine passes easier; Headach worse Issue runs well: Capt: Mist: Cort: peruv: ℥ss 4ta: q: hora: Omittn: pulv: Valer: Syl: & Capt: Julap: Mucill. - 8th: continue - 9th: - Headach easier contne: - 10th: continue - 11th: continue - 12th: Dissmissd much relieved - 148) (149 Mary Niven - Œt: 24 - married - Novr: 11th: - The 2nd cunl: was seizd with acute pains in her chest & across the region of the stomach shooting to the back which have continued so ever since, says she has observed within this two days her skin preternaturally yellow - Pulse 94. Tongue clean & dry, thirst, no appete: rests ill Belly & Catamenia acguln - about 12 Months ago had a low fever, since which she has had a Parlysis of the Tongue & Extremities of which the upper are now better, was in the House about 4 Months ago for Parlysis, but was dismissd without relief, has used no Medicines for her present pains & knows no Cause for them - 12th - P - 80 & weak, urine of a high colour & tinges linnen yellow; the pain she complains of lies under short Ribs of the right & stretches backwards to the spine - 150) 12th: Applicr: Hirudines tres regioni hepatis et postea. Applicr. fot: parti per horam, et repetr: Fot: vis indies Capt: Infus: Tamarind: ℥ij sing: horis ad alvi solutionem cros mane - Middle Diet 13th - Complains at present of pains in her Bowels & Back; her medicine has produced no Effect - Applicr: Emp: Epispast: parti abdomini dolenti - 14th Medicine produced 3 loose stools last night; blister operated well pains much easier yellow colour the same - 15th Pulse 108 rather weak - complains of nausea Capiat. Pulv: Eet: vespene - (151 16th - P - 110 - pains of Abdomen diminishd & recur only now & the, Emetic opd: well & stomach foul - ꝶ: Pulv. Rhei. ℈ij ♏ ƒ f: pulv: Capt: cras mane - 17th - P - 96 - pain of the Abdomen easier - 18th - P - 90 - 4 loose stools yesterday, no Compt but weakness 19th - Pulse 86 & rather weak - Illicr: seintil: Elect: ex Brachiis & Cruribus in dies - 20th: Capot electrified, quia menses adfuerunt - 21st - Pulse 86, yellow colour much diminish'd no pains, Catama: ahuc remanent - 22nd Catamenia assaverunt: Utation Electricitas 152) 23rd: P - natural was at the wheel to Day & it produced a starting in the muscles & a great degree of Heat - Has had less trembling in the muscles since she was electrified - continue Electricity - 24th - A great increase of heat & some sweat during the Electricitas; no Alteration in the power of motion in her Muscles - 25th - Had last night some return of the pain of the Abdomen but it is now easier, which prevent her going to the Wheel 26th - Complaints the same continue the Wheel 27th: Continue 28th - can speak more distinctly & walk with less shaking than he did - Broth sourd on her stomach let her have some Meat - 29th: continue, 30th: ditto Decr: 1st: & 2nd: continue - 3rd: 4th: & 5th: cont. 6th: & 7th: continues better. - 18th: Paralytic complaints have been at a Stand for so (153 Decr: 18th: Niven - Days Omittr: Elects: et Capt - semen: sinap: integri: Cochliar: i magnum vis in dies - 19th: continue 20th: Belly more open & Body less susceptible of cold since she began the Medicine - Continue - 21st: continue - 22nd: continue - 23rd: Catamenia adsunt - Omitt Sem: Sinap: 24th: Catama: adhue manent. - 25th: Catama: dispamerunk: - had some cold Fitts last night - 26 no Headach nor cold fitts. ꝶ Folior: Arnicæ mont: ʒij Aqua bullient: ℥xij ♏ ƒ et infund per horas quatuon. Cap: ℥ij quaten in dies - 27th: The Medicine brings off some flatulence from her stomach & produces slight nausea repr: Infus: - 28th: very sick after each dose repr: Infus: 29th: felt on the 27th: in the Evening a prickling in the Arms and thighs frequently for three Hours Continue Medne. 30th some Sickness after Medicine Continue - 154) 31st: Nausea & vomiting after the Medicine the [crossed out] Nausea from one Dose to the other - Capt: Infus: Arnicæ German ℥ij u: a. January 10th: 1789 - Has continued the Use of Amica German in the dose of ℥ij without any Effect or visible change in her Complaints - Capt: Infus Arnica German: ℥iij pro dosi ut antea - 11th: omittn: Infus Doromica ꝶ: Assa Fœtid: ℥ss Ol: Stillit Sucin ℈i Syr: gr: s: ♏ ƒ et ft: Massa Pill: Divide in pill: pendontes ex grs iv - Capt Pill quatuor pro dosi ten de die - 12th: Continue - 13th: After taking the pills felt an increase of Heat - repr: Pill quater in die - 16th: dimissd cured of her Icterus & somewhat relieved of her Paralysis (155 George Smith Œt Œ - Jany 16th: 1789 - About a fortnight ago was attacked with headach nausea some vomiting & pain of his Belly which except the nausea & vomiting have continued ever since, P: 90. Tongue clean; Belly generally round attributes his complaints to cold took an Emetic on Wednesday Morng which operated well & relieved the nausea & vomiting & a dose of physic the same Evening which brought off a large Worm ꝶ: Pulv: Rhei ℈j Calom ppt grs: iij Conserv: q: s ft: Bol: Capt: Cras mane 17th. P 100 & rather weak, passd many Lumbrici a year ago, Has an Eruption about his nostrils & upper Lip which appear sweln ꝶ: Ol: Recin Succi Simon āā ʒiij ♏ ƒ Capt: Hora Somni - Low Diet - 18th: pain of his Belly gone 2 loose stools & nothing prœternatural in them; still has headach - repr: Mist: ut: antea - 156) 19th: Pulse natural, Headach gone omittr: Mistura 20th: Dismissd cured. - (157 Alexr: Haislep Œt: 17 - Novr: 17th - On the eight Currt: was of a sudden deprived of the powers of voluntary motion of the right side & Tongue which have continued ever since; P - 96 in both arms but not so ful in the paralytic Arm as in the other, heat now of the affected side entire but for the 3 first Days was quite lost during which Time he had a considerable degree of fever; Tongue clean, B regular rather round, urine very pale & passes both it & the fœces in the Bed but sometimes makes signs when they are passing away; Appe: very great; was in the House last May for a Dispondency of Mind which supervened after being much engaged in religious pursuits & went out relieved after getting Opiates & Cathartics, some Time in April he got a Fall from a Horse on the crown of his Head from which he seem'd to be no way injured but after some Days seem'd to complain 158) complain of a pain in his Head, used no medicines, when question'd about his Affection complains by signs of his Head - statim abradatur Capilliem, et postea Applicr: Calvar: (cute prius madefacto accto, Emplast: Epispast; vene camphor: - Capt: cras summo mane; Infus Amar cum duplice senæ ℥iv - 18th - Pulse 86 and weak; Blister not yet operated, quieter to Day, Physic not yet operated - 19th - pulse 96; Blister not operated, no insensibility after the Tale; Physic operated once - Repetr: Emp: Epispast Capin Cras mane repectatur Infus: Amar cum tiiptiic senæ - 20th Pulse 86, Blister not well risen, physic not operated, nothing preternatural appears on examining the Head - Symptoms the same - (159 21st: P - 84 natural; Blister on the left side rose only & discharged; but it discharged none from the right side; 3 loose stools other symptoms in the same state - Applicr: Epispast: 20 pone Aures - Repr: Infus: Amar: cras mane - 22nd Pulse natural; Blister on the left side operated well, & not even Inflamation excited by the right; physic produced no Effect: Extra nantur scintillæ Electric: ex part: affect: quotidic - 23rd on receiving the electrical sparks seem'd to be much paind; but he bore the shooks much better; physic operated well thrice; can use the right Leg much better than when he came in; Repetr: Electricitas - Omittr: Infus: Amar: - 24th - walks better, Repetr: Electricitas full Diet - 25th walks better but still passes Urine & Fœces insensibly - Repr: Electrics: - 26th: continue 27th: Do - 28th: Ditto - 29th - Can speak so as to be understood - Contr - 30th: Continue - 160) Decembr: 1st: Improves gradually in the powers of voluntary Motion & in his speech - 9th the powers of Motion much greater [in?] the lower Extremity but no great in Improvment in the right Arm; let the Electric fluid be particularly appli'd to the arm 20th: has continued to mend gradually for some Days - Let him have the dumb Bell - January 7th: P 120 pain of the Abdomen, Tongue clean, Thirst, no Nausea; ꝶ. Ol: Recin ℥j - Spin: Vin: Tin ℥j ♏ ƒ Capt: Stat - applicr: Fotus Abdomeni - 8th: P 108 4 loose stools from the Medicine pain in the Belly gone - Vomitted during the Night - Capt: sol: Tart: Emet ℥ss 4ta: q: hora - Omittr: Fotus & Ol: Rain. 9th: P 100 vomitted after the second Dose & after every subsequent Dose; Omittr Solut: Capt: Mist, Cort: peruv: ℥ss quater in dies. 10th: better continue - 11 & 12th: Continue - 28th: The power of Motion in his right Arm but better restored; the Faculty of speech perfectly recover'd & the Fatuity which he labor'd under has given place to a sound exercise of his Reason. Dismissd - Relieved - (161 Charles Manson (a Cobler) Œ: 45 Novr: 21st: A pretty large colourless & equable swelling occupies the Abdomen with evident fluctuation: Has also Cough with pretty copious viscid Expectoration sometimes tinged with Blood; & Œdematous swellings of his legs towards night - P - 90, T. clean, no thirst appetite bad sleeps tolerably, B - regular, swelling of the Belly of 3 Weeks standing that of the legs only of 4 Days has had Cough more or less these some years, complains of some in the Cartilage Ensiformis next the right side on pressure; but no swelling can be perceived has had no Medicines but a Teaspoon ful of Crem: Tart: & nitre this Morning with some Gin; which he thinks made him pass more Urine than usual - 22nd P - 84 - Cough & Dyspnœa increase when he ties on the left side, Urine pale & diminishd in quantity - Capt: Tinct: Digit: gt. x4 ex Aqua Font: ℥j H. S: et repr: Mane - 23rd pulse 80 Urine ℔ij Capt: Tinct: Digit gt 50 - 24th: Felt: much weakness after both doses; u: ℔ 3 Repr: Tinct: Digit: - Costive Injn: Clysma - 162) 25th - Nausea & Headach - Urine ℔j Glyster operated well; Repr: Tinct: Digitalis - 26th: Urine ℔ij Medicines no sensible Effect - Repr: Tinct: Digit: gt: LX & Capt ut Ant: - 27th. - no sensible Effect from his Medicines U: ℔ 1 3/4 & deposits much sediment belly increas'd 1/2 an Inch - Repr: Digital - Meat to Day & Daily - 28th: No Effect from the Medicine, Urine turbid & with much sedt: Abdomen increasd 2 Inches; Urine ℔ij ℥ij - Repr: Tinct: Digit: ut ant - 29th - run off - (163 John Grey Œtatis 50 - Novr: 9th - Has much pain from the top of both hip joint shooting at times down the thighs & legs the knee & ankle joints as also that of the left wrist are occupied with a considerable degree of swelling; the rest of the extremities are much emaciated & their motion greatly impeded - says that the pains are commonly increas'd when warm in Bed these are of two Months standing and were supposed to have arisen from exposure to cold, has been at different periods of his life affected with Rheumatism - Pulse, skin & Belly natural, Tongue rather foul with increasd thirst; has been sweated & used friction with Ol: Tereb: before Admission, & has taken Extrata Gent: & Aconiti, & Infus: Amar: since Admission with little Benefit - 10th - Pulse 80 & rather weak, pain stretches down the outside of both Thighs to the Feet, about a month before he was affected - 164) 11th Pulse 74. & weak, the parts swelld have been so for 2 Months & he felt the pain in them about a fortnight before the swelling ꝶ Mellis opts: ℥j Ol: Tereb: ʒij ♏ ƒ fiat Sinetus - Cujus Capiat - Cochle. unum parvum - mane & state Capt: Decoct: Hordeat: ℥viij post sing. Dosin - Middle Diet - 12th Pain in his thighs & right ankle severe during Night - Continn: Medicamenta - 13th - Pains of his thighs & legs better, swellg: of the right Ankle fallen, got an Opiate last Night as he complaind of much pain; sweated during the Night Repetr: Smetus ut Ant - Omitn: Haust. - 14th - Compts: easier - 165) 15th. - Symptoms the same as yesterday - 16th - Pain in the Thighs much better, right Ankle much swell'd the right Knee pained all night - Continn: Sinctus - 17th - Sciatic pain almost gone, right Ankle Knee in the same state - Omitn: Sinctus - ꝶ. Tinct: Canthar Ol: Olivar āā p: Œ - ♏ ƒ et appr: quator in dies Talo dextro - 18th: continues as yesterday 19th - Swellings appear to increase, Belly round Injiciatn: Clysma domest: Vespene - 20th: continues same 21st: the same 22nd Both Ankles swelld Applicn: Epispast: 166) Grey - circa Talum utrumque; Omittn Siniment: 23rd - Blister operated well - 24th: Right Ankle discharges much the left but little; the pain of the left Ankle almost gone, that of the right in the same state - 25th - Continues the same 26th: - P - 108 & weak an increase of Heat during the Night - pains as yesterday right Ankle much swelld last Night - Capt: Solut: Tait: Emet: ℥j 4ta quaque Hora - 27 P - 84 sweated much during Night, pain in the same state; Nausea & Vomiting after the 1st: Dose but none after the Subs. sequent Ones, purged once - Omitti Solut: - 28th - Ankle not easier from the Blister ꝶ. Pulv: Cicut: grs. x Syr: q: s: f: Bol Capt: H: S: & Mane - 29th - Medicine produced no sensible Effect - Capt: pulv: Cicut: grs: xv forma Boli ut ant: - (167 Grey - 30th: Nausea & general Heat after the Medicine; Repr: Cicut: grs: xx ut ant - Decembr: 1st: some nausea, headach, & gentle sweat after the medicine, pains easier - Repr. - 2nd - Some Effect from the medicine, which are much stronger in the Morning than evening - Repr - Bol: - 3rd: Complaints the same: Capt: Pulv: Cicut: grs: xxv ut antea - 4th: P - regl: nausea & headach with slight vertigo all the forenoon; pains easier Repr: Pulv: Cicut: u: a: 5th. P. 92. pain in the upper & exterior part of the left Thigh; less nausea after the medicine - Repr: Cicut: u. a - 6th: Swellings & pains easier, Bolus had no sensible Effect: Capt: pulv: Cicut: grs: xxx u. a - 7th: Inclinable to sleep; pain above his Eye Capt: Pulv: Cicut: grs: xxxv u. a. - 8th: pain of his forehead, weight of his Eyelids some Colic pains, heat of his feet & Ankles Repr: Remed: - 9th: pains easier, some Effects from his Medicine as before Capt: Pulv: Cicut grs XL - 168) 19th: no sensible Effect from the Medicine [crossed out]; Rheumatic pains easier - Capt: pulv: Cicut: grs: XLV u. a. 11th Out side of his right Ankle paind Bolus produced no sensible Effect - Capt: Pulv: Cicut: grs: L - u: a - 12th pains easier & swelling less - Medicine had no sensible Effect Capt: Pulv: Cicut: grs LV - u: a 13th: no Effect from his Medicine Capt: Pulv: Cicut ʒj u: a: - 14th: Dismissd cured - (169 Robert McTartin - Œt 13 a Shoemaker - Decr: 1st: Has great pain in the Knees Elbows & Shoulders stretching along the course of the mucles but is particularly severe in the upper Extremities has very great Weakness of the Joints of the lower Extremities so as to prevent walking unless when supported; with great loss of feeling & sense of coldness, the Anesthesia extends from the Middle of the Legs to the Ankles, P - 90, T. clean, great thirst but cannot satisfy it for the bad Taste of his Mouth, sleeps well but when disturbd by the pains, Appe good Belly regl: Compts: of 4 Weeks duration & clean or slowly without any known Cause has used no Medicines - 2nd - P - 86 - rather weak, no Symptoms of worms - ꝶ: Pulv: Rhei grs xx Mere: d: grs iv syr: q: s: f: Bol: Capt: Cras Mane - 170) Decr: 3rd pulse 88 - physic not yet operated pains easier - ꝶ: pulv: Cicut grs: v Syr: q: s: ft: Bol: Capt: H: S: & Mane - 4th P - 100 & weak nausea & vomitting after the Medicine last night, & nausea this Morning - 3 loose stools, Capt: Pulv: Cicut: grs: v ut antea - 5th - P - 100 - pains easier & walks better Capt: Pulv: Cicut: grs: viij ut ant - 6th: Symptoms easier - Capt: Pulv: Cicut: grs: x ut a - 7th: Complaind of pains in his Arms last night, Medicnes: have produced no sensible effect, Walks better, Capt: pulv: Cicut: grs: xiv ut: a. - 8th: Had pain during the Night in the right Arm, Headach; Capt: Pulv: Cicut: grs: xviij - 9th: severe headach after the powder last night & this Morning - Repr: Pulv: u. a. 10th: - Headach after the Bolus - Capt: Pulv: Cicut. grs: xx forma Boli hora som: & mane - (171 19th: Pains of his Arms gone, more use of his lower Extremities & more feeling in them had Vertigo & Headach after the Bolus, Biley rather round Repr: Bol: u: a: - 12th: - walks better, Headach after his Medne. Repr: Pulv: Cicut grs: xxiij - 13th: - same symptoms after his Medce: Repr: Bol: u: a: - 14th: Complaints easier Vertigo & Headach after medicine - Capt: Pulv: Cicut: grs xxvj u: a: 15th: Complaints diminishing - Repr: Bol: let him have some Meat - 16th: Medicine produces the same Effect Repr: Bol - 17th: Medicine produced no sensible Repr: Bol: - 18th: walks better continue - 19th: Has been free from all pain this two weeks. Elicianr: Scint: Elect: ex inferioribus Extremitatibus - 20th: continue Electricity - 21st: continue. 22nd. walks better since he began the Electricity - Continue 24th. walks better; - 172) Januy: 24th: 1789 - under the use of Electricity his power of motion gradually returnd & the pain of his Joints disappeard Dismissd cured the 25th: - 173) James Meike Œt: 13 - Decr: 11th: complains of constant thirst attended by an uneasy sensation of heat along the Œsophagus which can scarcely be alleviates by drink with some emaciation & general debility - His time is considerably increasd in quantity & is of a pale colour & insipid taste - P - 120 - Tongue & Belly natural Appe: impared rest tolderably, was attacked by the above complaints abt: six months ago & says they have been agravated within this month; knows no Cause; about a fortnight ago passd a Sumbricus Worm & about six weeks ago after the use of some physic ha pass'd a great number of Ascarides; is often observed to pick, his nose; has used 3 doses of Physic & a mixture with some relief - 12th: - P 82 - & soft, grinds his teeth especially during night - Urine as pale as Water Pupil large - since 9 P - M has drank ℔ xiv of water & his urine since that time amts: to the same Quantity - 174) ꝶ: Pulv: Rhei: grs: xxij Merc: dul: grs ei Syr: q: s ♏ ƒ ft: Bol: Capt: cras summo mane Middle Diet - 13th: P - 84 & irregular - Urine ℔ xxv drank ℔ xv physic not yet operated nostrils some within from his constant picking them - ꝶ: Pulv: Starmi ℈ij Sal: Martis grs i Pulv - Rhei grs iij Syr: q: s: ♏ fiat Bol: pro dosi Capt: dosim quater in dies - Habeat Fruct: Tamas ℥j Capiat ad vibitum - 14th: - P: 92: - Drink ℔ xvij Urine xxix ℔ - His Beer Milk & Broth appears to Amount to ℔ iiiss Bread ℔ss - his time appears to exceed the Injesta by ℔ viij had only 1 stool - Repr: Bol: u: a: - 15th: P - 92 - appetite rather diminishd since the attack; skin not dry usually sweated some this Morning; his Thirst & drinking increases from 4 oClock pm till 6 next morning, after which Time (175 it diminishes & the passing of the Urine keeps the same proportion; Urine ℔ xxiv ℥ij - Drink of every kind ℔ xvj Bread ℥xiv no pain on pressure on the region of the Kidneys applicetn: Angulum satis ampsum circa regionine renum - Injecn: Clysma domest: statim, Repr: Bol: u: a - let him have two oranges a Day - omittn: Fruct: Tamarind: - 16th: P - 110 Urine ℔ xxiv. Meat & Drink ℔xviij - 5 loose stools since the Clyster Eliciantur Scintil: Elect: ex regione renum - Omittn: Bol: - 17th: P - 102 - Urine ℔xxiiss Injesta ℔ xviij ℥ij no purging - Repr. Electricitas quotidie - 18th: P 116 - Urine ℔ xxiiss - Injista ℔ xviijss - Repr: Electricitas - 19th. P 100 - Urine ℔ xxivss Injesta ℔xix Continue - 20 P. 108 - Urine ℔ xxv Injesta ℔ xxiss Heat of his back & thirst less after the Elect: Continue - 176) 21st. P 124. Urine ℔ xxiij Injesta ℔ xviij 2 loose stools of a soft nature - Conue: 22nd P 104 Urine ℔ xxiv Injista ℔ xviiss repr: Elects: - 23rd: P. 116 - Urine ℔xxvj Injesta ℔ xviiiss his Weight was 75 ℔: when weighd yesterday at 4 oClock p: m:, being weighd at 6 p: m his Weight was 74 ℔: 13 ozs being weighd again at 72 past 9 to day his weight was 73 ℔: 11 ozs. at 72 past 11 his weight was the same - Repr: Electas: - u: a 24th. P: 92. Urine ℔ xxvij Injesta ℔ xviij to be weighd as formerly Repr: Electas: - 25th: P. 96. Urine ℔ xxi Injesta xviiss - Wt: when weighd at 4 P: M: was 76 ℔: 8 ozs: two Hours after his weight was the same; this Morning at 1/2 past 9 - weighd 74 ℔: 10: ozs - two Hours after 74 ℔: 9 ozs: - Electricity & Belt seem to have been attended with no advantage - Omittn. Cingul & Electas: - Capt: Mist: Cort: peruv: ℥ss 4ta: quaque hora - 26th: P: 84 - Urine ℔ xx Ingesta ℔ xviiss weight at 4 P: M: 75 ℔. 8 ozs: at 6 p.m. (177 Meikle. - his weight was 76 ℔ : 6 ozs: at 9 a: ck to day weighd 74 ℔ - at 11 - 74 ℔: 9 ozs - repr: Mist: Cort: peruv: - 27th P; 86 - Urine ℔ xxiii Ingesta ℔ xviss at 4 P: M: Wt: 76 ℔: 5 ozs: at 6. - 77 ℔: 3 ozs: at 9 to day ℔ 75: 4 ozs: at 11 - 75 ℔: Heat of the Œsophagus somewhat diminish'd - Haveat Auranti: 4n: in dies - repr: Mist: Cort: peruv - u: a 28th: P: 112 Urine ℔ xix Ingesta ℔ xiv at 4 P: M: Wt: 75 ℔. 14 ozs: at 6: - 76 ℔: 7 ozs - at 9 today ℔ 75" & at 11 - 75 ℔ 14 ozs - repr: remeda: - 29th: P 120 Urine ℔ xxij Ingesta ℔ xvij at 4 yesterday wt: 7 so that he had increasd during two hours ℔ i 4 ozs: - Hodie hora nona Wt: 76 ℔: 2 ozs at 11 - Wt: 77 ℔: during which two hours his increase of weight has been 14 ozs: - so that in proportion during 24 Hrs - his increase should be 12 ℔: 12 ozs: repr: Mist: Cort: u: a - 30th: P: 88 - Urine ℔ xx - Ingesta ℔ xvij feels himself stronger & heat of throat diminishd 178) diminishd as is his Thirst: repr: Mist: Cort: u: a 31st: P: 112 Und somewhat irregular - Urine ℔ xx iij Ingesta ℔ xviss yesterday from 1 P: M: to 9 P: M his urine ℔ x Ingesta ℔ v: from 9 last Night to 7 to Day A: M - Urine ℔ xi Ingesta ℔ viij - His Drink & urine are in greater Quantity during the Night than Day repr: Mist: Cort: - January 1st: 1789 - P: 90 yesterday from 2 to 4 P: M: drink ℔ ij - Urine ℔ i - from 8 to 10 at Night drink ℔ i 3/4 urine ℔ ij 74 - from 12 to 2 A: M: drink ℔ ij 72 Urine ℔ ij 3/4 - from 6 to 8 A: M drink ℔ iij Urine ℔ iij from 10 to 12 am drink ℔ ij Urine ℔ iij - Fauces moist & seem to him less hot Omittn: lotum Corpus Ung: Simp: H: S - 2nd: P 108 - pass'd a small Lumbricus - Urine ℔ xx iij Ingesta ℔ xvij - (179 ℥iij of Ointment required to rub him over - Repr: Ung: simp: u: a - Thirst as usal - 3rd: P: 96: Urine ℔ xx ℔ xv Apptin Ung: simp: u: a. . 4th: P: 116 Urine ℔ xx Ingesta ℔ xviss Heri hora 4ta. P: M: Wt: 76 ℔: 8 ozs: hora 6ta: 78 - hodie hora 9na: ℔ 74 - hora 11ma: 74 - Omittn: Ung: ꝶ: q: s: ft: Bol: stat: sumend: & repr vespere & Mane - 5th: P: 96 - Urine ℔ xix Ingesta ℔ xvss Heat of his Body 96°: of Farenheits Thermometer - repr: Bol: u: a - 6th: P: 104 Urine ℔ xix Ingesta ℔ xiiss Thirst much less. repr: Bol: - 7th: Urine ℔ xx Ingesta ℔ xviij - repr: Bol: u: a - 8th: P: 96 Urine ℔ xxi Ingesta ℔ xix omittn. Bol: - Capt: Seri Alum: ℥iij quater in dies - 9th: P 132 Urine ℥ xx Ingesta xvss - Continue - 180) 10th: P: 90 Urine ℔ xixss Ingesta ℔ xvss repr: Serum Alum: - 11th: P: 112 Urine ℔ xxi Ingesta ℔ xvj Omittn: Serum Alum: Capt: S: S: gt xxx - H: S: & Mane - 12th: P. 88 - Urine ℔ xxi Ingesta ℔ xiiiss drank only to vj of water during the night, whereas he used to drink frequently ℔ x some Headach. repr: Haust: Anod: H: S: & Mane 13th: P: 88 - Urine ℔ xix Ingesta M xiss. - From 10 P: M: yesterday to 7 A: M: drank ℔ v feels his thirst during the Day not diminishd - Omittn Haust - Capt: Pulv: Anod Dover ℈i form Bol: H: S - 14th: Urine ℔ xv Ingesta to x drank only ℔ iv from 10 P: M: to 7 this Morning sweated none, slept better let him hace a flannel shirt repr: Bol: H: S & cras mane 15th. No sweat from his Medicine, Urine ℔ xiv Ingesta ℔ ixss - Capt Pulv - Dov: ʒss form Bol: H: S - 16th - Urine ℔ xiij Ingesta ℔ ixss no sweat was very hot during the Night but sweated [illegible] repr: Bol: H: S: & cras mane - (181 Meikle 17th: Urine ℔ xiij Ingesta ℔ ix no sweat from the Bolus Capt: Pulv: Dov: ℈ij H: S: & cras MAne 18th: Urine ℔ xiij Ingesta ℔ ixss no sweat but a greater degree of Heat: repr: Bol: u: a 19th: Urine ℔ xiv. Ingesta ℔ ix. The Bol has no Effect but that of making him sleep Thrist diminishd - repr: Bol: u - a 21st: P: 82 sweated a little about his Head & shoulders after his Bolus last Night, but vomited the Bol this Morning Urine ℔ xi Ingesta ℔ ix repr: Bol: ut antea H: S Capt: Pulv. Dov: grs: x4 cras mane 22nd: P: 90 Urine ℔ xss Ingesta ℔ ixss vomited last Night after the Bolus as likewise this Morning, no appetite & much nausea - Omittn Bol - 182 23rd: Urine ℔ xij Ingesta ℔ ixss let him be weighd as formerly Capt: Pulv: Dov: grs: x4 H: S & Mane ut antea - 24th: Urine ℔ xiij Ingesta to xss Weight of his Body at 4 P: M: heri 78 ℔: 10 ozs: at 6 P: M: 79 ℔: 6 ozs: at 9 this Morning 77 ℔: 10 ozs: at 11 - 78 ℔: - vomited the Bol: this Morning sweated none during the Night Capt: pulv: Dov: ʒss H: S: & Mane 25th: Urine ℔ xij Ingesta ℔ xij Ingesta to x vomitd his Bol: this Morning no sweat during the Night - Habeat: Balneum Tepid per sex minula vespere repr: Pulv: Dov: u: a - 26th: Had the Bath about 6 P: M: yesterday vomited both Boluses sweated none Urine ℔ xi Ingesta ℔ ixss Capt: pulv: Dov: ℈i - u: a: Habeat Balneum Tepid: - 27th Vomited both boluses no sweat - Urine ℔ x Ingesta ℔ ix. Capt: Pulv: Dov: forma pulveris ut antea - (183 28th: Retaind the powder last night but did not sweat vomited the powder this Morning Urine ℔ xij Ingesta ℔ x repr: Pulv: ut Antea - Omittn: Balneum Tepid: - [inferior. Extrem] Applicn: Fotus Aqua tepid: infenoribus extremitatibus bis in die per quadrantem horox - 29th: Some sweating but partial after the fomentation did not vomit the Pulv: Dover: but no general sweat - Urine ℔ xi Ingesta ℔ ix - Dismissd at his own desire - vide pag: 189 - 184) (185 David Greig - Œt 50 A Piorighman - Decr: 9th: - The right side of the upper Lip & right Ala nasi are affected with an ulceration the Edges of which [crossed out] [crossed out] appears ragged & elevated with some Tumefaction of the neighbouring Parts it extends along the Nose [crossed out] nearly to to the inner Canthus of the Eye & seems to affect that organ with some degree of Inflamation - On inspecting the Fauces no Ulceration can be seen - Functions natural this affection supervened about 3 years ago & as he says was caused by scratching wart seated a little above the affected Ala Nasi; has never been affected with Sues venerea & no Scrophulous Symptoms ever appeard in his Family has used some Ointment with little advantage - 10th. Capt: Pulv: Cicut: grs: viij Forma Boli: H: S: & mane - 11th: Bol: produced no sensible Effect Capt Pulv: Cicut: grs: xv - u: a - 186) 12th: Medicine had no sensible effect Capt: Pulv: Cicut: grs: xxij - u: a - 13th Complaint in the same state Bol produced no sensible Effect - Capt: Pulv: Cicut: grs xxx - u. a 14th: Ulcer appears cleaner but pain not diminished - Capt: Pulv: Cicut: ℈ij u: a 15th Medicine had no sensible Effect Capt: Pulv: Cicut: grs: 4 u: a - Full Diet - 16th: Felt some warmth from the Bol: this Morning. Capt: pulv: Cicut: ʒj u a 17th: no Effect from the Medce: Capt: pulv: Cicut: grs: 4 xx u - a 18th: No Effect from the Medicine Capt: pulv: Cicut: grs: LXXX - u. a 19th Continue - 20th: warmth of his Breast Vertigo & watering of his Eyes after the Medicine Repr: Pulv: Cicut: u: a: - 21st: Ulcer looks cleaner has more pain in it than when he came in Capt - Pulv: Cicut: grs xc: u: a - (187 22nd: Vertigo for a few Minutes after the Medicine - repr: Cicut: u: a 23rd: Continue. - 24th: Little Effect from his Medicine Capt: Pulv: Cicut grs c u: a 25th: P: 100 and strong, about 3 Hours after the Bolus last night began to appear delirious & could hardly be kept in Bed, he felt his right side pained his heat increasd & more thirst. Slept none ꝶ: Acet: distill: ℥j Aquæ: font: ij Syr: Balsam: ℥ss ♏ ƒ Julap: Capt: ℥j stat et repr: 4ta: q: q: nora Injicn: Clysma domest: Stat: Omit: Cicut: 26th P 88 & strong Cheeck & nose red swelld & painful; 3 stools since the Clyster - Flat V: S: ad ℥x. Capt: Infus Tamaind ℥ij 3ta: quaque hora Low Diet: Omitr Julap - 27th: P: 94 & soft Blood natural the swelling & redness spread over the right side of his Face; & blinded both Eyes, 2 loose stools no delirium & slept some; severe Headach: the swelling has come the length of both Ears which are much swelled; sore not affected; Applicn: Emp: Epispast. Vene Camphor: nitera Scapulas - 188) repr: Infus Tamarind - u: a Elevatur caput quantum fieri potest - 28th: P: 92 & soft Blister opread. well & the blisterd part not affected by the Erysipelas Ulcer looks well & not more paind, Face much swelld - Applicn. Ung: Saturn: Ulceri repr: Infus: Tamarind: - 29th P: 86 Face less swelld 5 loose stools Erysipelas as before repr: Infus: u: a 30t: 8 loose stools ulcer looks better Face less swelld & can now see - Capt: Infus Tamar u: a 8va: quague hora 31st: Compts: easier - Omittn: Infus: Tamand January 1st: 1789 - The Ulcer looks well, diminish'd & the Matter well digested & less painful 2 loose stools - 2nd. Convalescent: - 3rd & 4th: continue 5th: Capt: pulv: Cicut grs: xxx form: Bol Hora somni & mane - 6th: continue 7th: continue 8th: continue 9th: Let him have a Dresser continue Medne: 10th: Medicine has little Effet Capt: Pulv: Cicut: grs: x 4 - 11th: & 12th: continue - remitted to the Surgeon Febry Symtoms somewhat relieved - (1 Pt. 2 Febres Continua - In the consideration of Fevers I shall not heat of any case in particular as we have had so many patients labouring under them in different degrees & as my practice has been pretty similar in all of them - You may have observed a striking similarity in the disease in all the different patients & it was much diversified in degree of Violence - I take it for granted you are all acquainted with the general Idea of Fever so well described in Dr: Cullens definitions which are amply sufficient for all the purposes of practice & nosology the no definition can be found that will not be liable to cavil from those who are determined to find fault - I shall not then insist on the Diagnosis 2) nor shall I descend into any nosological distinctions calling one a Typhus & another a Synochus as I think there is something common to the whole class & that in fact they only differ in degree, I shall give them therefore one common name of continued Fevers, the principal varieties of which you will find well pointed out by Dr Cullen These varieties depend more in my opinion on the Constitution of the patient & many accidental circumstances than on any difference of the contagion, the difference of Constitution has manifestly great Power in changing the Effects of Contagion for the proceeding from the same source it will in the Sanguine plethoric &c produce the Synochus & in those (3 of a contrary Habit the Typhus - Many external circumstances have likewise great Effect, as Cold - This is evident by fever's being combined with Pneumonia, Catarrh, Rheumatism, sore-throat &c - Independant of cold & other external Circumstances the fever is likewise varied by the method of Cure employ'd - When Evacuations are much used it is frequently converted soon into a Typhus & when the contrary mode is push'd too far it has often been renderd very inflamatory - I have more than once observed the bad Effects arising from the too free Use of Ardent Spirits they increased the delirium astonishingly & renderd it rather a Mania - These and Reason incline me strongly 4) to think there is no real difference between the varieties of Continued Fevers - there certainly is between them & Intermittents - I am not certainly however whether this conclusion will extend to the pure Inflammatory Fever or real synocha so rarely to be met with - I never saw above one or two instances of it but I imagine if the patient had escaped the Inflammatory stage & the Fever was allowed to go on it would at last degenerate into Typhus - I formerly thought I had seen pretty frequent Instances of inflammatory Fever particularly in Soldiers but I am now taught greatly to distrust these Observations & to think rather the disease was cut short by Medicines or nature (5 before the usual debility supervened which it would otherwise have done & that they were only attended with inflammatory symptoms somewhat more violent than usual in the Beginning With respect to the prognosis in Fevers it is in general favorable; yet we should be cautious as most surprising changes sometimes Occur - I have know a person recover from the most dreadful situation you well conceive while I have known others after the approach of the most favorable symptoms sink suddenly & expire - I had one particular instance of this in a patient who had got rid of the Fever so completely that he was setting up & dressed & while I was giving out the report he 6) became suddenly convulsed & expired the only remedy he had taken was the Antiml: Solution the Night before which had operated only once up & down. The prognosis is determined by the different Time at which some symptoms appear if the delirium comes on early it is a very bad Symptom but rather the contrary if its first appearance is on the 10th or 12th day - If the patient has been mismanaged or neglected for some Time the recovery is perhaps impossible - Patients are left labouring under a Fever for a week or more without any assistance & some times they are absurdly bled, purged or sweated till their strength is entirely gone - The Prognosis is often determined (7 by the nature of the prevailing Epidemic - The difference of which is often very remarkable, I have had at at one period a hundred Patients in fever one after another without losing One - While at another period I have lost several in few days - During 11 years practice in the clinical ward I have in 5 of them not lost one fever Patient & in the other six I have lost from 5 to 8 every year - And as my Practice was in general the same the difference of success could be only ascribed to the different nature of the Epidemic As to the causes of Fever they are little understood & the nature of the predisposition to be affected by the Contagion [crossed out] unknown - It has been 8) said to depend entirely upon debility but tho this has in some Cases its effects it certainly is not all, for the young strong & Healthy I have in several Instances observed are the soonest effected & in them the disease is most severe of this we have a proof in Kerr who was a stout health young man - I have observed the old the pthysical & dropsical most frequently escape the Contagion where it raged while those of a Contrary Habit were affected - I have known the Contagion to sfned pretty generally in the clinical Ward & in all my Practice there I never knew one pthysical Person affected & but one dropsical & I am sure we cannot find two more weak (9 states of the Body - Weakness however does not at all Times & in all Circumstances tend to induce the disease, but undoubtedly many of the causes which dispose to debility dispose also to Fevers - The Age principally liable to the attack is from 30 to 40 tho I myself have seen it attack persons from the Age of four to that of fifty even in one Family - Of the Occasional Causes Contagion is undoubtedly the chief which is supposed to arise from the Accumulation of the Effluvia of the Human Body in any confined place, this would appear to be true from the frequency of the disorder in Jails, Hospital & Ships, Cities & amongst the poor &c - But then this is to be considerd that many People 10) have been crowded together for a length of Time without the Contagion being generated as in badly regulated Jails in ships in stormy weather when the port Holes have been shut for some Time & has been quite confined & it may be said that when it has appeard it was owing to the introduction of it accidentally - But the appearance of Contagion under the Circumstances mention'd where it could not be traced & other considerations render the first opinion sufficiently probable - With respect to the power of other Causes which have been supposed of themselves capable of producing Fever. I entertain much doubt; As Cold, the Passions, internal Heat particular Diets &c - For they occur very day without the supposed Effect - However by hurting the general Health they certainly may cooperate with the Contagion & render its (11 Effects none certain & dangerous - With respect to the proximate Cause nothing complete or satisfactory is yet known. next to Hoffman no man has gone farther in refuting former erroneous Opinions than my very learned Colleague Dr Cullen; but the Opinions he has proposed are by no means satisfactory - Fever is I think clearly an affection of the nervous system by any attempts to reduce it to one or two Condition of that System will be in effectual Dr Cullen imagines Fever to depend principally or Debility & spasm, but we have Debility in all its different Degrees, from Health, to Death without any Fever or spasm. We have spasm without Fever or Debility in many Instances & again we have spasm & Debility conjoind without any appearance of the Disease supposed 12) to arise from them - As for Instance in person coming out of the Cold bath when it disagrees with them after which I have known a Constitution of the skin & a Debility of the general system remain without consequent Fever for a long Time - On the other Hand, we have fever without any spasm frequently [crossed out] can be perceived both continued & intermittent - I have seen the different Symptoms of these last Species recur singly at the usual periods without any appearance of Spasm & I have seen the same happen usual form - Besides all this violence of the Symptoms is by no means proportioned to the Violence of the Assignd Causes - (13 The Debility is greater after the Cure or towards the End of a Fever than at the beginning or during its Continuance - I have Known fevers to continue for several days with a relaxed skin & uninterupted moisture, & I have seen spontaneous sweating continue so long that I was obliged to employ remedies to stop it - Of the uninterupted moisture of long continuance we have had an Instance this Year in, Cath: ♏ Gregor - As therefore the supposed Causes occur without producing the Effect, it is often produced when their presence cannot be detected, & as when they have accidentally preceded the supposed Effect is by no means proportiond to the degree of violence, we may very safely conclude that they are not to be considerd as the Causes of the Disease - 14) No-body can pretend to deny the frequent Occurrence of Debility & Spasms die Affection of the skin in Fevers - But they are mere symptomatic & the latter is a symptom that does not demand much attention in the Cure - It is on the Account that I do not push Emetics, Diluents & Fomentations Diaphoretics Blisters & the other remedies for relaxing the surface so far as may be expected, for Experience has shewn me that it is not effectual or admissible & I am sensible my Practice will on this account appear to some of you feeble; but I assume you I do it now much less than I did some Years ago. Fever is a disease which does not last long there is something in its nature which determines it either to + (15 to be terminated in Health or Death at some particular Period - I would by no means consider it as an Effort of nature solely, but there are certain changes going on in the System which bring it at length to a Termination - Here its difference from all other diseases in which tho Physician has much more to do - If the Fever can be cut short in the beginning it should; Other chance is well worth trying, but if we dont succeed at first the Idea should be given up as I believe the remedies for this purpose are very absurdly persisted in too long - Of all the remedies for this Purpose Emetics are the best, especially Antimonials 16) as operating more briskly & given perhaps a greater Agitation than Ipecac: by which alone it is probable they are useful excepting by the secondary mode of operation to wit, that of emplying the stomach of its morbid Contents with which it is most frequently loaded from the Debility of its Fibres & therefore where I think the patient too weak to bear the operation of an Antimonial; I frequently order a gentle Vomit of Ipecac: - or a simple Infusion of Chamomile flowers - Emetics likewise prove useful when they operate as laxatives and clean the Bowels but the Effect is uncertain - (17 You may observe Soften order the Peruv: Bark, yet I am very doubtful of its Effects x & whether they are to be trusted to in the remission of Fevers - After the Antimonials I try to secure the Ground it has gaind by the Exhibition of the Peruv Bark but in this I often faild so that I began to lay it aside till Dr Clark's Book came into my Hands since which Time I have frequently tryed it & altho I have often cured the disorder it seemd to have faild in producing the desired Effect & upon the whole I have not been so successful in the use of it as Dr Clark seems to have been - However I most frequently administer it as it can do no Harm by increasing the phlogistic Diathesis & I know not what: (as some people have thought) - and it may 18) do good by supporting the Vis Vitœ There are two remedies employed by some in Fevers which I avoid most carefully Viz: Venæ section & Blisters - My Reasons I shall now give you as to V: S: it may perhaps when the inflamatory symptoms run very high be occasionally necessary - But I am every day more & more convinced of its inutility; the inflammatory symptoms being so very soon succeeded by great debility that it always renders the Fevers more dangerous - I have been sometimes led to employ it by apparently inflammatory Symptoms which ran very high, but have often had occasion to regret it afterwards - In this way we are often reduced to a dilemma - The Inflammatory Symptoms appearing to + 19) to threaten immediate danger, while the dread of the ensuing Debility prevents our employing this remedy & these fears are frequently well founded especially if the Evacuation should be large so that no general Rule can be given - of late I scare ever employ it: mead a revolution seems to have taken place in this respect especially among Physicians here - A candied old Gentleman has confess'd to me that he does not employ the remedy now above once for thirty times he die formerly = Blisters I consider as very improper remedies in Fevers I never saw any Advantage arise from them & frequently much Harm. They may be useful in topical affections as Head-achs, sore-throats &c, but in 20) general they should never be employ'd - If we wish to exhibit a stimulus Wine or even a Sinapism will answer much better. - You will see now that my Practice in Fevers is merely palliative & that my principle Indications are to relieve Symptoms, particularly dangerous ones & to suffer the disease to bring itself to a conclusion - It is of consequence therefore to be acquainted with the different Symptoms as they occur & the means of removing or relieving them - For this reason I pointed out the Congeries of them the reports & shall here give you a short sketch of the principal of them & (21 shew what they most probably depend - as so many occur, some Arrangement is necessary; & I shall divide them into the three following Classes - 1st: Impair'd Functions. - 2ndly: - Disagreeable Sensations - 3rdly: Changes of Sensible Qualities - Almost the whole of the different Functions, are impaird or deranged & hence it is one the most universal diseases that attacks the human Frame - One of the principal Causes of this is, the great & general debility, which is sometimes from the beginning very severe - I have known it render a patient almost at once unable to support himself - This will not appear very surprising when we consider that even tho Influenza or contagious 22) Catarrh was attended with extreme Debility of this Nature on the very first attack tho a milder disease - At other Times however the debility advances very slowly -I h ave known Patients go about their ordinary Business a Week after the first Attack. In general the more early the Debility occurs the worse - It manifests itself first, in the Voluntary motions by lassitude - The Patient, cannot sustain himself in the erect posture & I imagine the pain of the Back that so universally occurs is owing to the Debility of its Muscles - The posture of the patient too is a proof of the general muscular Weakness; he can neither lie on the side nor turn from one side to the other in the usual way but lies prostrate on his (23 Back, & being unable to support himself generally sinks towards the feet of the Bed - This Debility farther manifests itself in the voice which is generally feeble & weak as being found by Muscular Action - The Countenance is peculiarly languid from the relaxation of muscles there the Cause of all this muscular weakness unknown & as to the Cure it is impossible to remove it but by removing the Fever - We should however avoid anything that may tend to increase it as great Evacuations &c and I should attempt to obviate it as much as possible by light food if there be any Appetite, but as generally there is none, by Cordials, as Wine which at any Rate can do no harm for if we perceive any bad Effects - 24) we can discontinue them & they are most frequently serviceable - I have often been obliged to give up the Wine but I can safely say I never did the patient harm by its Exhibition - The Peruv: Bark may also be employd to support the Vis Vitæ; I am sorry however I have not been more successful with it in my trials in Fevers of the continued Type - I believe one of the most powerful Means of supporting the patients Strength is the Application of pure cool air which has wonderful effects - I did not fully understand its importance till about two years a gone & When a Fever raged violently in this City I was called to see a (25 Man who was confined in a small Hole of a Room the window of which was not open - He laid in a small bed sunk into a nick in the wall & had been in that situation since the first attack of Fever which was about 36 Hours & during that Time the Fever had made such a progress I could fairly pronounce Him moribund - I immediately had his Bed removed into a passage from the street into a Pack-Court where there was a constant stream of cold air & in this situation he recoverd beyond Expectation: for tho I apprehended instant Death when I saw him first he continued to live for some Time, but he had been too far gone to form any reasonable Hopes of a Recovery - 26) I saw enough however to convince of the utility of the remedy - To this Head also of Debility belongs Tremor which sometimes lasts for some days before Death & to which it is frequently a Prelude the patients often recover [crossed out] after they are perceived. It is impossible to draw a line between them and the Subsultus Tendinum; they run into one Another - I have seen the subsultus so violent that every Part of the Bed shook but such rarely happens till a short Time before Death immediately preceding which some patients have two or three strong Fits like Epilepsy - The remedies for these Affections are Wine pretty freely & large doses of Opium without scruple & repeated as soon as the Effects of the preceding dose are worn out - (27 I have frequently seen the best Effects from them in case where I did not expect the patient would live a few Hours - In other Functions we generally observe a great derangement - The senses are much disorderd as the Touch - There are extraordinary affections of the sensations of Heat & cold & I knew one remarkable depravation of the Function, where the Patient imagined every thing applied to him extremely hot - The Taste & Smell are impared sometimes however they are very acute - Heating & Sight are sometimes are very acute which I believe is owing to some inflammatory state of the Organs - There is a manifest appearance of it in they Eye & we should be lead to suppose there is a similar Affection present in 28) the Ear - I believe this Default is frequently alleviated by gentle Topical bleedings, by Blisters or by shaving the Head & applying cold water to it - I took on the inflammatory state of these Organs as a very unfavorable Symptom - Sometimes the Patient is really deaf and it is curious that this should prove a Favorable Symptom which in my opinion it really is - I have practiced this 4 or 5 years successively & I have never lost one patient in whom this Symptom appeard, and since that Time have lost after it an extreme small Number - no satisfactory Account can be given for this the only thing like one is that it consists in a state opposite to the - (29 inflammatory which is so dangerous a Symptom - Any Imperfection of the sight is a Fatal Sign such as seeing spots in the Bed - clothes pecking at what are thought flies in the Air &c - Most of those are affected with these Symptoms die some few however recover - I am myself an Instance of recovery after such a Depravation of sight - I knew one very particular affection of the Function we are speaking of - The patient imagined he saw stripes or streaks in the Bed Cloths For the Depravations of sight I I have mentioned I know no remedy - The internal senses are also commonly affected; hence Delirium which I hope you do not imagine always depends upon an inflammatory state 30) of the Brain- It is evident from considering the [considering] Causes, concomitant symptoms & manner of Cure it most commonly depend on Debility - In general no remedies are in particular required for it, as it most commonly disappears with the Fever, is relieved by Wine, Opium, & Tonics - If however an inflammatory state is manifest, Leeches & Blisters will prove of use - stupor which is remov'd by the same Medicines as Delirium; we sometimes meet with in an extraordinary Degree. Some use Blisters but I believe it is not so alarming as imagind nor it is very necessary to remove it - Sleep is in general very bad and it is a symptom very distressing - It is sometimes procured in (31 the Beginning by Evaucants as Antimls: Cathartics &c - : sometimes by Fomentations under the use of which I have known a Patient fall asleep - They are of use when the skin is dry & the Patient cannot sleep, but they (Fomentations) should not be persisted in long as they tend to weaken him - Opiates are frequently employed and often with great success, & washing the Head with cold water has been found useful as also cold air - Sometimes we find a great increase of sleep towards the End of Fever and in general those that fall into that state recover - I suffer them to sleep on unless when it is necessary to awaken them to take Food, Medicines, or Evacuations by stool & Urine - 32) In the Vital Functions the Pulse is at Times very frequent & indeed mostly so: we sometimes however find it very slow - We are principally to form our Judgement from the increas'd frequency & debility - I cannot say what degree of Frequency is absolutely fatal - I have known a Patient die before his pulse was 140 & I have know another recover when his pulse were 150 but this does not happen once in one hundred & fifty Times - In general there is great danger or when the pulse has risen to 130 - I know of no remedy particularly adapted to the quietness of Pulse - It is sometimes very frequent for a length of Time in Convalescence. - Intermissions of the Pulse are frequently habitual - 33) The breathing is seldom very laborious till towards the approach of Death; except when the Fever is combined with Catarrh - Hence I consider laborious breathing as one of the worse Symptoms - In the natural Functions the appetite is in general remarkably bad, which is in part owing to the Debility of the stomach, and partly to its connexion with the Skin - We should not force food in our Patients, but tempt them to take some now & then; for it is of no advantage whatever except in the convalescence of the Disorder. And I believe abstinence in the Beginning is a good a remedy as any that can be employ'd - The Appetite when the Patient is in a state of Convalescence often is much restored by a gentle Emetic, Laxative or Clyster - 34) Thirst is frequently a troublesome symptom as is to be removed by Diluents frequently varied an generally acidulated; by small Beer which I consider as good a drink as can be given; by ripe Fruits - A foul Tongue & mouth are generally present & troublesome & sometimes become sore - They are worth attention as indicating the state of the Fever in general - They shew a remission when they become moist & clean & the contrary - We sometimes find the Tongue brown & dry in the middle moist & clean at the Edges which is in general a favorable appearance - This state if the Mouth I believe arises from a Want of Secretion which (35 I think seems pretty general over the whole system - The state of the Tongue we are now speaking of often seems removed in some measure by an Emetic - The Stomach is I believe in almost a similar state from bad Digestion & I imagine there is a Want of Absorbtion throughout the while Canal as appears from the great Quantity of Fœces in proportion to the Aliment taken in - Costiveness is a very common Symptom & is most conveniently obviated by tasting ripe Fruits but more generally by Clysters - We sometimes have very great Diarrhœa which is to be remov'd by Opiates Astringents &c - sometimes involuntary stools pass owing to the Stupor - As to the urine no attention is to be paid to 36) any Prognosis drawn from it: for I have seen a copious sediment in the very beginning of Fevers and have seen it perfectly clear towards the End of the Disease - It is of much more consequence that it be dischargd properly, the retention being a very dangerous & disagreeable Occurrence * - The Catheter should always be introduced if it does not pass freely on taking some mild diuretic as Julap: Nitros: or on the Application of some Fomentations - The skin is most frequently dry and this state is best removed by Emetics & Fomentations but these --------------------------------------- * Note I has been remark'd in the royal Infir: many of Edinburgh that patients requring the Catheter generally die - (37 you already know I dont wish to push far - It is much relieved by cleanliness - As a critical Evacuation I do not regard Sweat; other Circumstances must be attended to - However if Benefit is not received in a short Time from it, I think it is best to check it by keeping the patient cool - You may observe I sometimes order'd the Diaphor: Julap - sometimes not - When I orderd it, it was when no other remedy with which it could interfere was necessary - The Julap: Satin: is a mere placebo when the patient is taking it, he thinks it some powerful Medicine & so it may prove useful - If it is ever of service it is by exciting a gentle Diaphoresis - 38) The second general Head of the disagreeable Sensations comprehends Headach, Vertigo, & Tinnitus Aurium these frequently occur combined, sometimes separate - They frequently depend upon Plethora of the parts & may be relieved by topical Evacuation as Blisters & Pediluvium - sometimes they depend on the Stomach sometiems on the Want of sleep in which latter case Opiates will give relief - They often however depend upon the Fever itself & are only to be cured by its removal or on Debility when Wine, Bark & good Diet are indicated. - Anxiety & Oppression are often present in different degrees are connected with Debility & a consequent accumulation of Blood about the Hemt (39 & great vessels - This sometimes perhaps produced by spasm; sometimes depends on the state of the stomach or the general debility of the Muscles - We hace always pain in a weak muscle & hence the Inability of retaining one posture & Restlessness - Anxiety & oppression with the Absence of this Restlessness is called by Physicians Euphoria, with the Presence of it Dysphoria, tho they by no means bear Proportion to the Violence of the Disease - Independent of any inflammatory affection there are frequently pains of the Back, Limbs & other parts which I believe are owing to a Debility of the Muscles & this Idea receives confirmation by the relief obtaind by lying in an 40) horizontal posture if the patient is sitting up - Some imagine [the] the pain of the Back is owing to come Congestion of Blood about the spinal Marrow but of this there is no proof - As to the changes of the Sensible Qualities the Heat of the Body is an important symptom, being connected with the progress of the Fever & it was from this the Ancients principally found them Opinions before they began to attend to the Pulse: particularly when it is very violent it indicates the Antiphlogistic Regimen Refrigerants & above all the Application of cold - The Colour of the Face should be attended to it being either pale flush'd or livid all which may (41 depend on topical Causes - Towards the approach of Death it is frequently very ghastly from the collaping of the Blood vessels occasioned by a feeble Circulation & the Debility of the muscles - Dimness of the Eyes & a Want of Lustic in them is a very fatal symptom tho I have sometimes seen a recovery of it & I remember one remarkable Instance of it - Yellowness of the skin seldom appears in this Country I have seen only two Instances of it - It is however frequent in warm Climates - I can give no good Account of it but am disposed to think it connected with the Bile - Petechiæ occur in very different degrees at different Times - 42) Physicians have been much inclined to consider them as the product of the Putridity & dissolution of the Fluids but it is not perfectly ascertaind whether they are not rather owing to a Debility of the Solids - They indicate the employment of Bark Acescants, Wine & cold air - Emaciation often occurs in Fevers to a considerable degree sometimes so as to prove fatal after all the febrile symptoms are gone; Instances of which I have myself seen - It is occasiond not only by a waste of the Fat in the cellurar membrane but also by a Dissipation of the Circulating Fluid - The smell of the patient is often very putrid & often independent of (43 Putridity or putrid Exhalations there is a peculiar Fator not easy to be described - We have had it in one Instance this year - They indicate the use of Bark, Wine, Acids, Cleanliness & cool Air - We often much with accidental symptoms as Excoriations which afterwards shew a Tendency to Gangrene - They are cured with difficulty - The first thing I employ is the Liniment De Haen - sometimes we are obliged to omit the Liniment & employ the Poultice & sometimes warm dressings to promote suppuration. The Bark & Wine are necessary - We sometimes experience very slow convalescence - 44) This especially happens when many Evacuations have been employed at the first of the Fever - I have often observed that Patients coming in when first attack'd & treated in a different Manner have been dismissd before other Patients who were in a State of convalescence on their Admission but who have been much evacuated at the Beginning - In such Cases a generous diet with Porter punch, wine with good air & Exercise will prove serviceable - (45 Febres Intermittentes - You will not I hope expect that I am now to enter into the History or Theory of Intermittents. Indeed the latter I must confess I do not understand so that my Practice is in a great measure Empyrical Intermittents should in general be cured as quietly as possible, notwithstanding the Favorite tho very absurd opinion of Physicians to the Contrary - I in general use no Remedy but the Bark whose great Virtues in this disease Experience has fally confirmd - The Anodyne Draught is a very powerful assistant. In frequently puts a stop to the fit altogether if taken just before it & if not it renders it milder - If taken in the hot Fit it [crossed out] 46) cases the Headach, relaxes the skin & brings out a sweat - You will observe I gave the [Draught] Bark as near as possible before the Fit, which Experience teaches me is the best Time - I never knew an Intermittent that could not be cured by these Means - I have tryed Chamomile Flowers in some Cases which with many other Bitters & Aromatics single or conjoind have frequently proved useful tho none are equal to the Bark - I tryed Mercury on the Hint of of one of my Pupils - This was first recommended by Sr: Geo Baker who exhibited it with great success when followed by the Bark in an Intermittent near London which could (47 not be cured by the Bark alone - This can be very easily explaind, - Mercury broke in on the Habit of the System which renderd the Disease so obstinate the Bark afterwards concluded the Cure - The Tendency to Diarrhœa which so remarkably prevails sometimes may prevent our using it very freely - You may have observed that I generally mark'd what part of the Fit was last to be removed as I think it proves that most of our Theories of Intermittents are not very solid as we find all the different parts of the Fit, as the hot & cold stages the Headach, the Dimness, the Debility nay the Delirium, which are (48 generally made to depend on each other occur quite separate & uncombined at the stated periods in different Cases - (67 - Hydrops - We have had under our Care several Cases of this Disease in various forms, I shall not therefore dwell on the distinctions but treat of the Disorder in general & those remedies most deserving attention in the Cure In no Case of Dropsy cure we form a favorable prognostic circumstances with seemingly slight hydropic Symptoms & good constitutions have slept through my Fingers in a short Time - The Age, Strength, bright Countenance & that modification of Dropsy we call Anasarca are in favor of a patient least more so them either Ascities or Hydrothorax - I have even found that when these 68) last proceed from Anasarca they are generally more easily cured & are less dangerous them when primary Affections tho at the same Time I must remark that relapses in Anasarca are more frequent than in the other Species In seeking the Causes of the disease in some of our patients we may lay aside the supposition of Obstruction as in Hunter & suppose it merely to arise from Debility of the Constitution, from Fatigue, cold &c - In the Cure of Anasarca we are not to expect any great effects from nature alone, for tho there Instances on the Annals of Medicine of dropsical swellings being carried off spontaneously by Diarrhœa, Vomiting &c (51 of Cathartics I always employ the milder as the neutral salts or the Ol: Recin: - On the whole I think the former rather preferable tho the latter answers abundantly well - Those cases of Dysentery which generally occur in this Country being of a Mild nature, are for the most part, removed by a very few Cathartics & and Anodyne or two after them - I use Anodynes in this disease more freely them the generallity of Physicians, thinking it better to remove the initiation after the Cathartic has operated then [before] to repeat them as symptoms may require, than to permit an uninterrupted course of purging - In our Case I orderd the Pot: Cretae: to correct Acidity & relieve gripes - Finding however no relief from this plan, I orderd a medicine which to 52) you will appear add & my views in giving it require to be explaind - You saw I did not intend it as a Cathartic giving it only in the quantity of grs: iij which I thought was as much as such irritable bowels could bear without purging & ordering at the same Time an Anodyne to prevent such Effect. My Views in ordering this will be explaind by reading you the Letters of Dr: Clark of New Castle, who first inform'd me of the practice & who in these Letters requests me to make trial of it - He says "I have formd that the acute "dysentery is of all other methods most " effectually cured by Calomel - I have " communicated this Information to my " Friends & their success fully confirmd my 53) " Opinions - It may perhaps be questiond " whether it acts as a Cathartic or Mercl: " but the proofs I think are incontestible " which shew that it acts in the latter " Manner for it is to be given so as not " to produce purging & the Moment the " Mouth is made sore & a Ptyalism begins " the disease Disappears - I have followed " this Practice in a great many Cases & " have lost only Patient but in him " the mercul: Irritation was not produced - " The best mode of exhibiting it is, it " there is any Nausea or Fever present " to give at Bed Time a Bolus with " Caloml: grs: v Emet: Tart: grs: ss & afterwards " to continue exhibiting it daily in doses of " from grs v to grs x with some Opium to 54) " remove irritation till Ptyalism is produced " which generally happens in about " 4 days or when about 30 or 40 grs: have " been taken - If then no natural fœces " appear it may be given without Opium " & in quantity sufficient to excite purging " which generally compleats the Cure - " The Quantity necessary is different in different " constitutions - I have known in " one Case 12 grs: produce the effect but in " general 30 or 40 grs: are necessary - " It has been employd with Children & " in Cases of chronic Dysenteria with Success - " When purgatives are employ'd as " in the common Practice they only remove " the Acrid Matter, nature must cure " the Disease, but Mercury seems at once " to remove it, besides when the Disease 55) " is removed by the former Method it is " frequently liable to recur which is never " the Case when Mercury is employd - In my Answer to this Letter & mentiond my Scruples with regard to the employment of it on Acct: of the irritable state of the Intestines & in answer to this he says - " I have employd it only in Chronical " Cases & in those acute ones where " other. Methods have faild & Experience " has proved that it does not act on the Intestines " as might be imagined - I employd " it one chronic Case of a very long standing " & which had resisted every other Method. " It was in a sailor returnd form " the West Indies - He look grs: ij of Caloml: " every Night till Ptyalism was produced " & then grs ij every other Night to keep " up the irriation by which means he was 56) " completely cured - The Case we had was not a fair one for trying the Merits of the Medicine so much recommended by Dr Clark - The 3 grs: seems to have purged since, for He had the next day 4 thin stool witht: Blood or gripes - Besides he did not give remedy fair-play, for he exposed himself to cold & was therefore obliged to give up - The Julap Sist: - was orderd, but he again exposed himself to cold in a manner which might produce severe Diarrhœa in a Person in health - suspecting some foulness of Stomach a Vomit was orderd & afterwards the Ol: Recin: to cleanse the Bowels. - The Julap Listens being repeated he seems nearly Well - (57 - Hydrothorax - Faciei pallor - This Symptom frequently attends the beginning of the Disease, but towards the End I have often observed a lividity ensue which arises from a stagnation of the Venous Blood in the Vessels of the Head - Pædum Œdema this often disappears & the water seems to be translated to the Thorax & sometimes from thence to the Head - I knew a Gentleman subject to the swellings & who whenever they disappeard became affected with great dyspnœa & when this dyspnœa [became again] also disappeard without the Feet becoming again swelld, was attacked with great Stupors & other affections of the Head: but when the swelling of the Feet returned he was relieved 58) of all other complaints, So that there appears a strong presumption that the Water was carried from the Legs deposited in the Thorax & from thence translated to the Head - Aqua in the Picture fluctuans; When this can be perceived it ascertains the Disease beyond all Doubt, but its absence is no proof that the Disease is not present - I never could perceive it but in one Case - Others who have had more Experience them myself assert that they have often felt it - shaking the Patient however is not a very safe or agreeable Practice as it may induce syncope or even Death - (59 When I tryed to discover Water in our patients Chest, by shaking the Trunk of the Body you saw how she fell immediately into a perfect Syncope & I for some Time Doubted if she would ever recover - I am convinced that even turning in Bed has sometimes induced Death in Hydropic patients; & besides this Danger the despair produced in the patient if he discovers we suspect Hydrothorax rendus it an Expedient by no means to be followed in private practice, as a Dropsy of the breast is generally tookd upon as a sentence of Death - Flatus & a Distention of the stomach tho not commonly taken notice of are frequent attendant 60) attendants of the Disease & Eructations often produce alleviation of the Symptoms - I have never been able to ascertain from the Symptoms in which Cavity of the Thorax the Water is containd - In one patient I found a very slow pulse which afterwards turnd quick & irregular & was attended with a great degree of oppression about the Præcordia & many symptoms of Dropsy in some part of the Thorax - On Dissection the Patient was found to be affected with Hydrops Pencardii, but in another Patient with very similar Symptoms no Water was discoverd in that sac - The prognosis in (61 this Case is unfavourable as I have known but very few recover from this Disease - The Diagnosis in Hydrothorax is in many Cases not only difficult but impossible - We may be called to a patient laboring under Dyspnœa only & this may give occasion to an Effusion so that a new Disease will supervene - In the case under our view I first orderd a Blister which was proper on either supposition that it was Dyspnœa or Hydrothorax for it has been proposed to increase absorbtion by them. It is certain that Evacuations from the neighbouring parts by Setons, Issues &c; have kept off the Disease & that it has returnd when they have been omitted - 62) I have seen such instances - The Blister seemd to have afforded relief the Mist: Mucilag: was likewise orderd which is by Many considerd an Expectorant, or as entering the Lungs & changing the Quality of the Expectoration but I have no faith in them as acting in such a Manner, - I imagine their Operation to be confined to the Fauces & Glottis which are often excoriated & thus increase the Cough - They may indeed indirectly change the Nature of the Maker expectorated; for by allaying the Cough they give occasion to its longer stagnation, a consequent absorption of its thinner parts & (63 therefore its inspissation - An Anodyne was orderd with the same intention of quieting the Cough, tho contraindicated by the great stupor; but when well timed I took upon Opium as the best expectorant that can be given & by stopping the Cough which occasiond the Congestion of Blood in the Head it may even have relieved the Stupor but as this last was increas'd it was omitted - The Pillulæ Scillitica in the quantity of grs x was next orderd wh: was but a moderate Quantity as the Mass contains but 1/10 of the powder of Squills; however it is as much as many Stomachs will bear at first & 64) if the Stomach is once nauseated by them it can hardly be got to bear any Quantity again - The Squill I took upon as one of the most powerful Diuretics, but like all others it is not a certain one it is absord'd & carried all over the Body & whatever parts of them are carried to the Kidneys affect them strongly - Mercury joind with them one way or another increases their power very considerably - I have tryed every Diuretic & never formd any so effectual as this Combination - It seems equal now Mercury is thrown in whether by the skin or stomach & the squill may be given in the ["fever" or "term"?] (65 of Pill, Bolus, Infusion, Vinague, or Wine, which last Van Sweilen highly recommends - When we have no Time to tone they may be both given at once, but when we have Time, the Squill may be given first - Even when the Diuretics purge I have often known them increase the quantity of Urine - I have found it once increasd from ℔ iss to ℔ xi tho a pretty smart Dirhhœa was produced at the same time - The greatest Quantity of urine I ever saw produced which was xv was by Mercury & Squills Dr Monroe has seen them produce a flow of ℔ xvij by Measure in 24 Hours - 66) I conceive that Mercury may act as a Diuretic itself when no determination is produced to the Surface, but considering it only as an universal stimulant it will have the best Effects when determined by another to the Kidneys, whilst as a general Stimulant it may also promote Absorption - It certainly excites the actions of vessels in other parts as we find by its good Effects on ulcers &c - I here preferr'd the Diuretic to the purgative weak but as I found no good Effects from it, I at last orderd a purgative which seem'd to have some Effects & to support the Vis Vitæ a ful Diet was enjoind with some Wine. - The Case ended in Death - (49 Dysenteria In some patients may at first begin like Diarrhœa & perhaps is a real Diarrhœa which degenerates afterwards into Dysenteria - This however is a matter of no great Consequence - In the Case I am to consider the Prognosis is favorable as Dysentery most frequently yields to proper remedies tho' the contrary is sometimes the Case - My Indications were 1st: to evacuate the morbid Matter 2ndly: to take off the spasmodic Contraction which it is probable constitutes a great Part of the Proximate Cause - Tho I do not well understand its nature, its Existance however as a 50) as a Cause of the Disease is at least renderd very probable from Dissection & from the Scybalæ that are passed during its Course - A great deal of my Practice however is directed with a View to alleviate Irritation & the Anodyne was employ'd perhaps too freely - A Cathartic Solution was orderd some Time after he got the first Anodyne &you may per = think it was the first Medicine prescribed; but as it was a disease of some standing I thought it best to alleviate the Irritation - I am certain however we may See on this side, for it is in vain to attempt alleviating the Irritation till ye morbid Matter is evacuated - 69) yet such are very rare & whatever power the vis medicatrix may have in other cases it is in dropsies very inconsiderable - They have no tendency to run a particular Course as in Fevers small pox &c - on the contrary the danger continues to increase from augmented Exhalation, Debility, oppress'd circulation &c &c - I am not certain whether the Water effused has not a tendency to relax the Solids & I think it may be proved by the longer continuance & greater degree of vigor that attends all encysted Dropsies tho the collection of water in some cases be amazing - While in Anasarca Ascites &c the Functions are much more impared - There is a great weakness of the digestive & assimilative 70) powers & hence perhaps the Blood becomes at length to be thin & watry - The two great indications of Cure in Dropsy are 1st - To carry off the effused Water 2ndly: To prevent a return of the Disease - Of all the Remedies employd for carrying off the water of Dropsy Diuretics are attended with the greatest advantages for if they do no good they can scarcely do any harm & they are frequently very successful. But one great disadvantage is the perfect uncertainty of their Operation, a disadvantage which I believe no Physician of Experience & Comd or will deny attends every remedy of this class - (71 As to the particular Diuretics Cremor Tartari has been frequently employ'd: it is generally given in large quantities of water & to this I believe much is to be attributed - I have frequently employd it with success, often with non, so that I am present somewhat disgusted with it - I never knew it answer better them when it purged, to which evacuation as promoting absorption its success is probably owing - Alkalies both fossil & vegetable have been employd & by some but with scarce any good Effect - Nitre I have tried but it did not answer my Expectation - Cantharides - I have given in doses of grs: j or grs ij once or twice a Day with equal quantities of Camphor but to no purpose & of the 72) Oleum Juniperi I may assert the same - Of late years a variety of poisonous bodies have been introduced as Diuretics in Dropsies as the Colchicum from the use of which I have seen some Instances of Benefit - I have tried it in the way of Oxymel & have given it in doses of 10, 15, & 20 grains but was upon the whole so much disappointed that I now rely but very little upon it - The Lactuca Virosa has been of late much celebrated in & according to Dr: Cullen is one of the most powerful Diuretics we possess he mentions its producing ℔ xxvj of Water in a Day which is a much greater quantity than I ever knew produced (73 by any Medicine I ever tried, I never used it - The Digitalis has been employ'd here for a good number of years & in some cases has certainly proved Diuretic in others not - The sickness it produces is so great that much care should be taken in its exhibition - It once I believe hastend the Death of a patient of mine & some of my pupils informed me that they had Known it attended with much worse Effects in London so that I shall hardly venture on it again - Of the Tobacco I have not had much experience, see Dr: Fowles Pamphlet - He mentions one striking Instance that it proved diuretic in 93 Cases out of a Hundred which is much more than can be said of any other Diuretic I know - 74) Garlic sometimes employ'd as a Diuretic is not to relied on - The most efficacious Diuretic I know is the Squill in the form of Pills as in the pharmacopeia Edinensis - The Wine, Infusion, &c are more apt to excite vomiting, the dose should be small in the Beginning & increasd gradually to any Extent the stomach will bear - Its effects are remarkably increas'd when combined with Mercury, - rubbing with Oil I have tried in more than 100 Cases & who it seemd sometimes to be attended with advantage, it was by no means frequently the Case & it is very foolish to trust to it alone - The Friction however which is employ'd is of service &may be always (75 used, as it interferes with no remedy & can do no Harm - Sweating - Tho at first sight may appear liable to Objection from the debility it induces, tho it has been generally mentioned with distrust, is a remedy I employ much more frequently than formerly - One Objection to it is that the Skin is very liable to be afterwards affected by Cold & 2ndly: the warm Bath may so weaken as to bring on sudden Death, but it is attended with some Advantages for it is more certain than the Diuresis - The only medicine I employ for this purpose is the Pulv: Ludorific & some cordial liquor as Gen Punch 76) or the Julap: Diaphoretic: I have found the Exhibition of Mercury before Hand very useful as a general stimulant to increase absorption &c - Another set of remedies which I am not very found of are Cathartics - Purging is by no means a certain method of increasing absorption & if it has not that Effect it is certainly attended with many disadvantages from its debilitating power - on Acct: of which Debility even where the swellings have been carried off by them they are extremely apt to return - Jallap with Calomel are the chief remedies employd for this purpose (77 & I have but little experience of other Remedies which have been proposed - As to the Rough Emetics, I imagine I have sufficient knowledge of their Utility from the effects of accidental Vomiting brought on by the Squills - I have seen it continue for 1, 2 or 3 Days together, hardly ever with the smallest advantage but often with the greatest Harm - I am assured by some of my Pupils, that it is often practiced in the West Indies with the greatest advantage - I never saw any good from it but in two Instances however it should be kept in View & may be employ'd where every thing else has faild - The cases in which I mentioned its success were 78) those where Patients who seemd nearly suffocated & in both it procured sensible & immediate relief - The Tart: Emet: is the medicine to be employ'd - Some other little Expedients have been proceed in Anasarca as the application of Cabbage leaves, silk-Hose &c but these are futile remedies & scarce worth employing - Blisters I should think are in the highest Degree improper, as a Gangrene will be very apt to succeed the Inflammation - Issues, Setons &c are said to have been very useful when the Water threatens to fall on the Breast & they are Worth trying, In obstinate Chronic cases they are (79 sometimes very useful, but more frequently of no effect - I have seen Hydrothorax relieved by them, become more urgent when they were healed, & again grow better when opend - setons in the knees are not advisable - Scarification is by no means proper - Punctures should be preferr'd & however unpleasant they become sometimes necessary & at Times remarkably useful - They sometimes continue to run 2 or 3 Days & discharge great quantity of Water - I saw one case where an amazing Quantity was in this way discharged - Sometimes however puncturing is followed by very disagreeable consequences 80) Consequences as Gangrene - In one Case where the scrotum was never touching - I orderd punctures which greatly [crossed out] diminishd the swelling but inflammation & a gangrenous appearance supervened; its progress however was prevented by Bark & Wine - The Diuretics were continued & I observed that under this Treatment the Urine was in creasd more than ordinarily - I had one patient whose Death was hastend by the puncturing, for within 96 Hours near half the Thigh turnd gangrenous - Another expedient which is often used, but which I am not very fond of is the laced Stortings, Bandaging &c - (81 The Legs most surely are prevented from swelling if they are properly managed, but the Effusion will take place some where else & I have heard of one Case where an Hydrothorax seemd to have been brought on by them. - Tapping in Ascites I have never known, & there is one reason why we should not defer it so long - viz that the presence of Water is enough to aggravate every symptom - I am much disposed to give credit to some Accounts of radical cures taking place from early Tapping (82 Erysipelas - The Disease in our Patient was not attended with any considerable fever, as is frequently the Case & sometimes so in Variola Measles & the plague - The Diagnosis here was very easy & the prognosis favorable - The causes of Eryipelas are very observe tho there certainly is something constutional in some people which determines them to be attacked by the disorder; as some have it every two or three Years - It is no doubt in several Instances contagious as was ascertaind in this Hospital about 18 Years ago, when it is probable a sufficient (83 attention was not paid to cleanliness - It has been known too to prove contagious these several years since, when I knew one Nurse so particularly disposed to be affected by the contagion that she took the disorder in this Way 2 or 3 Times - Independant however of such a Cause the Disease is supposed to arise from an Acrimony either generated in the Body or thrown out on the part, or externally applied - It is sometimes attributed to particular out &c, but these are not well ascertaind - As to the proximate Cause it is plainly an inflammatory Affection 84) Fever the Fever attending it is most frequently mild tho sometimes it is dangerous. - It sometimes requires very large blood lettings, at others a very contrary plan as it shews a disposition to putridity - There was formerly a very remarkable difference between the London & Edinr: Hospitals, in the treatment of this complaints the former employd Bark, Wine &c & the latter every part of the antiphlogistic regimen & both were equaly successful, for which reason I was once disposed to think there was a real difference in the Nature of the disease in different circumstances, but was afterwards led to imagine that both (85 were superfluous & that the Disease like the sore throat would disappear of itself - In some Cases however I have found bleeding absolutely necessary & in others a contrary Treatment - I have not however I must own formd it necessary for many years to order bleeding in any Case In our patient the disease was mild but as the pulse was weak & the disease had been present some Days I orderd the Bark & Wine tho I make no Doubt & he would have done well without it - of external applications tho safest & best I think is flour or powderd starch - Dr Kirkland in a late work reprobates them & was mild watery solutions of lead - They I doubt not in general are safe & useful - 86) - Hysteria - This Disease under which we have had several patients laboring is very disagreeable to the practitioner especially in an Hospital, where exercise, air & employment of mind are precluded, tho they may be rectmd among its most powerful remedies For this reason I wish to take in as few hysteric patients as possible as I believe more have been seizd with this disease in the Hospital than have been cured in it - I have known six seized with it in one Night - It generally happens that a temporary relief is obtained by various remedies & as soon as that happens I send them (87 out - Tho the disease is not dangerous, it ought by no means to be passed over in silence as it is frequently very severe, & many of the symptoms & forms it assumes are apt to deceive the young practitioner - As to the definition & description of it Dr: Cullens are the best, but you must not expect to find the combination he finds in every case; for sometimes one Symptom appears & sometimes Another - Whenever the Globus is present I think the Disease characterized, tho its absence by no means proves that Hydrothorax is not present I have sometimes known the sole symptoms of the disease to be 88) a paralysis or loss of motion of every muscle of the Body for some minutes; sometimes in the form of an Intermittent - The Globus sometimes tho rarely produces vomiting when it answers at the Stomach: when in the Throat it induces difficulty of destitution Dysphagia Hysteria - sometimes of the speech & at others the asphyxia Hysteria - The pulse is sometimes immoderately frequent - I have counted it at 180 & - Dr Whyte mentions having found it 220 - Patients are at different Times affected with weeping laughing, Clavus &C - They sometimes fall down motionless & at (89 others have violent pains of the Bladder & Kidneys & - it has sometimes on this Account been mistaken for Calculous complaints - I had a Woman in the Clinical Ward laboring under Hysteria, who was affected with the most astonishing Cough I ever observe'd, continuing for two days without a second of intermission on the Cough subsiding her belly became very costive & when this disease disappeard she was attacked with violent affections of the Bladder - I have known a patient fall from one Fits into another for 26 Hours together without intermission, & the Convulsions are some times so astonishing strong as to require the strait waistcoat - 70) I believe I never knew Hysteria produce any Affection of the Mind as Epilepsy does, tho I think the frantic state of Mind may arrive at such a height as to produce similar effects - It has been supposed that Hysteria may go to such a height as to promote Epilepsy, tho I do not know that it has ever been the case - I had once a patient indeed in whom the two diseases completely marked were combined so that the patient would now perhaps be seized with an Hysteric paroxysm & in a short time after with a fit of Epilepsy - In the fit the distinction between the two diseases is rather difficult - The foaming is not always (91 always present, in Epilepsy & sometimes (tho not frequently) accompanies Hysteria paroxysms, but during the Intervals & at the coming on of the disease, it can readily be distinguishd - It has been a prevailing notion among Physicians that Hysteria was somehow connected with renewal appetite; but tho' this may sometimes, yet it is not always the Case - It is brought on by different passions as grief, anger, fear &c and many Women who might be supposed to make no Scruple of owing it have on being questiond deny'd it - One Circumstance in Hysteria is to be particularly noticed, viz that it depends on a particular predisposition, proceeding from a certain mobility which is frequently connected with Debility - 92) Baron was not in this State, & the mobility I mention by no means depends upon it constantly - A peculiar concomitant irritability is likewise present; hence Females are so subject to it - I would not however confine it entirely to them, tho the instances of Hysteria affections in the other sex are very few & in those cases which have been related I believe many mistakes have made - I never saw but one instance of the Kind myself, & that was in a young man who was affected with Globus and he was of a very irritable habit, but I may safely say for one Man 10,000 Women are affected with the Disease - (93 Hysteria does not depend upon a geral Irritability on Mobility alone, it seems in general to proceed from a particular irritability connected with the genital system - The general irritability is greater in infancy when no Hysteria appears, &it almost only occurs from the Age of Puberty, to the cessation of the menses, & to this there are but few exceptions - I have seen Women of 40 or 50 attacked with it & I knew a Lady who was much affected with the disease in her younger days, attacked with strongly marked hysterical Symptoms at the Age of 66 - It frequently attends the Sanguine Temparament which is generally much 94) connected with irritability - There is a remarkable connection too betwen it & the period of Menstruation I knew a Lady who was affected with Hysteria during the flowing of the menses from Causes which at another Time could produce no such effect, & it may be observed that the period of menstruation is one of unusual & general Irritability - This peculiar irritability of the system productive of the Disease may arise from innumerable Causes, but the Proximate Cause must remain unknown to us as long as the Nature of the nervous system, sensations &c is so little understood - (95 It seems much connected with a flaccidity of the simple solids & it is partly by its effects on these, partly by its action on the living principle that Heat such as warm rooms &c has such a tendency to produce it - This Irritability is likewise connected with Plethora as is shewn by the temperament, it frequently attacks by its arising from the Stoppage of Evacuations &c - It is likewise connected with debility especially of the Bowels & Stomach, hence it accompanies Dyspepsia - Custom seems to have a strong effect in rivetting the disease as it has in Asthma, Epilepsy, Intermittents &c - The effects of predisposition are in Hysteria very remarkable 96) remarkable - certain circumstances & causes which are indeed inevitable often bring on the Paroxysms in the predisposed which if applied to 10,000 others not predisposed would be productive of no effect - such are the passions, external senses, sudden noise, certain smells, either fragrant or otherwise, particular objects as Cats or other Animals disagreeable sights, particularly those of another person laboring under the disease & it frequently first commences in that way - The same tendency to imitate is observed in many other Instances - As Yawning, Laughing &c - (97 As the Muscles however employd in these last actions are in general subservient to the Will we can prevent the Operation of that remarkable tendency towards them & I am sure much may be effected in that in Hysteria - It is a Maxim I inculcate very strongly to my Patients, to use their utmost endeavours to prevent the coming on of the fit - I have often Known it succeed, tho my advice is by many not well received - In others their predisposition is so strong that their endeavours are ineffectual - In some there is a peculiar pleasure 98) attends the coming on of the fit analogous I suppose to that we experience in indulging yawing &c that they really encourage them & bring them on by reason of every possible effort, & in cases like these I should suppose every remedy must prove inefficious - Fits are frequently brought on by Theatrical performances this happen'd in several Instances during Mrs: Siddon's performing at Edinr- I knew one Instance in Paris when Death was the consequence of a violent fit occasind by the representation of a Tragedy - External Heat is often likewise on (99 exciting cause; hence are Hysteric Fits so frequently observed in crowded assemblies - Any great stoppage of an evacuation, any disorder of the Stomach &c renders the fits more violent - Hence it has been Known to be brought on by full living & to come on constantly after a Meal - I believe Hysteria fits will never come on without some exciting cause; though our Patients will frequently deny it, but this is no proof against it, for passions of the Mind which they will not own and circumstances so trifling that they are ashamed to acknowledge frequently induce it - I knew one Instance 100) (101 tried it in many respects, but doubt much as to its good effects in Hysteria - Exercise is of the greatest benefit, & I believe has sometimes produced cures alone, & more especially when combined with the occupation of the Mind - We are often obliged to compel our patients to use it - I had an account of a Lady who on the slightest threatening of a fit was immediately placed on Horseback, & obliged to ride pretty hard; this always prevented the farther progress of the Paroxysms & at length perform'd a Cure, - From hence it will appear of what service it must prove, to undertake a Journey especially on Horseback for 102) The cure of the Disease - With respect to moderating the fits, they are never attended with danger, at least I never saw them, so that we have generally nothing else to do but to prevent the patients from hurting themselves - The principal disadvantage that arises from them is that Habit they induce & to prevent this & stop the progress of the fits many Medicines have been proposed, as Fœtids to the nose, Pediluvium dipping the Hands in cold or warm water, dashing cold Water on the face &c &c I have frequently known attended with success - (103 Draughts with Volatile Alkali or Œther, immediately before the fit frequently prevent its formation & I believe they possess more power then than at any other Time - Opium has likewise been given with the same intent by the Mouth, or by Clyster, but they generally lose their effects in a little Time - Camphor has been recommended I have tried it without much success - With respect to my particular practice in these Cases we had we had under own Care - I one I ordered the pediluvvium & the Pil: Aloct: with a View to bring on the menses, tho I confess we ought to be cautious in administring - 104) administring them for we are frequently deceived by Women with Child who wishing to get rid of their Burden & produce a miscarriage, attribute many complaints to a cessation of the menses which they are cunning enough to say, happend many Months before - How far this was the Case with our Patient I shall not say - but supposing a real Amenorrhœa present I know nothing so powerful in restoring the Menses as the Aloctic pills, from the great irritability given the rectum - She was remarkably hard to work as a Scruple had no Effect - The Anodyne Castor, Assafœtid &c were given without any benefit (105 At the period of the Menses, Electricity & Oil of Savin were employd to which I believe, the Root oiwes its Virtues & I took upon it as the best mode of exhibiting it, but I am far from placing much trust in this or any other Emanagogue - The only Remedy which seemd to have any Effect was the cold Bath as the some you saw the good Effects of the Draughts of Œther the Fœtid Julap &c - 106) (107 108 - (109 George Kerr Œ t 24 da Servt: - February 9th: Is affected with headach vertigo, nausea, Anorexia Polydipsia & constant tickling cough occasioning pum in the Breast but attended by no expectoration P - 120 Belly costive sleeps ill, - These symptoms appeard on the 5th: with coldness shivering &c as usual in Pyrexia - Knows no Cause has used no Medicines - Sumat: Solut: Antim ℥ss mowsotito Haust Anod H: S: - Cras Julap Satin ℥j 3tia quague hora Cerevisiam tonuem adlibitum - 10th: Vomited well with his Medicine no stool, Tongue white clean & moist, pretty constant drowsiness, Pulse & other Symptoms as yesterday repr: Solut: Antim - Injicr: Enema Corm: vespere nisi prius - 11th: no vomiting tho he took 11 doses of the Antim: Sol: 7 or 8 thin fœtid stools some of them bloody - P - 114 of nal Strength skin dry somewhat hot, copious small redish Eruption about the Neck, Tongue natural - 110) ꝶ: Vin: rub: ℥ viij Aqua ℥ iv Pulv: Cort: peruv: ʒ vj ny sumat ℥j 3ta: aa: hora - sit in promptu: Julap: sisten: ℥j Tinct: opii gt xx quem sumat imiente diarrhœa - 12th: P - 120 bad sleeping disturbed by another patient, 2 thin bloody stools Repr: Vin: ad ℥xij Reliqua, ut heri - 13th: P - 114 some sleep, much stupor but no delirium, much [crossed out] Tenesmus & a little Blood discharged - repr: vin: & Julap Listent: ℥ss port sing: dejest: 14th: P - 126 very soft no more Diarrhœa, pretty sound sleep, slight delirium when awake repr: vin: ad ℔ iss - reliqua ut heri - 15 P. 120, no stool, no delirium, almost constant dosing - repr - remeda. - 16. P. 114 of moderate strength, constant doing parchd - Injr: Enema ex Aqua tepid ℔ j reliqua ut antea - (111 17th: Two thin stools since the Clyster P 120 Tongue still parch'd, less thirst, & he feels now more awake Continue - 18th: P - rather above 120: more stupor very slight delirium in other respects as before Continue 14th: day of the fever - 19th: P. 100 - much delirium in the Night stupor continues, Tongue parch'd, skin dry but cool, Appe: bad no stool repr: Enema ix aqua tepid - reliqua ut antea - 20th: P 108 - Tongue softer becoming moist about the Edges, 1 stool with the Clyster, bad appe: - omittr: Cortex, repr: Win ad ℔ j - 21st: P - 96 & soft, skin cool, Tongue pretty clean & moist again, great Stupor, will not take wine or Food has had much vomiting - likes & retians the Beer on his Stomach - Omittn: 6 tin: 1 ut: - Habeat: Ceravis: ten: ad libitum Porter ℔ ij in die - 22nd: P - scarve 90: Anorexia continues but without vomiting likes the porter his Eye & Countenance somewhat more nate: no stool this two Days repr: Enema ex Aqua tepid - repr: Cervis & porter - 112) 23rd: P - about 90 still loaths all food & tired of porter - to have a Bottle of strong Ale instead of porter - 24th: Convalescent but still bad appetite & very weak, Belly natural - Continue - 26 - Convt: A Bit of Steak, for Dinner - March 4th: dismissd Cured (113 Thomas Boyd Œt 27 albriter February 11th: Complains of Headach, nausea anorexia & Oppression about the præcordia There appears over the surface of the Body & Limbs an Eruption of a pretty deep red colour with considerable pain & swelling of the external & internal fauces affecting also the Tonsils; on the left of which is seated a considerable Ulceration - The hands of Arms are likewise in some degree swell'd, P - 130 Tongue foul, Delirium, Belly costive was seized on the 7th: Inst: with the Usual Symptoms of Fever on the 8th: he first perceived the sore Throat & discoverd the Eruption on the 11th: - attributes his complaints to exposure to cold - utatur: Infus: rosar: rub: pro Gargarism, omni hora dum vigilat Injicr: Enema com: stat - ꝶ: Vin: rub: ℔ j - Aquæ: Font ℔ ss Pulv: Peruv: ℥j spir: H: Anod: gt: xxx H. S. Atradator Capillit: & appr: Faucs: extunos Emp: visic: ij - 114) 19th: Clyster operated well, no sleep & very violent delirium in the Night which still continues, efflorescence going off; Hands considerably swelld - P. 116 & of good strength considerable Fœtor of the whole Body & health - Ulceration of the Throat worse & blacker much viscid mucus in the Mouth repr: Vin:, Cortex, & Acid Vitriol: ut heri prescriptum fuit - Gargarism: ut: antea - Omittr: Haust: Anod - To have a clean shirt & the strait Waistcoat: - 13th: Died at 4 this Morning - (115 Thomas Boyd - in this patient we have an Instance of a most violent Cynanche Maligna Dr: Gregory in delivery his Sentiments on this case goes fully onto the nosological distinction between the Cynanche Maligna x Anginosa Scarlitina as it is a matter of importance in practice - He is of Opinion that they are Modifications of the same Disease & quotes several Instances in his own practice where in the same Family exposed to the same Contagion & labouring under the Disease at The same Time, he has observed some to have the scarlet Efflorescence with little Ulceration of the Throat while others had a violent affection of the Throat with little of the Efflorescence; Dr Clark of New Castle who has had extensive opportunity of seeing the disease & has wrote expressly on it is of the same Opinion so that they conclude them both to be one & the same disease; the peculiarities depending on Constitution & other Circumstances - 116) For the best & earliest distinct Account & practice he referrs to Dr Fothergil In the present Care the Straight Waistcoat was used as the Delirium was so violent that the patient wounded himself much by his Exertions, but in most cases of Delirium in Fevers the Doctr: is of Opinion such restraint is of disservice & would rather advise the patient to be reasonably indulged in sitting up &c as by this mean they become soon tired & are disposed to continue quick afterwards - The Use of Gargles cannot be too earnest, recommended & in Children when we are not able to make them use them the most he recommends is to force it in the mouth with a syringe - The Tinct: Rosar is perhaps as good as form as can be applied Dr Gregory thinks that patients are never affected with this Disease but once at least he never saw it return nor from Inquiry on the Subject has he been able to learn any Instance to the Contrary - (117 Catherine Mc: Gregor t 47 - February 24th: Complains of nausea Anorexia great debility & slight pains in her Legs - There appears a numerous Eruption over her neck, shoulder & arms of small red Spots, says she has been constantly subject to a considerable mucous discharge from summer which she thinks diminishd since the Accession of the present Symptoms - P - 130. Tongue clean & moist skin moderate, Belly costive, was attackd on the 20th: Current with the usual Symptoms of Fever, has used no Medicines Sumat stat: vin: Ipec: ℥j & Ulatem Infus: Chamomil: Enema Vespere nisi prius - ꝶ: Vin: rub: ℔j Aquæ ℔ss ♏ ƒ - Sumat ℥iij 3 tia qq: hora - Habeat H: Anod - H: S: - 25th: Vomit & Clyster operated well good Sleep. 118) Tongue clean & moist, P 136 some deafness Eruption less perceptible repr: Vinvum - Sumat pulv: peruv ad ℈ij in die ex Lacte - Habeat Cerevis: ten: ad ℔ij in die Haust Anod. H: S: - 26th: Much diarrhœa in the Night she had drank freely of small Beer - P. 92 skin cool, some Appe: Tongue clean Omitr: Cerevis: ten: Sumat post sing deject: Pot: Cretae: ℥ij Utatur: Julap: Mucil: urgent tussi repr: Haust: Anod: Cortex &c in: - 27th: skin, Tongue, & Pulse nasl:, 3 thin stored in the afternoon good sleep - Omitr Cortex repr: vin: A Bit of Steak for Dinner mist: mucil: & H: Anod - ut antea - 28th: no Compts: but Cough & weakness Applicn: Emp: Epispast: pectori reliqua u: a - March 1st: Cough easier better sleep Catamenia have appeard much Leucorrhœa - Continue 14th: dismissd Cured 119 Jane Center Œt 29 - February 24th: On the 16th: Currt: was seized with the usual symptoms of Pyrexia which have continued ever since unabated & accompanied with Debility - Complains chiefly at present of nausea, Anorexia troublesome Cough & Headach over the whole Body there is a numerous Eruption of small red pimples - P 120 increas'd thirst, Tongue pretty clean Belly natural, Catamenia regular - Has taken two Emetics & been Bled without relief - Sumat in die Pulv: C: P ℈ij ex Lacte - ꝶ: Vin: rub: ℔j Aqua ℔ss. ♏ ƒ. Sumat ℥iij 3 tia: qq: hora - Haust: Anod c gt xxx Hora somni - 25th: P 108 - Heat moderate, Eruption much kess pretty good sleep, Tongue dry but pretty clean no stool - Continue - 26th: P: 108 - Skin Hot, Tongue dry & Nat Stool no appe: much thirst she loaths the Wine Omittr: Vinum Habeat Cerevis ten ad ℥iij - 120) 27th: P 108 - Petechia narly gone off, no stool Enema Com: vespar - nisi prius - Reliqua ut Antea - 28th: P - 108 - very soft, skin cool great weakeness - gangrened spot on the left hip & a little on the shoulder of the same side Habeat stat: Vin: Donest: ℔ij applicn: Lin: Du Haen part: gangrened affect: repr: Cortex - March 1st: P: 100 some gangrene on the other side no stool, some vomiting after taking the Bark yesterday repr: Enema Lint: Dr Horn ad part affect. Vin: Alb: & Cortex u: a - 2nd: P: 100 & weak ganrenous spots not increasd Tongue somewhat dry repr: remedia - 3rd P. 112 & rather stronger Gangrene in The same state The same state repr: Vinum rub ℔ij & Cortex - (121 4th: P 100 & rather stronger frequent soon after she took red wine Tongue very Black & dry Gangrene in the same state got a Clyster which operated well Continue 5: P - 100 & rather stronger gangrene appears in a better state Tongue rather more moist Continue 6th: P - 100 a little Excoriation on the left hip some vomiting this Morning repr: remedia - 7th: Got a Clyster last night which operated well complaints rather easier repr: remedia - 8th: Continues easier but loathes the wine - Omittr Win, repr Cortex - 9th - P: 84 Funetns: natl: first gangrene spot still sore - Continue 11th: P: 96 much bilious vomiting last night Body costive some pain about the gangrened spot repr: Enema Cortex u. a - 12th: P: 96 bad sleep some nausea still some part on the left Hip more troublesome Omittr Linimn Dr Haen 122) Appr: stat: Cataplasm Emol: parti gangrœnosæ - repr: Cortex - Habeat Vin rub: ad ℥viij - 13th: P: 96 vomiting from the Bark since beginning it - discharge from the sore Omitt: Cort: reliqua ut heri - 14th: P: 96 much darrhœa without gripes some vomiting from the Wine to Day Sumat post sing: deject: Julap: Sist. ℥ss Sumt: H: S: Opii gr. ij Omittr Haust vinum ut antea - 15th: P - 96 no stool gangrened spots mending - Continue 16th: P: 96 - good sleep & appe: sores clean & discharged much - Continue - 17th: P still 96 & soft much discharge from the sores some new blackish spots appearing - sleep & appetite mending - Body costive vomiting sometimes from the Wine repr: CortL u: a 1 reliqua ut hori Enema Vespere - (123 19th: P: still 96 much discharge from the sores - Bark retaind but she will not take the wine - Continue - 21st remitted to the surgeons - 124) (125 Mary Mc: Donald Œt 25 Asoul. March 9th: On the right Hand & Arm is situated a considerable hard painful swelling - The right foot & Knee are also affected in a similar Manner tho the swelling of the Knee Appears more puffy. On the Arm near the Elbow there is a small escar which she says proceeds from a colourless Turnour without pain that appeard on the part 12 Months since & came to a suppuration 6 Months after & this has frequently recurred - Pulse Tongue appetite Belly & sleep natl: - Amenorrhœa for two years - The affection of the Leg supervened a year that of the Arm a Month ago - Has used no medicines - 10th: Sumt: vis in die Pil: Gummos gr. x Adeat Machin: Elect: ad promov: Menns To have ful sick add ℔j Porter daily - 12th: no Change of Symptoms - repr: remedia appr: Emp: Epispast. Genu dext: oft. fenticalus quam proxime inpa Genu - 126) 13th: No change of Symptoms ꝶ: Aceti Scillit ℥viij Gum: Ammon: ʒij tere probe ft: Solut: ad manum qua dolet - applianda ter in die per parmum linteum - 16 - Issue runs a little, n o change of Symptoms Omitt: Pill: Gum: - Sumt: Elect: peruv: rebor: Motem: Jugland vis in die. - repr: Electricilas - 23rd - Hand Foot & Knee remain unchanged little discharge from the issue - Contne: - Sent out little relieved - (127 Barbara Watson Œt 10 A Servt: - March 8th: Complains of violent Headach with nausea Anorexia thirst general pains & Debility, skin hot P - 130 Belly Appe: & Catamenia regular Tongue dry & force constant drowsiness - These Symptoms supervened on the 5th: Instant with the common Symptoms of Fever - Thinks she has caught the Disease from attending a Family who have been ill with Fever Has taken no medicines - Sumat. Sol: Antim ℥j - Julap Salin ℥j 3ta: q: hora 9th: Soluation operated well by vomiting no stool gentle moisture on the Skin P - 132 Injun Enema com: vesper - repr: Julap salin - Habeat Cervis: ten ad ℔ij & H. Anod H. S 10th: P - last night & at present 120 very soft better sleep, a stool with the Clyster Tongue moist & pretty clean she has taken 128) some food loathes the small Beer Omittr Cerevis - Habeat stat: Vin: rub: ad ℔j Aqua Font ℔ss ♏ ut sumt: Cyathum subinde - Julap & Haust: u: a - 11th: P: 92 & soft skin cool & soft Tongue moist Appe: still bad no stool some sleep no Delirium she complains still of Headach - repr: Enem: reliqua: u. a 12th: P; 72 very soft pretty good sleep some return of appetite - repr: Vin: - Sumt: Pulv: C: peruv: ℈ij ten in die ex lacte - 13th: P. 84 still very soft Tongue in the [same] middle foul little appetite vomiting with the Bark last night none taken to day no stool - repr: Enema & Vinum - Omit Cortex 14tg: P - as yesterdau some return of appe Tongue clean & moist - Continue - 15: P - imder 90 appe: mending steak for Dinner Continue - (129 16th: P - 100 & stronger bad sleep Tongue clean but dry in the middle no stool some appetite - repr. Enema & Vinum 17th: P - 76 bad sleep much headach no stool - repr: Enem: stat: Vin: & Haust: - 18th: P - 72 Tongue & sleep almost natl: Continue - 24th: P - 120 Skin hot bad Sleep Headach sickness & trembling of her limbs after breakfast to day - Sumt: Pulv: Ipec: grs xv & utatur Infus: Chamomil - Sumt: Julap: Salin ℥j 3 qq horce H: Anod c q xxx - H: S: - 25th: much sweat in the night good Sleep P- scarce 84 appetite still bad Tongue a little white Body costive repr: Enem: vesp nisi prius - 26th: P 108 of good strength both Tonsils very red & swelld deglutition painful & difficult Bad Sleep & frequent rigors Clyster operated - repr: vin - uratur Gargarism, Emollient: - & ol: volat: c panno laneo Sumt: P: C: P - ℈ij quator in die ex lacte - 130) 28th: P - 126 pretty full & soft, redness & swelling of the Tonsils as formerly no ulceration, Tongue foul & parched bad sleep no appetite or stool - repr: Enema relique ut Heri - 29th: P - 108 & soft redness & swelling much less in the fauces some viscid mucus about the Tonsils but no ulceration - Severe Rheumatic pains about the Shoulder & Arms vomiting from the Bark & draught wine retaind no appetite - Omittr Cortex & Haus - repr Vin Habt: Indus: saneum - 30th: P - 108 of good Strength - Rheumatic pains & throat as yesterday - Omitt & Vinum - Sumt: Julap. Diaph 3 tia: qq: hora Fovr: orma probe per horas ij - Bibat Decoct Avenac: ad Libit: - 31st: P - near 120 throat still sore pain continues in the arm much sweat in the night but not on the Arm - Appr: Emp: Epispast Hermori qua dolet religua u: a: - 3rd: P 108 pain of the arm no better much headach some Nausea Mittr: Lang: E Brach: dext: ad ℥x religua u her (131 Watson - 4th: Blood has a firm buffy coat in the first Cup - P - & pains as yesterday no sweat - Mittr: iterum Languis ad ℥viij - reliqua ut heri - 5th: Blood still with the buffy Coat P - 108 & soft bad sleep some sweat no stool pains little better - repr: Julap: Diaph & Enema vesp - nisi prius To have both for Dick - 8th: P - 108 much headach pains still severe in the shoulder some sleep & sweat 10th: P - still 108 pains severe in the right shoulder but no where lese, some swelling about the Axilla as well as the joint [of] the Triceps & the scapula, pretty good sleep & some sweat admovr: Hirud viij Humero dolento Reliqua ut antea - 11th: P - 108 pain of the shoulder much relieved none any where else - appe: weak - Belly costice repr: Enema Vesp. nisi prius reliqua u. a - 132) 13th: P - still frequent pains easier 6 Leeches were applied last night to the Tumor in the Axilla Admovr: itaum Heiud: vj part: tument. Continues feverish & weak the Tumor slowly advancing to maturition till the 28th: April when she was remitted to the Ordinary Physicians & Surgeons where the Tumor was opend & another Formd in the other Axilla 133) Helen Henderson Œt 15 A Mantua Maker - February 27th: Complains of Headach, Nausea Anorexia, pain in the right side, great Debility & some deafness - P 112, Thirst Tongue white & moist Bad sleep, Belly natural, Catamenia have not Appeard - The febrile Symptoms came on the 12th. in the usual Manner - The deafness a few Days ago - Has taken one dose of salts, two Emetics & some Wine & Bark with Alleviation to the Symptoms - Sumat pulv: Cort: peruv: ℈ij 4 er in die ex lacte ꝶ: Vin: Rub: ℔j Aquæ Font: ℔ss ♏ ƒ - Sumat Cyathum swinde H: Anod gt xxx 28th: Pretty good sleep, no delirium P: 108 Tongue dry - Continue - March 1st: Pulse 96 - pretty constant dosing - Continue 2nd: P: 80 no Complaints - repr: Cortex Vinum & Haust. - 134) 3rd: Convalescent 5th: Omittr Vinum repr Cortex - 12th: Goes out Cured - (135 136) (137 Jane Mushart Œt 45 A Lace weaver - February 5th: Is at present affected with loss of voluntary motion of the whole of her right side, her memory being greatly affected but more with respect to Words than things, for on any Circumstance being mentioned she seems to have an immediate recollection of it tho she could not find words to describe it herself. - speech a little affected - P - 80 & ful of the same strength in both Arms - About 4 years ago was attacked with total loss of motion of the right side & of speech which caused her to be received into one of the London Hospitals but was not relieved after staying six weeks when she came to Scotland & she was in the clinical ward near 3 Months & was dismissd relieved since which Time she has been growing gradually better particularly in her Memory - 6th: Habeat Bal: lepid: & postea Indusium laneum - Utatur strigili fortiter mani & vespere - Habeat: Mactunam Electuiam quotid: ut educantur Scinpil: elect: partibus: affect: prasertim Bracio - Ful Dick - no relief goes out improper - Feby: 10th: 1789 - 138) Jane Mc: Searn Œt 18 A Servt: - February 12th: Complains of constant pain in the Epigastric region increas'd on pressure with slight tumification at Times - Has also Anorexia frequently attacked with nausea Headach with inclination to vomit after meals - P - 88 - Tongue clean sleeps well, Belly regular Catamenia absent for 6 Months since which she hath been troubled with the above Symptoms & attributes the Obstruction to Cold - Has used no Medicines - 13th: Sumat vespere Pulv: Ipec: grs xij Utater Infus: Chamomil: rd vomit: peomer: Habeat: Pediluv. vespere Incipiat cras mane sumere Pill: Gymmos: grs: x - house exercise daily - 14th: Vomit operated well Headach gone Appe: still bad no other change - Continue 15th: Complains of much pain in her Stomach in other respects as formerly Sumat Urgent: Gastrodynia Potio: creatac: ℥ ij - Reliqua ut antea - 139) 16th: Temporary relief from the Pot: Cretac repr. potio: Cretac: Omitr: pil: Gum: Sumat: Elect: peruv: robor: Molem jugland: bis in dies - 17th: Stomach easier continue - 19th: Stomach continues easier - repr: Elect: robor: ut antea Habeat : Mach: Elect: ad Menses promoven. 20th: Continues better, no Catama: Continue 21 Contines easier some pain about her Back since she was electrified repr: Remedia Utatur: pedituvio vespere Sumat: H: S: Pil: Aloct ℈i 22nd: Pills have operated twice no Catamenia repr: Electricas: - Sumat Pulv: Folior: Sabin ʒ ss vis in die Omittr: Electuarium 23rd nausea but no vomiting from the powr: repr: sabin ad ℈j pro dosi in die 24th: much nausea from the Sabina - stite Omittr: Sabin - 140) ꝶ: Cerevis: Fort: ℥xv Pulv: Rub: Tinct ʒvj ♏︎ƒ Sumat ℥iij ter in die incipens cras - 27th: no Catamenia other Complaints gone repr: Pulv: Rub: Tinct ad ℥j - 28th: No Catamenia inother respect well - Dismissd Relieved - (141 Jane Mc: Searn - readmitted March 11th: Has Vertigo, nausea, Anorexia, general pain in the fauces which are very red but no ulceration can be descern'd slight delirium - P- 132 Tongue foul much thirst Belly natural, Amenorrhœa still continues says than soon after she left the House she felt herself very unwell till the 3rd instt: when she was seized with shivering but no fever - Had a similar fit on the 4th or 5th with usual Symptoms of pipexia - She perceived the pain in her throat last night attributes her complaints to cold which she got on leaving the House - Has used no Medicines - Sumt: Hora 5ta: Solut: Antim more solito - Julap: Satin: ℥j 3 tia quague hora cras - Utatur Gargaris: Emol: subinde - 12th: P - still 130 & Soft vomited well has had no sleep throat rather easier still red & swell'd with viscid mucus in the fauces no distinct sloughs, no Efflorescence on the Stein 142) one natural stool this Morning much delirium in the Night ꝶ: Vin: rub: ℔ j Aqua Font: ℥ vj Mucil: Gum: Arab: ℥j Pulv: Cort: Peruv: ʒ vj ♏︎ƒ - Sumt: ℥iij altera quaque hora incip: stat: - Appr: Emp: Epispast: duo parva faucibus externis stat: repr: Gargarism & Omittr: Julap: Satin 13th: Better Sleep & much delirium P - 14 less pain in the throat swelling redness & viscid mucus as Yesterday no distinct sloughs, no stool, no appetite she can swallow liquids - Repr: Vinum mixtum sine cortice Sumt: Pulv: Cort: peruv: ℈ij 4 er: in die ex lacte - repr. Enema - 14th: P - 120 much delirium in the night throat still painful - Continue - 15th: P - above 130 rather less delirium (143 swelling of the Fauces less, some Ulceration about the root of the Uvula on both Sides no stool no Efflorescence - repr: Enema, Vin: Cortex & Gargarism: - 16 - P - 140 & small rather less delirium, less swelling but more Ulceration in the Fauces Vertigo but no Headach some appetite she swallows the wine easily but can scarce be made to take the Bark Repr: Vinum ad ℔ iss cum Aqua ℔ ss - Cortex ut antea - Abravatur Capiliteum - 7th: P. near 130 better sleep & very little delirium throat rather better but still sore 3 thin stools - repr: Vin & Cortex - Omittr: Garg: Emol: Utatur Tinct: rosar: rub: pro Gargaris - Sumt: Julap: List: ℥ j c: S: S: gt xxv H: S: si Diarrhœa constitent - 18th: P - 100 Tongue almost natural good sleep & scarce any Delirium, appetite better Continue 144) 19th: P - 126 bad sleep & much delirium more Ulceration about the throat a thin very fœtid stool yesterday much general fœtor to day no Appetite repr: Vin, Cort, & Gargarism Habeat Aurant: duo in die H: Anod c gt xxv H: S: - 20th: P - 108 Throat better 3 thin stools in the Evening none since the Draught fœtor no perceptible much Headach no delirium - Continue - 21st: P - still abt 120 good sleep & appe - Tongue clean & moist delirium quite gone Continue more natural, Throat better swallowing easier - Continue 22nd: P - under go irregular weak & are easily quickend skin cool, throat well good sleep & appe: no stool Injicr: Enem: ex Aqua tepid ℔ j - reliqua u: a: - 23rd: Convalesct: to have a Bit of Steak for Dinner - Omittr Cortex. repr: vin ad ℥viij 24th: P - natl: Convalesct: repr: Enema ex Aqua tepid april 4th: goes out Cured (145 Jane Robinson Œt 19 A Servant - February 7th: Has headach, nausea, Anorexia, Vertigo & polydnia - P: 160 - bad sleep, Belly round Catamenia about 3 Months ago were absent for 6 weeks when they appeared & were very profuse for a fortnight since which they have constantly flowed but in small quantity - Tongue foul, skin hot & dry was in the House 5 weeks ago with febrile complaints of which she was dismissd cured - The present symptoms of pyrexia appeard on the 5th in the usual Manner, attributes them to cold - Has taken no Medicines - 8th: P - above 120 - ful spontaneous vomiting last night & this Morning heat moderate copious univeral weat since about 2 in the Morning, good sleep & general relief no appetite, Thirst constant Sumat urgent: tussi Haust: effervescent - & repr: pro re nata Binat cerevis: ten ad libitum Injiciatur Enema com: vespere nisi prius - 146) 9th: P - still very frequent other symptoms mild the vomiting return'd in the afternoon but stopd on taking the effervescent draught bad sleep as she thinks from the Cough Omittr Haust: satin: efferves: nise vomitus redieset Sumat Julap: Mucilag: ℥ss urgenti tussi - Haust: Anod ut: antea - 10th: P: still very frequent much speaking in her sleep but no delirium when awake cough still troublesome, Heat moderate skin gently moist, Tongue almost natural Thirst, Anorexia & costiveness - Habeat Vin: Rub: ad ℥viij - Enema com: vespere - Mist Mucilag & Haust. Anod u. a 11th: P - as frequent as ever but fuller & stronger Tongue skin voice & sleep natl: Cough easier Anorexia Thirst continue Sumat ter in die Pulv: C: peruv ℈ij ex lacte - reliqua ut antea - 12 P - 150 & soft Tongue almost natl vertigo slight delirium in the night but some sleep, Thirst & anorexia as formerly no [crossed out] Cough troublesome - (147 Repr: Vin ad ℔j - Et Cortex, Mist: mucil: & Haust: Anod: ut antrea Injicr: Enema Vespere - 13th: P last 138 today 120 pretty good sleep no delirium some return of appe - skin soft general relief - Continue - 14th: P 114 in other respects as formerly Injicr: Enema vespere nisi prius reliqua ut antea - 15th: P: 96 good sleep; thirst, no appetite yet - Continue - 16th: P: 100 good sleep - Appe returning repr: Enema - reliqua u: a 17th: Pulse almost natural, appe: returning Omittr: Cortex, repr: Vin ad ℥viij 18th: Convalescent. To have a Bit of steak 21st: complains still of weakness & Vertigo sleep Appe & Belly natl: P - 106 as the set up dress'd - ꝶ: Syr: Simp - Mucil: Gum: Arab a. ℥j Spir: Vit: ten ℥ss - ♏ ƒ - sumat: Cort: parv: ter in due in Aqua ℥ij 148) 23rd Convalescent but slowly P - last night when she was quiet almost natl: but still much quickend by Exercise or even sitting up slight nausea from the Vit: Mixn - Continue - 24th: Convalescent continue - 27 - Goes out cured - (149 Cathe: Herriot Œt 19 a Serv. - February 8th: Is affected with Headach Vertigo, nausea, anorexia & general Debility P: 80 Tongue clean heat moderate, Belly & Catamenia regular was seized on the 6th: Instant with the usual symptoms of pyrexia which she attributes to cold & moisture - Has used no Medicines Sumat Solut: Antim ℥ss neow Solito Capt: Julap: Satin ℥l 3a: quaque hora & Habeat Cerevis: ten: ad libitum - 9th: Vomited once but pretty fully; bad Leep little Appetite - P - 84. Tongue clean & moist Skin almost natural - Injicr: Enema com: vespere nisi prius repr: Julap Satin, Habeat H: A; H: S - 10th: P - natural, Headch: almost gone - Anorexia & nausea continue , Tongue clean, skin cool - Sumat vespere - Pulv: Ipec: grs: xv & utatur Infuso Chamomil: - 11th: vomit operd well sickness gone Headch much relieved appe. returning - Sumat vis in die Tinct Amar ʒij ex Aqua Font: ℥ij: - 150) 12th: Complains of her Head & Stomach Cataa: adsunt - Continue - 13th: complains of sickness & pain of Stomach ꝶ: Aqua Menth: pip: ℥ij Mag: Alb: ℈ij - Pulv: Rhei grs xv ♏ ƒ ft: Haust stat: sumend - 14th: no sensible Effect from the Drat: Gastrodynia continues Headach gone repr: stat: Haust: ut heri præscriptus - 15th: Catama: cessarunt - 1 stool from the Drat: stomach still uneasy - Head quite well - goes out relieved - 151) Janet Ross Œt 62 a Widow - February 14th: Has globus in the left side arising from the Hypogastric unto the Epigastric region, & thence as she says sometimes into the fauces occasioning slight Dyspnœa Complains also of frequent Eructation, nausea pain, in the lumber regions & of late frequent Shiverings - P: 92 - Tongue natural some appetite - No Calamenia for several Years was subject in the early part of life to Menorrhagia & Dysmennorhœa attended at Times with paroxysms of Hysteria Belly very costive, sleeps ice, Intellectual Functions somewhat impaired Has used no remedies for the present complaints Habeat: H: Anod. c gt xxx H: S: sumat pill: Gummos grs x Mane & Vespere - 15th: P: 100 full & strong, skin somewhat hot tad sleep, vomiting on taking the pills - Omittr: Pil: Gummos - Injicr: stat: Enema Sumat Julap: Satin ℥j 3ta: q: hora 16th: P - natural, pretty good sleep & appe - less pain & Globus, repr: Julap: Satin: 152) 17th: rather easier Omittr: Julap: Satin: - 19th. no more Hysteric Symptoms, complains of Weakness & some Oppression about the abdomen Continue - 25th: Gone out without leave (153 Rachel Walker - Œt 19 Unmarried February 5th: Complains of headach, nausea Anorexia pain in the Epigastic region Loins great prostration of strength - P - 120 Tongue foul great thirst skin hot & dry Belly very round, Catamenia regular sleeps ill - was seized with these complaints on the first Instant with the usual symptoms of Pyrexia; has used no Medicines knows no Cause - sumat solut. Antimons: ℥ss H: S & repr: omni semihora ad vomitum usque sumat: Haust: Anod: com: H: S - sumat Julap: Salin: ℥j 3ta: quague none incipiens cras mane - 6th: solution operated well both ways gentle moisture on the skin all night all Night & still continuing, good sleep Headach, Tongue, Thirst, Anorexia as formerly P 120 & soft - repr: Julap: Salin & Haust Anod - Habeat Aurant: duo indie - Ceriviseam senium - ad libutam 154) 7th: P: 120 & of natural strength, skin soft neat natural, Tongue force, bad sleep some headach thirst & anorexia continue sweat ceased yesterday afternoon & has not returned - repr: Remed: u: a 8th: P. 112 good sleep copious sweating in the night less thirst - no appetite Tongue growing clean about the edges; costiveness Injicn: Enema commun: vespere Reliqua ut antea - 9th. severe vomiting last night on taking any thing into her stomach some vomiting to say; bad sleep but no delirium P. 102 other symptoms as formerly Omittr: Cerevisiam, Habeat vin: Rub: ℥ viij ut sumat ℥j subinde Sumat Haust: effervescent: urgent. nausea - repr: Haust Anod: gt xxx H: S; Omittr: Julap salin - 10th. P 114 & soft almost constant swet for 36 Hours much drowsiness both night & Day no appe - Thirst, & Costiveness Tongue clan [crossed out] at the Edges but very foul & parched in the middle Continue - 155) 11th: Sweat continued till 6 at night without relieft of Symptoms, was checkd by keeping her cooler & has not return'd; good sleep some general relief P - 108 Tongue & appetite a little better - Continue - 12th: P - last night 96 at present 104 good sleep no delirium, no appe: thirst less, Tongue still dry, neat moderate - repr: Enema vespere reliqua ut nesi - 13th: P: 96 - Tongue almost clean & moist good sleep no Delirium, some appe: Continue 14th: Pulse scarce 96 Tongue & Skin natl: has not yet taken food but longs for Beef steak Continue remedies - Let her have a Bit of steak for Dinner 15th: Convalescent - Continue diet & Wine 16th: Convalescent - 17th: Convall: Omitr: Vin: 21st: - Goes out cured - 156 (157 Mary Urquhart Œt 20 A Serv: - February 16th: Complains of severe & constant pain in both [crossed out] Hypochondria & the Epigastric region, also severe Headach nausea, Anorexia, Dyspnœa at Night, a troublesome sense of internal Heat & some cough, P. natural Tongue clean, Belly costive, Amenorrhœa fir 9 Months - These complaints have been present for 3 weeks attributes them to cold has used no Medicines - ꝶ: Sal: Glaub: ℥j Cryst: Fact: ʒj solve in Aqua Bullient: ℥ x et adde Aqua Cin: ten: ℥j - Sumat portitis vicibus incipeins Stat: Sumat H: Anod: com: H: S: - 17th: Threw up her physic, no stool bad sleep, pretty good Appetite to day P - near 90 - Skin hot Tongue clean Injicn: stat Enema com - Sumat. Vespere Solut: Antim ℥ss moni semetiora ad vomitum usque - 158) 18th: P, about 90, Skin somewhat Hot, Glyster not needed, Solutn: operated well both ways, some sweat in the Night, Tongue clean & moist, some Appetite, good Sleep - Sumat: Pulv: Peruv: ℈ij 4er in die ex lacte - Habet Vin: Rub: ad ℔j in die - 19th Complains still of pain about the stomach, pulse & appe: natural - 20th: Convalescent - 21st P. frequent & rather feeble, she complains of weakness & cold sweats some times - Functions seemingly natl repr: Cortex & Vinum 22nd Convalescent but weak Omitr: Cortex repr: Vinum Sumat pil: Gummos grs x vis in die 23rd: Continues better - Utatur Ung: Antips - 26th: Goes out cured - (159 Nelly Scott Œt 18 - A Servt: February 11th: Over the whole surface of her Body & Limbs there appears a considerable Eruption of elevated inflammatory pimples in many parts indistinct particularly on the face which is much swell'd - Anorexia, P. 96, Tongue foul & affected with the Eruption, Belly natural, Throat very sore great thirst, skin hot, - On the 5th: Instant was seized with the Symptoms of Pyrexia which continued severe with great Oppression about the prœcordia untill the Eruption appeard on the 10th - when they abated considerably - Is not sensible of having been exposed to any variolous Infection has used no Medicines. - Utatur Gargar: Emol: subinde - Injicr: Enema com: stat: - ꝶ: Vin: rub: ℔j Aqua Font: ℔ss Pulv: Cort: peruv: ℥j Ol: Vitriol. ten: ʒj - ♏ ƒ Sumat ℥j altera quaque hora Haust: Anod: com. H: S: - 160) 12th: P: 116 & soft face: more swell'd, swelling of the hands beginning; Throat very sore much salivation, pretty good sleep, some vomiting from the last dosse of the Medicine repr: Remedia - To be shifted every Day - 13th: P 112 & very soft much swelling of the face very litle of the Hands none of the Feet - pustules rather flat pretty well filld & with a red Base, great salication much sore Throat & difficult deglutition, bad sleep & some delirium in the Night Omittr mixtura - Habt: Vin: rub: par: ad ℔iss in dies - Sumat pul: C: p: ʒj 3tia qq: hora ex lacte. Appr: Emp: Epispast faucibus ex ter nis - repr: Haust: c: gt x 4 repr: Enema - Gargaris - ut ant - 14th: P. above 120 stronger than Yesterday a stool with the Clyster, quiet sleep no delirium, deglutition & breathing easy, Salivation continues scarce any swelling of hands or feet The pustules fill well, she takes all her Medes: repr: Vin: rub: ad ℔ij in dies Cortex & H: Anod (161 15th: P: 136 - some swelling of the Hands none of the Feet, small pox crusting on the face no stool, some vomiting from the Bark last night none of it taken since, in other respects as yesterday - repr: Vin: ad ℔ij in die Cortex ad ʒj altera qq: hora nisi vomuerit - Enema, Haust: & Cercvisia - ut an - 16th. P - above 120 of pretty good strength considerable swelling of the Hands & very little of the feet - other symptoms as before - Vomiting from the Bark - Omittr: Cortex reliqua ut antea - 17th: P: 150, very great genl: fœtor without any topical Gangrene, she takes some Sustenance particularly broth, in other respects as yesterday repr: Win: & Haust - Injn: Enema ex Aqua tepid ℔j - 18th: P 108 - of good strength, swelling of the Face & Hands much abated, that of the feet more considerable, much less Fœtor pustules crusting every where good sleep & appetite - Continue - 19th:, P. as yesterday, sleep & appetite rather worse - repr: Enema: Haust & Vin ut Antea - 162) 20: P 108 of good strength much thirst last night other symptoms as before repr: Vin ad ℔j in die - 21st: P - 100 had a stool with the Clyster last night; good sleep & appe - rather more Fœtor - ꝶ: Elect: Linit. Crem Tart: āi 3 g Syr. simp: q: s - ut ft: Elect: partitis viribus sumend - incipt: Stat - 22nd: no change of Symptoms, no Effect from yesterday's physic nor from an equal Dose this Morning Enema Vespere nisi prius 23rd: no Effect from the physic a large stool from the Glyster P - 112 ꝶ: Pulv & Jalap: comp ʒj Pulp: prunor. ʒiij Syr. q: s - f Elect - partit viribus sumend - incip stat 24th: P 100 no effect from the Physic but one thin stool from the Clyster Sumat stat: Decoct: Tamarind cum duplice senæ ℥iv & repr: omni Hora at tertiam vicem nisi prius alvres fluxnit - 25th: One large stool from the Physic - P - last night and at present 96 - Continue - (163 Scott 26th: P - still 108 - Sumat Decoct: Tamarind ad ℥ iv c dup: Senæ - omni Hora donec Alvus respondent 27 Took 5 Doses of the physic had 1 large stool two Hours after the last dose P - 96 feel & soft - Continue March 1st: Convalest: repr: Enema vesper nisi prius - A Bit of Meat - 8th: Pulse 96 - good sleep & appetite one natl Stool daily - Continue - 9th: Bad sleep & appe: P: last night 120 at present 108 - ꝶ: Pulv: 1 Jallap: comp ʒj Elect: Senit: ʒiij syr: simp: q: s: ft: Elect: tenue Simat Cochl: parvum omni semihora donce alvus responderit incip: stat: 10th: no Effect from the Physic nor any stool better Sleep pretty good appe - PP - last night 96 at present 104 - repr: stat: Elect: u: a - 11th: 1 stool from the physic much sickness P 120 Tongue white 164) Sumt: Vin: Ipec: ℥j & utatur Infus - Chamomil - 125th: Vomit operated well no stool bad sleep & appetite P: above 100 very soft & with intermission ꝶ: Syr: siyrup: Mucil: Arab: āā ℥j Spir: vit: ten: ℥ss ♏ ƒ - Sumat coch: parv ter in die ex Cyatho Aqua font: Vin: rub: ad ℔ j Haust ut antea - 13th: P 114 in other respects as yesterday - 14th: P - above 120 bad sleep Anorexia & nausea Tongue white but moist Complains of some due pain in the Abdomen - Omitr Vinum, repr: Mist: Vitu Injicr: Enema vesper - Haust: u: a - 15th: P 116 better sleep much weakness & better Appetite - Continue 16th: P - 116 bad sleep & appe: costiveness slight pain in the Abdomen ꝶ: Pulv. e Jalap: comp: ʒij Elect: Senit: ʒvj. Syr: q: s ♏ ƒ ft: Elect: tenue - Cujus Sumt: Cort: parv: omni hora donec Alvus respond - incipas (165 Scott - March 17th: P - 108 slight gripes but no - another Effect from the physic tho she has taken it all - repr: Enem: vesper: nisi prius & Habeat H: Anod c: gt: x 4 - 18th 3 thin stools from the Physic P - 120 better sleep Tongue still furred Appe bad ꝶ: Julap: Salin ℥ viij Emet: Tart. grs: ij - Solve - Sumt: ℥j altera quague hora - Omitr Felyuee 19th: P - 106 rather stronger Tongue clean had much vomiting in the Evening from the Medicine one stool ꝶ: Tamarind ℥ij Mannæ ℥iss Tart: Solut: ℥ss - Coque paulispen ex Aqua font: ℔ij ut Solvant Tart: Solut & manna - Cola - Sumt: ℥ij altera quague hora incip cras mane - 20th: P - under 100 Tongue more clean & moist no sensible Effect from the Medicine - Continue - 21st: P - 96 and stronger, Tongue clean & appe: better good sleep, 3 thin stools in the 166) Evening none to day repr: remed: per hunc diem Omittr Cras - 22nd: P - 84 skin cool Tongue sleep & appetite natural one stool yesterday Continue - 23rd: P - 92 - no stool other symptoms as yesterday - repr: Decoct: Tamarind c Manna & Tart: Solubili cras mane - 24 no Effect from the Medicine P - 84 repr: Decoct: cras nisi Hodic Alvus reponderit - 26th: One stool last night - Convalesc: now in every respect but weak - Contte - 29th: P - 96 - Tongue whitish but moist Functions natural but she is still weak repr: Tamarind c Tart Solut - April 14th: Goes out cured - (167 Jane Fisher - Apedlar - March 18th: It appears that on the 10th: Inst: after Exposure to cold she was suddenly attacked with total loss of motion of the right side & of speech, with complete Anesthesia of the side affected which still continues - P - 60 & not to be felt in the paralytic side, Tongue clean, Belly & appetite natural Could not learn the particulars of the Catamenia - Has used no Medicines Appr Sinapism: ad crus & Bract affat per horam Vesper - Induat Indus Sancum - Utater Strigili fortiter mane & Vespere - 19th. P - 50 just perceptible in the right arm motion & feeling as bad as ever Speech very imperfect Tongue much furred no Stool - Abradatur Capillitium Admovn: Cucurb: Cruent: Temp: sinsitro & Educn: Sanguis ad ℥viij Injicn Enem: Com: Vesper nisi prius - 168) 20th: P - about 50 complete Stupor she spoke somewhat distinctly when she was cupped but none since - Mitr Sanguis stat ab Arteria Tempor: ad ℔j appr: Emp: Epispast: Capiti 21st: P - rose to 60 immediately on the Bleeding has varied a little in frequency since at present is 72 of natural Strength in both Arms, Blister has risen well Stupor still very great no Speaking nor swallowing the last 15 Hours - Injicn: Enema pengans applur: Sinapism: pedibus - 22nd: P - 72 very feeble & equal in both Arms stupor Continues very complete swallowed some food this morning [hastening?] continues natural 2 pretty large thin stools since the Glyster both upper & lower Extremities considerably colder than natural - Applicn: Epispast: ij Crusita prope talos & Epispast Mechæ Hab Flat Vin: rub: ℥viij ut Sumt ℥j altera quague Hora - 169) 23rd - P - 84 very feeble rather less stupor some imperfect attempts to speak she takes some food then wine, no stool Blisters have not risen either on the Legs or neck - repr: Sina[os: ad pedes Enema pengans & Vinvum - 24th: P - last night 104 to day 80 & feeble stupor continues but with some confused speaking - Glyster not retaind but a large stool after it - Urine & Fæces passd in Bed. Take her Wine & some thin Food all the Blisters rose & discharged well in about 45 Hours - repr: Vin. some swelling in the Face with redness - 26th: P - near 100 rather stronger than yesterday stupor rather less other Symptoms as formerly - repr: Enema purgans - Vinum ut antea - 27th: P - 132 sensibly weaker in the o light than in the left Arm, Stupor Palsy & Erysipelas of the face as before three thin stools 170) since the Glyster - These & the Urine passd in Bed - she still swallows food & wine - repr: Vinum - 28th: P - about 140 very feeble Stupor rather less Palsy & Anesthæsia no better Erysipelas of the Face much less painful swellings of the left Knee since last Night at first red & like Erysipelas now much paler & yellowish one natl Stool pass'd in Bed she still takes food & wine - Continue 29th: P - as Yesterday & less Stupor Speech more distinct some pain in the right Lef but no swelling nor redness - These now gone off from the left Knee no Stool - Appr: stat Sinaspism - Peditus & Emp: Epispast: Genuis - repr: Win ad ℔iaa Enema com vesper nisi prius - 30th: P - last night 150 at present 112 feeble but regular it was stronger last night blisters have not risen Glyster operated Urine & Fœces passd in Bed - A restless night with constant groaning - (171 Fisher repr: Vin - Appr: Emp: Epispast inter Scapulas Sinapism: ad Pedes - 31st P - 128 - considerable swelling & redness about the right Hand last night now gone, blisters have [not] risen on the Knees but not between the Shoulders repr: vinum - Appr: Sinapism manibus & Brachiis Enema com vesp - nisi prius April 1st: P 120 - Clyster operated no Mange of Symptoms Continue - 2nd: P -120 scarce to be felt in the right Arm a large natural stool last night urine & fœces still pass'd in Bed - repr: Vinum - Appr: Emp: Epispast parv iterum Capiti fotus siccus ad crura & pedes 3rd: P - about 110 very feeble breathing somewhat laborious Eyes growing dim fœtures collasping some tremor of the 172) Hands, she still swallows, frequent thin stools passed in Bed Continue 4 Died at 4 P- M- Yesterday - (173 Marion Pennycuick Œt 18 A Serv February 17th: On Saturday 14th: Inst began to complain of Lassitude & Headach - On Sunday had rigors & vomiting - Towards the Evening of the same day there appeared on both cheeks & sides of the Nose a diffused Inflamation of a deep red colour disappearing on pressure; the Cuticle at present is elevated in several places with watery Vesiculæ & the redness continues to spend P - 112 small & feeble, no appetite great thirst, Catamenia have appeard only twice these two years, the last Time about a twelve Month ago - Belly regular, Has taken a dose of Glaubus Salts * sprinkled the parts affected with Hour - Sumat: Pulv: peruv: ℈ij 3tia qq: hora ex lacte incipiens stat - Haust Anod c: gt xxx H: S: Decoct: Avenace: ad libit: Farina ad Vullum - 174) 18th: P; 162 Skin still hot - Erysipelas & Headach continue, Tongue clean & moist some Appetite & Sleep - repr: Cortex, Haust & Farina Habeat Vin: Domest. ℔j in die Enema Vesper: nisi prius Milk Diet - 19th: Eruption subsiding on the Face but spreading towards the left Ear, slept but ill P - & appe: nearly natl: repr: Haust: c gt: xxxv - Vin & Cortex ut antea - 20th: P - natl Erysipelas subsiding on the Face spreading a little towards the left Temple & Ear - Bad Sleep - Contue. 21st: P - natl. swelling subsiding every where some pain about her HEad & left Ear with beating of the Vessels - Eruption of the [crossed out] Face nearly gone Skin yellow - Vessels drying up - Continue 22nd: Convalescent - rather costive slight heaviness about the Head - Omitr Cortex - Sumat: Elect: Cryst: Tart: ℥j part: visibus. incip: stat: (175 23 no complaint but slight Headach Continue 24th: Goes out cured - 176) (177 John Gaudy Œt 17 a Taylor March 7th: Complains of considerable pain in the Shoulders sides stoins also in his right wrist which last is a little swelld - P - 100 headach, Tongue white bad sleep Belly natural - was seized about ten days ago with the above Symptoms then occupying the lower extremities but from which they have now been pretty. compleatly removed - Knows no Cause, has taken a Vomit - Mittr Sanguis stat ad ℥viij Sumt: Julap Salin ℥j 3tia: quague Hora Sumt: Haust: Diaph H: S: cum S: S: gt: xxx & Vin Ipec ʒj ♏ ƒ Induat Indus: laneum - 8th: Blood has a thick firm buffy Coat on one Cup none on the other some sleep pains letter - Mittr Sang: iterum ad ℥xij Rep Temid: Decoct: Avenac: ad Letitum - 178 9th: Blood has a firm buffy Coat or the first cup scarce any on the 2nd: P - 92 & soft pains still severe Foveantur crura probe vespere Sumt: Pulv: Sudor: grs: x omni hora ad 4 am: vicem nisi prius sudaverit Bibat Decoct: Avenae: ad Lebitum repr: Julap - Omittr Haust - 10th: P - above 100 pains gone from the Legs but continue in the left Shoulder & Arm, good sweat in the Night which has now ceased repr: stat: Fotus - Pulv: Diaph & Decoct: Avenae adlibitum - 11th: Sweated much in the Night no sleep much pain in both Arms & about his Stomach increas'd on pressure P - 120 Body costive - Injicn stat: Enema com: ꝶ: Magnes: ustæ ʒj Aqua Font: ℥ij Syr: ʒij ♏ ƒ ft: Haust stat: sumend: - (179 12th: Was bled in the Afternoon to ℥x Blood has a thick firm buffy coat P - 102 Pains very severe about his sides & increas'd on pressure 2 stools after the Clyster no sensible Effect from the Magnesia, no vomiting nor Cough appr: Emp: Epispast: lateri qua maxime dolet, repr: ad libitum - 13th: P - scarce 84 skin cool pain much relieved where the blister was applied still continues in the right side left shoulder & Hand no stool repr: Enema, Decoct: Avenae & Haust: Diaph: - 14th: P: 88 - & soft pains about this sides continues but are easier, pains came into his right Hand last night complains of pain in swallowing which goes down with the mouthfull till it gets into the stomach Continue 180) 15th: P- scarce 84 & soft no return of pain in the blisterd side much pain about the right side, Arm & Shoulder repr: Fot: ad Crura Pulv: Sudor & Decoct Avenae - 16th: P - scarce 84 very little sweat, pains still severe in the right side & Shoulder & left Breast, Hand now well, repr: Fotus - Pulv: Tudor ad ℈i Hora 5th & iterum hora 7ta: Decoct & Julap - u. a - 17th: P: 84 pretty general sweat with some interruptions Pains rather worse - repr: Julap: Salin: & Decoct: Avenae: per heme diem & noctem Omitr Cras - 18th: P - about 90 pains rather easier bad sleep some sweat no stool - repr Enema Habt:H: Anod c gt xxx H: S: Decoct: Avenae: ut antea Omitr: Julap 19th: P - 90 pains severe in the left Shoulder & beginning in the right - Appr: Emp: Epispast: Humere sinist qua dolet 20 - Pain relieved in the Shoulder or still severe in the other Arm - P - above 90 & weak Continue (181 Gaudy - March 21st: Pains nearly gone except from his Arms - Continue - 23rd: Pains more severe in general some Epistraxis this morning probably the Consequence of picking his nose - Sumt vis in die Pulv: Cicut: grs vj - 24th: P - 100 bad sleep pains no better Mittr: Sang a Brachii ad ℥x Utatur Julap: Salin ad ℥j 3tia qq hora - Omittr: Cicut: - 25th: Blood with a large proportion of Serum & a firm buffy coat - P - 96 & Soft pains no better bad sleep no Sweat - repr: Pull Sudorif: Fotus ad Crura & Julap: Salin: u: a: præscript: 26th: Some sweat in the Evening scarce any in the night or to day pains no better P - as yesterday - repr: Pulv: Sudor Sumt: Julap: sudor ℥j 3tia: qq: hora Decoct: Avenae: ad libitum - 182) 27th: Copious sweat with relief to the pains - repr: Julap: Diaph: & Decoct: - 28th: some sweat pains worse both in the Trunk & Limbs - Omittr: JJulap Diaph - repr: Cicut: u: a - April 1st. Pains almost gone from his Limbs some remains of them in his Breast Continue c Heat for Dinner 2nd. - Complains of Cough some return of pain into his Hand which is swell'd Admovovr: Hirud: iij ad manum dextram qua dolet - repr: Cicut. - utar: Mist Mucil: Urgent tussi - H: Anod - H: S. - 5th: P - 96 - pains as formerly cough troubles some bad sleep - Omittr Cicut. repr: Haus Diaph: - 6th: Sereve pain & swelling in his right hand still much pain in his right side Admovr: iterum Hirud iij manui qua tumet Appr: Emp: Epispast: lat: Dolent: 7th: Hand much relieved, pain of his side letter since the Blister - Conue: - (183 8th: P: - still above 100 pains as formerly ꝶ: Nitri ℥j Solve ex Decoct: Avenae: ℔iv & vivat ad libitum - 10th: P - still above 100 pains of his Limbs much easier that of his Breast Continues some sweat from the Medicine, copious discharge of Urine the whole Quantity of his Medicine taken in a Day - repr: Nit: ℥ss ex Decoct: Aven: ℔ iv - 13th: P - 84 pains in his Limbs easier sickness & uneasiness as he thinks from the Draught - Omittr: H: Anod - religua u a 14th: Pains easier but still felt at night some gripes Diarrhœa & Thirst - Omittr: Mixt: Nit: repr: Decoct: Aver 15th: P - scarce 84 little except about his Breast - Inimgr: Pictus mane & Vespere ol: Dolat: Caustic - 17th: Goes out Cured - 184) (185 Betty Anton Œt 22 - A Serv - February 18th: For these 6 Months past the left Mamma has been occasionally affected with a painful distension & assuming a livid Hue which symptoms are generally succeeded by a considerable Hamorrhagia from the Orifice of the nipple. The Breast at present does not appear any way diseas'd, but about 14 Months ago a superficial Ulceration occupying its whole surface attended with much uneasiness [crossed out] in the Axilla but without any enlargement of the Glands this she attributes to a Blow she received on the part which was succeeded by a slight Tumour in the Substance of the Mamma which gradually disappeard as the Ulver heald - She was a patient in the clinical Ward this Winter with an Œdematous swelling of the Arm [17?] which she was dismissd Cured - For Case Se Homes practice page - 101 - 186) Sumat Pulv: Stypt ℈j 4er in die Applicr: panna Lintea aqua frigida madefacta mammæ affectæ sœpius in die 19th: very little Hœmorrhagy & only once, the stupes not Applied - Continue - 20th: still pain in the Mamma but no Hœmorrhagy - Continue - 21st: no Hamory: but some pain slight Tension or swelling of Mamma - Mittatur sanguius & brachio sinistro ad ℥viij repr: Pulv: Stypt: u: a Applir: ter in die Cataplas: Sat: frigid mammæ - 22nd: Blood natl: no Hamory: more pain but no more swelling nor Hardness in the Breast very bad sleep - repr: Pulv: & Cataplasma u: a H: Anod: c gt: xxx H: S: Utatur pedectur: Vespere - 23rd: Hamory: from the Mamma above 2 Hours, no perceptible swelling or hardness but some pain, bad sleep, Body open - repr: Omnia ut heri - (187 24th: no more Hæmorry: or other Change Continue - 25th: Much more pain & slight tension such as commonly precedes the Hæmorry: Appr: Emp: Epispast Pectori statim - amoto Emplastro Utatur Ungo: Epispato: Reliqua u: a - 26th: no Hæmory: but much pain in the Mamma Continue 27th: still much pain in the Mamma no perceptible tension or swelling - Issue runs well - Continue - 28th: Hamory: from the Mamma in the night Time pain much easier now, Contue: - March 2nd: Continue - 3rd: - Continue 8th: No more Hæmorry: more pain & fulness in the Mamma Sumat Sal: Galub: ℥j Cryst: Tart: ʒij ex Aqua Font: ℥x - reliqua u: a 9th: slight Hæmorry: from Antons Nipple bad sleep & pain in the Mamma repr: Remed: & H: Anod eg: xxx: H: S: 188) 10th: no Hamorry: but much pain Omittr Haust - Sumat Opii grs: ij H: S grs: i cras mane 11th: Better sleep - Symptoms the same continue - 12th: Breast still painful but without Hamorry: - Apr: Emp: Epispast: parv: lateri sinistro pone Mammam - 13th: Catamenia fluent Breast as Yesterday 14th: more pain & some swelling in the mamma no Hamorry: Sumat: Stat: Sol: Cath: u: a præscripaet 16th: No change of Symptoms - Goes out without relief (189 Jane Leith - Œt 18 - Feby: 5th: at the lower part of the sternum & extending along both Hypochondria there is some degree of fulness with Hardness & pain on pressure especially felt on the left side this is attended this is attended with frequent vomiting of every thing she takes which is frequently mixed with Blood - A Sense of stopping in the lower part of the Œsophagus with regurgitation of Food at Times - Much nausea loss of appetite & general Debility - was admitted into the Clinical Ward on the 22nd: of Decr: when labouring under the same Symptoms - For particular See Homes practice Page 109 - It appears she was a patient in the House last summer at which Time she was affected with a hard 190) painful enlargement of the left side for this she was in the practice of taking large Quantities of Opium & was advised to country Air & a Corns of Cicuta which she continued take for a considerable Time with the Effect of removing the swelling as she says - For Remedies administerd for her Relief since admissi into the Clinical Ward - See page. 6th: Sumat Julap: Mucil: Acid - ℥ss 4ter in die Injicr: Enema ex Aqua Frigid vespere nisi prius - 7th: Vomiting severe - Blood still throw up, Hardness & pain on pressure near the Stomach as formerly, bad sleep. Enema nitril profuit Injicr: Enema con: statim repr: Julap Mucil: Acid - Sumat Opii pur: grs i H: S: - (191 8th: Enema respondebat - more pain about the left side of the stomach better sleep some Vomiting but without Blood Continue - 9th: Some Vomiting last night & a little Blood thrown up to day bad sleep - repr: remedia - 11th: more vomiting & headach very little Blood thrown up - pain severe on pressure, Belly open - repr: Pil: Julap Mucil, Acid - u: a 13th: Rather more vomiting of Blood last night but none to day, Much pain . . . Continue - 14th: Dismissd improper - 192) Seith From the information of Mr. Tyfe under whose care this patient was it appears that for a considerable Time she was affected with Eruptions on her legs of scrophulous appearance that after this she was attacked with an Obstruction, of Œsophagus which terminated with a sense of something bursting within her & the [Syrtion?] of pus & Blood, that after this it was necessary for some Time to support to with Wine & Beef broth conveyd by mea of a flexible Tube introduced into the stomach as there was a regurgitation of every Thing taken into the Œsophagus - Dr: Gregory Thinks this one of those Cases the nature of which we can only be certain of from Dissection, but it is proba that the Obstruction or Schirrous may have extended itself to the Stomach & that the Hamatemesis & other complaints are of such a nature that they are not be rel by Medicines & that if there is any cha of recovery it is from the operations of nat The cold Glyster he has used often in cases Hamorrhagy particularly of the Uterus & font it not only safe but of great Service - (193 Gavin Brown Œt 55 - Shoe - March 23 - On the under Palpebra of the left Eye and near the External Canthus extending downwards a little way on the cheek, is situated an ill defined & considerably elevated Ulcer, painful & very apt to bleed - This first made its appearance about 12 Years ago in the form of a dry scab which soon after suppurated which as recurred frequently since, size increas'd greatly within these 2 years - Says he got an Ointment from Dr Cullen about 18 Months ago which nearly heald up the sore but immediately on Omitting the Application it broke out again ꝶ: Arsenic: Alb: ℈i Aquæ distillat ℥xij Coque in Vase vitreo in Balneo Arenœ ad ℥x & per Mart: cola - Applicetur per penicillum ad Ulcus vis in die - Feel Diet To have a Dresser 194) 24th: repr Solutio - Appr: Ulceri Sinit: Simplex - 28th: much pain from the Solution much blackness of the Tumor - Omittr Solut - Appr: Catap:: Emol: pout: affect: & repr: H: S; & cras mane - 29th: The greatest part of the surface of the Tumor appears hard & dead part of it unalter'd - repr: Solut: & Linimm: Omittr: Cataplasm: - 31st: much pain from the Scirrhous seems to waste with a more favourable like Suppuration repr: Solut: cum duplice Aqua April 2nd: Still much pain from the solution some Inflammation with [illegible] pimples around the scirrhosity - Omittr: Solut: repr: Cataplas: Emol: H: S: & cras mane Ulceri - 4th: the Surface of Scirrhus to the 195) thickness of about 1/2 of an Inch seems dead & likely to separate from the parts below repr: Cataplasm per hune diem Solut: & Lint: Cras. - 5th: The surface of all the dead part of the scirrhus came off with the poultice pretty good suppuration on the present surface very great pain from the Soltn repr: Cataplasm - per hune diem, smissa solutione - rep Solut: cras 8th: Excessive pain from the Solution so as to prevent sleep - a dead like Crust forming again on the Scirrhus which is now sensibly less in Bulk Omittr Solut - repr Cataplasm 10th: The dead surface came off again & the Scirrhus is considerably diminishd & looks clean Omitr Cataplasm rep Solut - 11th: repr: Cataplasm - cras mane & H. S 14th: repr: Solut. Omittr Cataplasm 17th: repr: Cataplasm: H: S: & cras mane 196) 18th: repr: Solut: Omittr Cataplasm 24th Much of the scirrhus seemingly dead some inflammation & Ulceration on the Neck the solution having been applied for 3 days without intermission omitr Solutio - rep Catap 26th: a large Scab the thickness of a half - penny came off from the Scirrhus which now reduced to 1/4 of its original size. repr Catap: Hodie - Lint: & Solut cras - 29th: much pain from the Solution the Surface of the roof of the Scirrhus seemingly dead - Omittr Solut & Linit: repr Catap - 30th: much of the Surface of the root of the Scirrhus was found & taken off [as?] the Scissais the progress of the Crew has been uniform & quick - Continue & remit to the Ordinary Physicians - (197 David Greig - Œt 50 a Labourer - February 6th: Was in the clinical Ward since December with an Ulcer of the Cancerous Kind situated on the right Ala Nasi & upper Lip which supervend about 3 years of ago from picking a Wart on his Nose - for the poutice - of the Case vide page - 185 - He has undergone a Course of Cicuta to great extent with little other advantage than the Ulcers appearing cleaner - repr: Pulv: Cicut ad ℈ij in die - ꝶ: Arsenic: Alb: ꝶj - Aquæ distillat: ℥xx coque in rase vitrio in baleno Arena ad ℥xij & per chartem cola, et appr: Ulceri per pencillum vis in die - Ful Diet - To have a Dresser - 7th: solution not yet applied repr. remed: Omitr: Ung Basil: - 8th: slight pain from the solution Applr: Solut: ter de die - Cicut: u. a 9th: some Bleeding from the ulcer in consequence of the dressings growing dry - repr: solut: Ulceri 434: in die & Rostea Applr: Ung: Simp - Habeat: Cerivisiam tenuem ad ℔ ij in die 198) 10th: Ulceration more painful & Black with Blood, Inflamn: & swelling spreading on the cheek - Omittr: Solut: Foveatur Ulcers aqua tepid: repr: Ungt: Simplex per hune diem vespere Appr: Cataplasma undliens part affect 11th: Pain & Inflamn: much less - repr: Fot:, Cataplas:, & Ung ut ant, - 12th: vomited from the powder - Omittr: Cicut: - repr: reliqua - 13th: Appr: iteum solut: Arsenic: ad Ulcers per pencillum, vis in die - repr: Ung: Simp: Omittr: Cataplas - 14th: Continue - 15th: Feels much heat after applying the Solutn: Ulcer has a better appearance it is less deep, less fungous, & Suppuration appears more favorable Continue - 16th: Continue - 17th: Ulcer as by last report - more Heat & pain from the solut 19th: Continue (199 21st: Ulcer on the Cheek much better, it is cleaner shallower & has diminishd From Ines in Extent, the ulceration on the Lip & nose not so much better, pain from the Solutn is now excessive - Omittr. Lutut nuxa in use & ungt: simp. ꝶ: solut: olin præscrip: Aquæ Distillat - āā ℥j ♏ ƒ appr: ad Ulcers per penicillum ut antea pro Ungo - utatur Sinima. Simplici 22nd: Less pain but still a good deal from the Solut: Continue 23rd ulcer sensibly better in every part still some pain from the solut Continue 28th: surface of the Ulcer diminishd at least one third which remains on the Cheek is healing fast - that on the upper lip advancing more slowly, that on the nose worst of all but sensibly mending - ꝶ: Ung: Simp: ℥ss Arsenicæ grs: ij ♏ ƒ Accuratissime applicn: ad alam nasi per horas quatuor vespere - reliqua ut Antea - 200) March 1st: Some Heat but not Excessive from the new Linimt - 1 repr: stat: Lmt: Arsen: ad Alam nasi & iterum vespere - 8th: Ulcer continuing to mend Omitr Solut & Linm: Appr: Cataplas: emol: stat & iterum H: S: part: Affect - 9th: Sore appears better since some of the hardend sloughs came away repr. Solut: Omittr Cataplasm 10th: repr: Solut & Lint: simplex - 11th: a little wart on the left side of the nose which seems to increase in size - 13th: Ulceration much better on the Cheek somewhat better on the nose & Lip repr: Solut: & Ungt: Simplex - 21st: Ulceration better in every respect repr - Solut: Arsenica: dilut & Ung: Simp 24 Ulceration on the Cheek still diminishg that on the Lip & those no Better repr: Solt: Omitr: Lint: Simp repr: Lin: @ Arsenica - 29th: Ulcer sensibly better - Goes out relieved to have ℥vj of Strong solut: of Arsenic & Lin (201 John Doby Œt 50 a Labourer February 24th: from the Information received it appears that he was affected about 6 months ago with Fever in which he laboured under great delirium and upon the former abating the Intellectual Functions remaind in a great Measure deranged which still continue with compleat watchfulness having slept none since he came into the House - His Face appears flushed Eyes suffered & Countenance wild, great general Emaciation - P - 80 & of good strength Tongue Appetite & Belly natural, drinks very little, complains of great uneasiness groans constantly is very apt to start & to be alarmd on the slightest occasion - ꝶ: Tart: Emet: grs x solve in Aqua Fontes ℥v - sumat ℥j omni semihora incip hora 4ta: 25th: Ful vomiting & two stools after taking the whole of the Medicine, some Horns sleep in the Night, which he had not had for many Nights before, but he awakend in a fright & has been more unquiet than before - 203) a Bit of meat for Dinner & ℔j of strong Beer daily - Fotus ad Crena per horam besp St. Anad e grs xxi H: S: incpt cras sumere Pul: peruv: ʒj 4er: in die ex lacte - 26th: Sound sleep for 1 Hour & a half after the Fomentations, some sleep in the night after the Draught but he awaken as much disturbed as ever - Belly open yesterday - Omittr: Haust: - repr: Fotus H: S: Cortex & Dieta u: a 27 - Pulse still natl: sleep immediately on the fomentations which continued so Time with no amendment of Symptom he loaths the Beer - Omitr Cerevis repr: Fot: Cort: & Dieta - March 1st: Very little sleep the two last nights & he is in general more disturb will not take the Bark but takes his meat heartily - P - 66 Omitr Cort: & Fotus To have the showr - bath every Morning (204 & to take Exercise at proper Hours on the Bank - 4th: Had some sleep during the Night Contins: Omnia - 9 Countenance more natural he has more sleep & is less disturbed when awaking he seems more rational & collected Continue - 13th: slept very ill & much and is much deranged to Day Sumat H: S: Haust: Anod: e L: L: gt LX Hora sexta incipiat sumere Sol: Tart: Emet ut antea prorscript: 14th: Because very unruly in the Afternoon by mistake got the Solut: first & the draught at Bed Time no Effect from the Solution, till an Hour & a half after the last dose was taken ful vomiting & purging then he slept well in the night and is more calm - & chearful to day Omitr Lavatio Frigida - 205) 15th: Slept well continues pretty calm but not quite so well as Yesterday - 16th: Much deranged last night & to day Habeat Hora 4ta: hora 6ta: Sol: Tart Emet at antea præscript: fruit - 17th Got his Medicines as orderd became [in?] unruly after the third dose of the Solution Vomited in 3/4 of an Hour after taking the last dose slept some Hours in the Night & awakend calm is much as usual today ꝶ: Camph: ℈i Spir: vin rect: gt: aliguot Conserv: rosar: ʒj ♏ ƒ div in portion tres sequales - Sum: unam quaum omni Hora ad 3tian vicem incip: hora Sexta - 18th: much sleep immediately after taking his Medce: he awakend calm & continues so repr: Campt: ut heri - (206 Dobbie - March 20th: Mental derangement continues but without fury - P - sleep & all the Bodily Funtions natural repr: Camphor: ad ʒss in dos: iij divis: ut antea - 22nd: Continues to sleep well & awaken calm mental derangements scarce any Better today functions natural but he is still weak - Omittr: temed: - 24th: Continues calm but deranged Bodily functions natural Goes out as improper 207) 208) John McKay Œt 73 - A Soldier February 23rd: Complains of constant inclination to pass Urine but [with] which cannot be affected without Assistance of the Catheter - Has also frequent numbness of the Legs & Thighs & sensation of cold in them, Troublesome Cough, which occasions two soft pulphy Tumours to protrude through the Rings of the Abdominal Muscles but which are easily reduced when the Cough is alsrostt - These are attended with no pain & he says they first appeard about 3 Months ago - The Suppression of Urine has been present 3 Days - Was in the House in April last for similar Complaints of which he was dismissd relieved & says that he had been ill of them 3 Years before - Functions natural - Sumat Julap: Mucilag: ℥j Ungent Fussi 24th: Adeat Machinam Electric: quotidie ut Soucr: Lantil: circa Sumbos - Habeat Vin: Domest: ad ℔j in die - 209) 25th: No sensible Effect from the Electrici water drawn off as usual applt: Emp: Epispast: Sumbis & Ossi sacre 27th: Passd some Urine by the natl. Effect repr: Electricitas - ꝶ: Mel: ope: ℥j Ol: Juniper ʒj ♏ ƒ Sumat Coch: part: vis in die - 28th: Has pass'd rather more Water to the Amount of some Ounces by the natural Effort Continue - March 1st: Catheter not needed to [illegible] the Urine being passd pretty freely by the Natl Effort - 2nd: Passes a little Urine naturally at Times - repr: Remedia - 3rd: passes his Urine in the Natural way - Continn Omnia - 8th: Convalescent Omitr remedia 12th: Continues to make his Urine by the [illegible] Effort tho with some difficulty - Goes out relieved - (210 James Meikle - Œt 13 - February 14th: Complains of increas'd thirst & copious discharge of limpid tasteless Urine; Functions natural - Has been affected with these Complaints for above 9 Months - He says they came on after working in a coal pit - Was received into the House in the clinical Ward in December last & used a variety of Medicines with much benefit particularly from the pulv: Doveri & the warm Bath - Vide page - 173 - 1st. Ports 15th: His urine to be measured - 16th: Urine to xvj Ingesta xvss - Sumat Pulv: Sudor: ʒss mane & vesper - 17th: Urine to xv. Ingesta ℔ xvss - no sweat, vomiting from the morning powder repr: Pulv: Sudor: ad ʒss [mane &] Vespere & grs: x omni hora ad tertiam vicem incipiens cras mane 18th: Vomiting within an Hour after taking the Evening powder - Vomiting from the two first morning powders - Urine ℔ xiv Ingesta the the same Vomiting estimated at ℔ ij 211) Omittr: Pulv: Sudor - 19th: Urine ℔ xv Ingesta the same ꝶ: Alumen: ℥j Conserv: ℥ss Syr: q: s: ft: Elect - Cugics Sumat Cochleane parv - 4ter de die incipiens stat - 20th: Has retaind two does & thrown up [illegible] of the Electuary Urine ℔ xvj Ingesta ℔ x - Continue - 21st: no more vomiting from the medice Urine ℔ xiv - Ingesta to xss - Continue 22nd: Urine ℔ xv Ingesta ℔xivss no vomiting 1 stool the whole ℥j of [illegible] taken in 24 Hours - Habeat Bal: tepid repr: Elect: 23rd: Urine ℔s xviss Ingesta ℔s xiiss no nausea from the medicine now repr: Alum ad ℥ij in die - 24th: Severe vomiting in the night, Urine ℔s xivss Ingesta ℔s xiiss Omittr Elect: - ex Alum: Inungr: Corpus mane & vespere Ungo: simplici: - 25th: Urine ℔s xv Ingesta ℔s xiv Continue (212 26th: Urine ℔s xv - Ingesta ℔ xiij Sumat Molem jugland: Elect: peruv. Sol: quater in die - repr: Ungt - 27 - Urine & Inesta ℔ xiv each repr: Elect: & Ungt: - 28th: Urine & Ingesta ℔ xiv each Contue: March 1st: Urine & Ingesta ℔ xivss each Omittr: Elect: robor: - Sumat: rubig: ferri prepciat: ʒ ter in die - 2nd: Urine ℔ xv Ingesta ℔ xiiiss repr: rubigo Ferri u: a - 3rd: Urine ℔s xiv Ingesta ℔s xiij Continue 4th: Urine ℔s xiv Ingesta ℔s xiijss Continue 5th: Urine ℔s xv - Ingesta ℔s xiv - Continue - 6th: Urine ℔s xiv - Ingesta ℔s xiiss - Contue: 7th: Urine ℔s xivss Ingesta ℔ xiiss Continue 8th: Urine ℔s xij Ingesta the same repr: rubige Ferri ad ℈ij 4er: in die 9th: Urine ℔s xv Ingesta ℔ s xivss - Omittr - Opii grs. ij H: S: grs: i mane - 213) 10th: Urine ℔s xij Ingesta ℔ s ix less thirst than usual in night repr: Opium 11th: Urine ℔ xijss Ingesta ℔ ixss good sleep in the night & drowsiness in the Day - Habt: Opii grs iij H: S: grs: i Mane 12th: Urine ℔ xi 1/4 Ingesta ℔ ixss Con 13th: Urine ℔ x Ingesta ℔ ix only ℔ j drank in the night repr: Opium ad grs: iij H: S: grs: ij [mane?] 14th: Urine ℔ x Ingesta ℔ ix repr: opium ad grs: iv H: S: & grs ij [illegible] 15 Urine ℔ ix Ingesta ℔ vijss - Continue 16 - Urine ℔ x Ingesta ℔ vij - repr Opium 17 - Urine ℔ xiss Ingesta ℔ viij - Omitr Opium 18th: Urine ℔ ix Ingesta ℔ viijss - Contue - 19th: Urine near ℔ xiij Ingesta ℔ ixss - 20 Urine ℔ xiij Ingesta ℔ ix - Goes out for the Country air (214 David Esther Œt 41. A Weaver February 16th: Is affected with constant pains of left side a little above the Spine of the Ileum & extending upwards across the Epigastrium with frequent nausea & vomiting afer meals of an Acid Matter - Some cough occasioning a soreness of both sides with viscid Expectoration in the Morning - P - & Tongue natural Belly very costive for which he is obliged constantly to take pills & has pass'd Blood at Times by stool - sleeps ill - These complaints have been present since the Beginning of May last for which he was receive'd into the House & dismissd after staying 3 weeks greatly relieved, but they again recurred in a few Days. 17th: Sumat Infus: Amar: ℥j vis in die - Sumat H: S: Pil: Stomachic: grs: xv To use Exercise daily on the Bank - a Bit of Meat for dinner - 215) 19th: Less pain, but some vomiting to day, Body open Continue - 20th: Thinks himself worse since he came, more pain in his Bowels Omittr: Infus: Amar - Sumat Pulv: Ipec grs: xv vespere Utatur Infus: Chamomil - Linipt: - Elect: peruv: robor: Molen jugland ter in die - 24th: Complains still of pain in the left side & much flatulence swelling of the Abdomen Belly open Sumat cras mane Pulv: Rhei ʒij - omitr: Elect post hune diem - 26th: Goes out relieved - (216 217) (218 William Brown Œt 21st: A Seaman March 13th: Complains of severe pain about the supereilia of his Eyes with constant throbbing of the Temporal Arteries, says that his sight is so much diminish'd that he cannot read the greatest print & that he has a constant appearance of light floating before [these] his Eyes - The pupils are much dilated but contract with facility thinks he sees best by moonlight - whenhe moves his Head suddenly to either side he is sensible of a crackling noise in the vertebræ of the neck - Functions natl: these Symptoms have been present eleven Months & attributes them to carrying a heavy burden on his Head Has used a Variety of Medicine & had leeches applied to the Temples without relief says he has received some Benefit from the use of Electricity - Sumat Infus: Tamarind: c: dup: Senæ ℥ij omni hora ad 4an: vicem nisi prius - 219) 14th: Admovr: Cucurb: cruent: Temporebus & Educn: Sanguis ad ℥ viij - Adlat mach: Elect: ut educr: Scint: Elect: multæ leves circa oculos - 15th: ℥ vij of Blood obtain'd, sight not better - repr: Electricitas Sumt: Pil: Merc: j omni noctre - 18th: Sight no better Pills purge [small?] Omittr: Pil: reliqua u a 20th: Sight no better Diarrhœa gone appr: Ung Merc: ad ʒj Cruribus Femor: omni norte - 23rd: Sight no better, mouth not affected, costiveness - Omitr: remedia Sumt cras mane Decoct: Tamarind: c: dup: Sennæ ℥iv omni hora ad 3tian: vicem nisi prius 25th: Goes out as improper 220) 221) (222 Andrew Jeofrey - Œt 21 - A Carter - April 15th: Has completely lost the power of voluntary motion in the left Arm; it is also somewhat diminishd in the Leg of the same side so as to prevent his walking or standing - His speech is also slightly affected - P - 72 - strong & of equal strength in both Arms - Functions natural - The Above supervened on the 12th: when in Bed with a severe pain in his Leg & sense of numbness in the Arm - Has taken some of Andersons Pills without relief - Mittatur Sangs: statim ex Arteria Temp: ad ℥xij - Sumt: cras mane Pul: Jalap. c: ʒj Bibat Decoct: Avenae: adlibitum - 16th: Blood natural motion of the Leg no better that of the Arm scarce perceptible pain of his Head relieved immediately on the Bleeding & now nearly gone Physic has not yet operated - P - 96 - appr: Emp. Visic Michæ - Enema Vesp - n. - p. - 223) 17th: P - under 70 motion of the Arm sensibly better - To move the Arm frequently 18th: was remarkably well & in good Spirits yesterday Evening. - early this Morning had a slight Epistaxis; since then has been much worse; does not speak has been generally in a state of stupor & when more sensible; in a state of [Invincibility?] disposed to weep has taken no breakfast; some hiccough of late & at breakfast - time some grinding of the Teeth & foaming - P - about 90 of good strength; no motion in the Arm, Leg as formerly - Abradr: Capillit: & Appr: Emp. Epispast Capiti - ꝶ: Mosch: ʒss - Sacchar ʒij terre simal probe & adde Aqua Cinnam: Aquæ Font āā ℥iij - Sumt: ℥ij altera qq: hora incip: stat: Hora 5tar Mitt: Tang: e Brach: ad ℥xij 19th: Blood has a thin buffy Coat (224 P. immediately rose to above 100 & became stronger; is good deal of Sweat in the afternoon for some Hours; frequent very strong Tremors or Startings in the night which are less frequent to day - Stupor & imbecility as before pupils somewhat dilated no stool, Urine passed in Bed scarce amp swallowing for many Hours; - It appears that he has now lost the motion of the left side: of the Arm yesterday afternoon, of the Leg more lately no distortion of fœtures no squirting P - variable, at present 120 some few Hours ago near 140 breathing still easy but with ocsional starting or catching Mittr: Sanguis stat: ex Arteria temporali dext: ad ℥x - postea Injicn: Enema purgans - 20th: Blood almost natural, P - now 225) above 160 & soft skin slightly moist, Heat a little more than natural no motion either volunary or convulsive in his Limbs swallowing better than Yesterday much screaming in the night Motions of the Eye Natural no signs of sensation in the Limbs nor [Arm?] from the Face - Enema retaind Urini still passd in Bed - repr: Enema Went out this Eveng: by - desire of his relations and died next - Dissection. The cranium being removd the blood vessels of ably distended with blood - On punctg. the D. Mot on each side about an inch from the superior sinus there issued grooms: blood ℥ij by [nausea?] - The Latl: Ventricles contd: nearly ʒij of a red serous fluid a small quany: of a similr: fluid found in posterior Ventricles The Pia Mater lining thes Cavius: was of nat Colour except that the blood vessls: into it The Plexus Choraides as well as those of the substance of the Brain were all preternaturally distended - There was no change observable in the consistence of any part of the Encephalon - He continued till death - to express by his Eyes & countenance an evident [satsfic?] at suing any of his friends or acquaintances & upon their leaving the room he whined & cryed - No symptoms of muscular contraction were perceived previous to his death He had been addicted for some years past to hard drinking - (226 George Cowly Œt 23 - Coachmen April 9th: Is very indistinct on which account the History of his Complaints cannot properly be ascertained however it appears that he was attacked on the fourth Currt: with the usual Symptoms of pyrexia now cheifly complains of pain in the right side aggravated by a frequent Cough which is accompanied by a scanty expectoration seemingly some oppression in breathing headach urgent thirst pain of the internal Fauces, which on inspection appear to be slightly inflamed with general uneasiness & picking of the Bed Clothes - P. 124 strong & ful skin, Hot, face flushed with suffused Eyes - Belly as he says regular Tongue white but moist rests ill the Above he attributed to 227) Hard drinking & exposure to cold says he has taken some Meds: Mittr: Lary: stat ad ℥xvj Appr: Emp: Epispast: Sat: dolent Injicr: Enema domest: vespere Fovr: Crura probe per horam vespere 10th: Blood with a firm buffy coat great delirium through the Night Died at 7 - this Morning - Dissection On opening the Thorax there was found ℥v or vj ℥ of fluid in the Cavity The lower lobe of the right side of the Lung was found highly inflamed & adhered very firmly to the Diaphragm bu means of a strong white membrane - The Diaphragm as well as the Pleura Costalis were much inflamed - The Brain was more red The vessels more turgid than Natural & there was an Effusion of nearly an ounce of fluid into the Ventricles - (228 229) (230 Abigail Smith Œ t 22 A Serv: April 6th Complains of great Headach nausea, Anorexia, violent pain occupying the whole of the left side of the Thorax increas'd on Inspiration & rendering her breathing laborious, is also aggravated by a constant tickling Cough - says she is easiest on sitting up face a good deal flushed - P - 136 & pretty strong, skin hot Tongue a little white & dry great thirst, Belly & Catamenia regular - Was attacked by these symptoms on the third instt. attended with ryors since which they have constantly grown worse - Was in the House sometime ago with an Acute pain in her Breast occasiond as she says by a fall which she says was relieved by cupping - Mittr Sangius e Brach ad ℥x Bibat decoct Avenae ad Libit - Sumt: Julap: Salin ℥j 3ta: qq Hora Injicr: Enem: vesp: nisi prius - 231) Appr: Emp: Epispast: Sat: qua dolet si dolor perstiterit cras mane 7th: Blood has a firm buffy Coat Pulse in 1/2 an Hour after the Bleeding 120 at present 132 cough very severe Expectoration difficult & viscid not Tinged Headach easier face still flushed no sleep - Mittr: Sang: e brach ad ℥xvj Utatul Mist: Mucil: Ungt: tussi Fovr: crura per horas ij stat & iteum H: S: - To use the Inhaler - hora nonat Habt: H: Anod stat: c gt xxx - ꝶ: Tart: Solut: ℥ij Aqua Font: ℥viij Syr: Simon: Aquæ Cin: ten: āā ℥iss ♏ ƒ. & solve - Sumt: ℥iij omni semi - hora incip: cras mane - 8th: Much difficulty in obtaining Blood from the Arm scarce ℥x obtaind & it trickled down the Arm & had no buffy Coat, much relief to pain & Cough in the Evening & night good sleep with the Anodyne, Pulse last night (232 & at present 120, severe return of Cough this Morning, Expectoration scanty difficult 4 only clear mucus - Mittr: Sang stat: ad ℥xvj e Brach si fieri potest si non ex Arteria Temp: postea applicn: Emp: Epispast pectori & Habt: simul H: Anod c gt xxv - Hora sexta, repr: H: Anod: H: S c gt xxv - 9th: P - 130 of good strength scarce any Cough since the last bleeding till this Morning pain gone breathing pretty easy ℥x viij of Blood obtaind from the Artery & has a firm buffy coat repr: mixt: mucil. - Injicn Enema vesper n: p: Continue the Inhaler - Hora 6ta: P. M Mittr: Haum Sang ad ℥xij - 10th: Blood has a firm & thick buffy coat on both Cups - P - 116 of good strength Cough & breathing much easier since the fourth bleeding skin cooler, Tongue still white 233) Expectoration easier but still scanty & not tinged with Blood a stool with the Glyster, less thirst some lip petite ꝶ: Julap: Salin ℥vj Tart: Emet: grs iij Solve Sumt: ℥j omni Hora ad vomitum usque incipiens stat: repr: Julap: Mucil: & H: Anod H. 11th: P 120 & soft heat moderate still cough & Expectoration & that not [crossed out] breathing easy pretty good sleep ful Vomiting with the Medicine but no stool - repr: Julap c: Tart Emet ut heri prœscript - Enema com: vesp. n. p: Mist: Mucil: H: Anod & Vapor Aqua callid: ut antea - 12th: vomiting repeated & [by] had one stool with the Julap good sleep no pain or Dyspnœa cough easier Expectoration more free but still scanty & only clear mucus - P - 114 skin cool no rigors nor sweat no sense of (234 Weight or pressure about the Thorax omittr: Julap: Salin c Tart: Emet - repr: reliqua - 13th: P - 120, skin cool good sleep little Cough Expectoration easier but still scanty. There has been constantly a remarkable redness of the Cheek Sumt: Julap: Scillit ℥ss ter in die reliqua ut antea - 14th: P. 120 bad sleep much Sickness seemingly from the Julap, face still flesh'd other symptoms as before Omittr: Julap Scillit - repr: mist: mucil - H. Anod & Vapous aquæ lipid - Enem: com vespere n. p - 15th: P - near 120 Skin pretty cool, less cough scanty but easy Expectoration no pain or Dispnœa good Sleep Tongue white Appe returning - 16 - P - 100 Expectoration freer - Continue 17 P - 108 skin & Tongue natural good 235) sleep - expectoration more Copious some Dyspœa in the Afternoon - Continue 18th P - still above 100 skin cool, good Sleep some remains of Cough less Expectoration considerable flushing of the face in the Evening - Continue - 19th: P - last night when sitting up 10 no flushing of the Cheeks at present - P - 96 other Symptoms as before 0 Appetite mending - to have a Bit of steak for Dinner - Repr: Julap: mucil c Acid: Vit. ad gratum acorem 20th - flutterd by a long & severe fit of coughing more Cough since yesterday, Expectoration as formerly - repr: remed. The steak to be omitted - 21st: P - about 108 cough easier, better sleep cheeks flushed last night no rigors some sweat in the night - (236 22nd: symptoms as yesterday Mittr: Sang c brach: ad ℥x reliqua ut antea - 23rd P - 100 skin cool Expectoration easy but more mucus good sleep & little Cough in the night more this morning - Conue. - The attempts to obtain blood were fruitless - 25th: skin cool other symptoms as before - Continue - 26th: no change of Symptoms Contue: 27th P - 108 much sweat towards morning Cough & Expectoration as formerly some Dyspnœa with sense of Weight & Oppression under the sternum - Contue: - 28th: P - as formerly cough more severe with only scanty clear mucous Expectoration, Oppression, Dyspnœa & Headach Mittr Sang: ex Art: Temp: ad ℥xij reliqua ut antea - 237) (238 Michael Page Œt 23 - A Sailor - February 18th: Both Testicles are very much swell'd & his Fauces greatly inflamed with an Ulceration of the left Tonsil, the under palpabra of the same side is much swelld & inflamed & there is an ill-looking sore on the Arm - Complains of severe pain in the Tibia which is increas'd when in Bed & often prevents sleep - Funtions natural - says that about 12 Months ago he was affected with Gonorrhæ, Chancres and a Bubo - for which he took a quantity of Mercury & was apparently cured - tho the pain in his skins has been almost constantly present since. The swelling of his Testicles & Inflamation of the Eyelid have been present 5 Months & the Affection of his Throat 8 Months, the sore of his Arm appeard a fortnight ago - 19th: Habeat Baln: tepid - postea Inungt: Crura Ung: Mere ad ʒj Bitat Decoct: Susitan: ℔ j moic 239) Appr: Cataptas: emol: Ulceri Brach: Full Dick 22nd: Plyalism beginning pains of this Limbs easier, slight Fluctuation in his right Testicle with hardness of the Cord - the Ulcer of the Arm looking cleaner Omittr: Ung: Merc ad Applicr: Ung Merc: Ulcer Applicr: Ung: Merc ad palpab: oculi smis repr: Decoct Susitan: & Ung Merc ʒj ut antea 27th: Mouth not yet sore putulary Erupn: on the parts rubbed - Sumat Pil: merc i omni Nocte Omitr: Ungt: - March 1st: Mouth not yet Affected some gripes & purging - Omittr: Pill: Merc - Sumat H: S: Julap: List: ℥j c 1: 1: gt: xx - 3rd: repr: Haust: H: S: Appr: Ung: Merc: ʒj per frictionem inferior: Extremss: H: S: 8th: Testicles much less & softer Throat (240 seeminly well, Ulcer in the Arm heald pains gone from the Bones Continue - 16th: mouth [crossed out] very sore swelling of the Testicles much less Omittr Ungt - 21st: Testicles almost of the natural Size & has Oness no pains in the Bones throat quite well, slight dry scab on the Ulcer of the Cum mouth still sore - Appr: Lin Simp: adlelcus brachii - 24th: Habt: Balneum Tepid vesp - 27th: Goes out Cured - 241) (242 Donnald Mc: Donnald Œt 25 March 9th: Complains of frequent loose stools attended with gripes particularly at night - Is much troubled with Acidity on his stomach & flatulence after meals - Is much emaciated - P 112 of good strength Tongue natural appetite bad much thirst pretty good sleep - Was attacked with these complaints about two months ago with little abatement since - Has used some Pills & powders - Sumt: H: Anod: H: S: 10th: Sumt: vis in die Pot: Cretae ℥iij Julap: sistent: ℥ss post sing: sedes Haust: Anod ut heri præscript - To have bread & milk morning & Eveng: & meat for Dinner - A Flannel Shirt - 11th: 3 thin stools with gripes good Sleep P - 96 repr: Julap: Sist ad ℥j post sing degect: - A Bit of Steak instead of boiled meat for Dinner - 12th: Three stools much gripes in the night P - 96 - Omitr: Haust: Injr. H: S: Enema Anod c: gt c - S: S: reliqua u. a - 243) 13th: One stool little gripes Vertigo & sickness on setting up P - 126 - Continue 14 One stool with gripes much sickness yesterday afternoon for about an Hour and a half with remarkable flushing of the Face followed by sweating on the fore head, The Clyster not given by reason of Pills - P - 96 bad sleep Omittr. Enema repr: Julap Sist: Sumt: H: S: Opii Puri grs i - 15th: P - 96 & stronger 2 thin stools last night none since the pills but much gripes - Continue - 16th: only one stool less gripes Continue 17th: Only one Stool some gripes P - abt 100 & regular to have an Orange 18 Two thin stools with much gripes P: 96 pretty regular Omitr: Aurant: Habt: Vin rub: ℥vj - 20th: Two stools scarce any gripes, Thirst still Troublesome, P - about 96 with some Intermissions Continue - (244 21st: Two thin stools with some gripes P - 96 repr: Opium ad grs ij reliqua ut antea 22nd: One thin stool yesterday & a very small one to day less gripes - Continue - 23rd P - about go with some intermission more Gripes 3 thin stools - repr: Opium ad grs ij H: S: grs j Mane Pot: Crotae: Julap: Sistens & Diaeta a u 24th: Two thin stools Yesterday none to day some swelling of his Leg & Thigh towards night but gone in the Morn: Continue - 25th: Three thin stools less gripes - Omittr: Julap: Sist & Pot: Creatae - post hune diem - ꝶ: Cort: Cascarill: ℥ss - Coque ex Aqua font ℔ij cola & Sumt ℥iij 4er in die icip: cras - Opium: u: a 26th: P - 108 3 thin stools last night bad sleep voice feebler no sensible Effect. from teh Decoctn: - Continue - 245) 27th: 2 Stools yesterday none today thinks himself easier Continue - 30th: One thin stool in the afternoon repr: Decoct: ad ℥iij quater in die Opium u. a - April 1st: One Natl Stool Swellings of the [crossed out] Extremities continue to increase towards night Omittr: Decoct: Cascarilla - 5th: Skin Hot much Gripes repr: [crossed out] Pot: Cretae: ad ℥iij ter in die - Opium u. a - 10th: Omittr: Pot: Cretae: Sumt: Julap: Sist: ad ℥j post sing: sedes - 17th: no stool these two Days - Omitt Opiu 18th: P - 100 - 3 thin stools much bilious vomiting Facies Hippoeratica indies acceden Sumt: Ungt: Nausea Haust: Salin: Effervescent: Opii grs: i H: S: 26th: Died last Night - (246 George Henderson Œt 26 February 6th: Is at present affected with a considerable diminution of the powers of voluntary motion over his whole Frame but particularly in the upper extermities, & of the Sense of feeling - Says that his Vision is much impared since he was attacked with these complaints but nothing præternatural appears in his Eyes - Pulse appete: Belly natural sleeps well - Was seized first 5 weeks ago with a coldness & numbness in his Legs while working in the Field on a very cold Day which proceeded gradually upwards to his Arms; Attributes his complaints to sleeping in a cold damp room Sumat semen: sinap ℥ss vis in die - Adeat Machin: Elect: ut educanr: Scintil: elect: part: affect: vis in die - Habeat Bal: tepid -Utatur stigili fortiler sapius indies - Induat Indus: lanum - Ful Diet - 247) 7th: No change of symptoms - Body costive - sumt: H: S: Pil: stomachic ℈j - 8th: Motion of his Hands sensibly better appe: good, spirits very bad - To have ℔j of porter a day reliqua ut antea - 10th: Motion of this hands still better but little feeling in them Appr: Sinapis: manibus per horam vespere - reliqua u: a - 11th: Motion of his limbs much better he felt the sinapisms hot to his Hands repr: Omnia ut heri - 13th: Convalescent but slowly little feeling in the Hands - repr: Balneum Omittr- Sinapis - Fricteo: Semen. Sinap:& Elect: u: 15th: Feeling & motion pretty good but his Limbs still weak - Continue - 16th: Hands no better for some Days - Appr: sinapis. Brachiis - reliqua - u. a - 17th: no relief from the sinapisms - Complains of much pain in his Arms (248 & shoulders since last night Pulse natl sumat: pulv: sudor: grs x omni hora ad 4en. vicem nisi prius sudaverit Bibat: Julap: Diaph: ℥j 3tea: q hora Decoct: Avenaceum ad libitum - 19th: Complains of rheumatic pains in the upper parts Applicr: Epispast: Humus dextro qua maxine dolet - 21st: Complains still of pain about his upper parts Continue - 22nd: Complains much of pain especially of his Head & Back which came on suddenly last night but without rigor as he says Bad Sleep & Appe - Body natl: skin hot Pulse about 90 - Sumat Sol: Antim ℥ss omni semihora ad vomitum usque - Jalap: Salin ℥j 3tia: q hora post vomit: - Decoct Avenae: ad libitum Omittr. reliqua - 23rd. P - natl: sickness & oppression gone some pains about him still, bad sleep appe: returnd, Vomit operated well 249) stomach very foul repr: Julap: Salin. - 24th: Pains very severe in the Right Arm & not quite gone from the left says that he has been in the practice of letting Blood till within these two years Mittr: Sang: & brach: dext ad ℥ viij - 25th: Blood natural pains as formerly - P nat: spontaneous sweating every night Sumat Pulv: Cort: peruv: ʒj 4er in die omittr: reliqua - 27th: Complaints rather better Continue 28th: Pains easier Limbs still weak sight Bad body costive Sumat Pill: Stomach ℈i H. S: March 1st: Continue 8th: Complains still of pain in his forehead & right side of his Head want of feeling in his Hands & great weariness of sight especially in the right Eye which he so waters much in the Night Time Omitr remedia Utatur Collyr: Saturn - 11th: Feeling of his obtuse Goes out relieved (250 John Williamson Œt 44 - A Labourer - February 25th: Complains of severe & constant pain situated on the middle of the Sternum and Aggravated by a Cough which is attended by a viscid Expectoration, has also Headach and is much distressd with Dyspnœa - P - 84 Tongue clean no appetite bad sleep from the Cough Belly regular - These Complaints have been present near 12 Months but much aggravated since August - Attributes them to cold & Fatigue - Used no Medicines - Habeat: Mist: Mucil: unge: tussi H: Anod: gt: xxx - H: S: - 26th: some relief from the Cough & better sleep - repr: Remed - Simat insuper Pil: Scillit: grs: x in die 27th: Continue 28th: Compts: no Better Body costive Sumat partit: vicibus, Ol: Recin ℥j Tinct: Senæ ʒij ♏ ƒ: incip: statim - 251) March 1st: 2 stools from the Physic Better sleep, Cough breathing & pain of In Breast as before - Appr: Emp. Epispast: pectori prois raos Haust: & pill ut antea 2nd: Blister not yet risen, Expectoration difficult P - natl: - Continue 3rd: Blister has operated a little Expectoration no easier - Continue - 4th: Capr: Pill: iij āā grs. v - Enema stat: 5th: Expectn: still difficult - Capr Pulv: Emet: Vespere - Omitr: remeda: hodie repr Cras - 6th: Vomit operated well stomach foul [illegible] 7th: Complaints no better Omittr pil Sov Sumat Julap: Fœtid ℥ss ter in die - 9th: Complaints no better Continue 14th: some pain of the Throat with slight redness & swelling of The Tonsils other Comp rather easier - Inungr: Fauces extermæ Oleo Volat: ter in die & tegemtur pam laneo - reliqua ut antea - - Goes out relieved - (252 Donnald Thompson Œt 39 A Coachman March 3rd Has Headach nausea, Anorexia pain in both shoulders frequent shiverings through the Day followed by cold sweats about his Face, Fauces also paind & somewhat red - P - 130 & weak great thirst, Tongue loaded Belly loose bad sleep - The Complaints supervened on the 24th [illegible] with vomiting and the other symptoms of Pyrexia knows no Cause has taken one Purge & Vomit - ꝶ. Vin: rub: ℥viij Aquæ Font: ℥iv ♏ ƒ Sumat ℥ij secunda quaque hora Pulv: C: peruv: ℈ij 4ta: qq: hora H: Anod com: H: S: - 4th: P: 130 & rather weak has had only loose stool & that immediately after he came in, some Headach no nausea some sweat & more general over his Medicine - Complaint in his throat the same repr: remedia - 253) 5th: P 160 & weak has been [been] delirious since 5 P.M. yesterday 1 natl: stool Sumat ℔ij vini Port: in die - Julap Mosch: ℥j 8va qq hora repr Haust: Anod H: S; - 10th Day of the Fever - Omitr: Cortex - Died at nine this Morning - 6th: - (254 John Yule Œt: 65 A Chairman February 15th: His upper slower extremities are affected with a considerable Œedma, There is a pretty evident fluctuation in the Abdomen & evident intercus in the parietes - Has also some cough & Dyspnœa - P: 64, Tongue natural, appe good Belly round, sleep natural, never starts from it but has disagreeable dreams at Times, can lie with equal case on either side & does not require to have his Head raised, Urine in diminishd Quantity - The present Complaints appeard about 10 days ago & attributes them to cold & moisture - Has been in the practice of dram - drinking Had similar affections about 6 years ago for which he was received into the House & was dismissd Cured - Has taken a dose of salts - 16th: Urine ℔ij 1/4 much swelling of serotum Inungr: Abdn: Ung: Merc: ʒj omni nocta Habeat Gin punct: ad ℔ij in die - Have a T: Bondage squill Pills of a particular preparation - see Monroe's Case - 256) 17: P. 72 & small, swellings as formerly Dyspnœa & bad sleep in the night - Urine scarce ℔ij - Ingesta of Broth, Beer & Punch near to lov - no sensible Effect from the Pills - To have 3 pills for a Dose 3 Times a Day - tomorrow - 18th: P - natural, good sleep, stupor & Delirium - Urine scarce ℔ij fluid Ingesta ℔i full vomiting to the amt: of ℔iv of very thin matter, much weakeness - the Ointt - & Pills were omitted - Omittr Gin punch & Ungn: Habeat - flat: Vin: rub: ut Sumat Cyathum subinde - 19th: P - 60 - delirium almost gone, Appe pretty good, Urine scarce ℔ij - Omittr Vin - repr: Gin punch ad ℔j adjecta Cryst: Tart: ℥j - 20th: P. 60 - Urine scarce ℥ij, much Cough & Dyspnœa, swellings as formerly repr: Gin punch: cum Tartare Appr: Epispast: Pectori Habeat: H: Anod c gt xxx Utatur: Julap: Muil: urgent tussi (257 21st: P - 60 & very soft - 4 thin Stools Urine ℔ij Blister has run well, pretty good Slap Cough & breathing easier - Appe: pretty good repr: Gin Punch per hune Diem Omittr Cras - 22nd: P = scarce 60 very soft with few but very long Intermissions, much Weakness Dyspnœa increasing paleness,bad sleep omittr: Gin punch - Habeat Vin rub: ut sumat Cyathum subinde 0 A Bit of Steak for Dinner 23rd Urine ℥xix one stool some greenish vomiting last night, P - 54 & soft little appetite, swellings but inconsiderable both in Limbs & Belly - repr: Vin - 24th: P - scarce 60 Urine ℔ij ℥ij Legs a good deal swelld Friceontur probe crura & fœmora Mane & vesper oleo Cicut: = Sumat cras pill: Scillit: i * Dr Trotter mane & Meridic - repr: Vinum - 25th: Urine ℔s ij symptoms as formerly no sensible Effect from the pills - Contiue: 258) 27th P - at present scarce 60 in the morning only 48 Urine ℔ ss - 1. natl. Stool Continue 28th: Urine ℔s j three stools, much & willing P - 60 & feeble Cough no better Induat Indus: Laneum - Fover: Crura probe - Sumat: Pulv: [pulv:] sudor grs: x altera qq: hora ad 4tain: vicem nisi pruis sudor verit incip Hota 5ta: - inter sudand: Bibat Julap: Diaphor ℥j 3tia qq: hora Vinum ut antea - March 1st: Vomited fully with the first & second powder & got no more of them Urine ℔ i 1/4 - good Sleep, no Sweat, Swellings rather less seemingly from the posture - Omittr: pulv: sudor repr: Fotus - Sumat Julap: Diapt & ʒj omni hora ad 6am: vicem - 2nd: P 60 & weak Urine ℔ i 3/4 mp moisture up on the Skin no passage for two Days Injr: Clysma domest: reliqua ut Ant. 3rd: Clyster operd: well - Continue Habt: Pill: Scillit ut pro Monroe prescript (259 6th: Urine near two Pounds Vomits soon after taking the pills. Continue 7th Urine ℔ i 3/4 swelling of his Thighs diminishd, continue - 8th Urine ℔ 1 3/4 one or two easy stools daily no more nausea swellings no better repr: remed: - 9th: P: 72 Urine near ℔ ij 3 thin stools much gripes swellings as formerly bad sleep last night - Omittr pill Scillit 10th: urine ℔ ii 1/4 two thin stools gripes still continue good sleep - swellings as formerly - Sumt: Opii grs: i H: S: Capt: Potis: Crotac: ℥ iij vis in die - 11th: Urine near ℔ ij gripes gone one natl Stool - Continue 12th: Urine ℔ ij one natl Stool - repr: Opium H: S: Sumt pil: Scillit cras mane & Medic - 13th: Urine ℔s ij ℥iij some gripes but no stool swellings as formerly - Contue 14th- Urine ℔ij 1/4 no other Change Contue - 260) 15 Urine ℔ ij no Diarrhœa nor Gripes Sumt: Pile: Merc. - H: S: reliqua ut antea 16th: Urine ℔ ij Symptoms as formerly repr: Pill: Merc: H: S: c: grs i Opii Pill Scillit grs: x - Mane & Mendic 17th: Urine ℔ i 1/4 1 Natl Stool Continue 18th: Two thin stools Urine not Measured probably not two Pound, Swellings as formerly - Omittr pil merc & Scillit: Mouth begins to be affected - 20th: Urine ℔ i 3/4 One Stool no Sweat Legs less Arms more swelld - repr: vin ad ℔ j in die Opium ad grs i - H: S: Mist: Mucil: urgent: tusse Omittr reliqua - 21st: Urine ℔ ij no stool some Gripes pustulous Eruption on the Skin swellings great repr Cortex peruv: ad ℈ij 4er in die ex lacte Vin - u. a - (261 Yule - March 22nd: Urine ℔ i 3/4 2 natural stools much gripes swellings increas'd - Fiant punct: due femori utroque Prope Gene - reliqua u: a - 23rd: urine ℔ 1 3/4 punctures only made to day no discharge from them 3 Stools of natural Consistence & without gripes Continue - 24th: no running from the punctures Urine ℔ 1/4 P - 72 of better strength than formerly Swellings larger than before - 25th: Urine near ℔ ij - P - 72 regular & of good strength, pretty good sleep & appetite two stools very little gripes - swellings no less Continue - 26th: Strength somewhat recruited swellings as formerly Urine ℔ i 3/4 3 thin Stools but no gripes - Omittr: Cortex Inungr: Crura & Famora Oleo Cicut: Mane & Vespere & fricontr probe - 31st: Frequent thin Diarrhœa with Gripes every thing passed in Bed other Symptoms 262) Symptoms as before repr: Opium ad grs i stat grs: ij H: S: April 2nd: No change of Syrup tor repr: Opium ad grs: 1 stat grs: iij H: S: & grs: i cras mane - 5th. Diarrhœa as bad as ever only suspended for about 5 Hours after the Evening Dose Habt: stat Opii grs: ij. grs: iij H: S grs: ij cras mane 6th: P - 96 Diarrhœa as formerly much Debility & collapse of Faturets 7th: Died this Moring - (263 Robert Forrest Œt 54 a Wright February 25th: The Legs, Thighs & abdomen are affected with a considerable Œdematous Swelling the latter of which is enlarged with evident Fluctuation - The Penis & Scotum are tumidied to a considerable Degree, slight Cough & Dyspnœa - P - 100 & very irregular, Thirst, Tongue clean & moist, Belly regular passes his Urine frequently & in small quantities, bad sleep - The swelling of the Legs first appear'd in April last & attributes them to obstructed Perspiration - that of the Penis, scrotum & abdomen 3 Weeks ago after drinking a large Quantity of Water - 26 Urine ℔ iij ℥ij Symptoms as yesterday fiat punet: in ima partis Saroti & in præpuntio - Sumat: Vin: 1 264) 27th: The Knees as well as Scrotum & Prepuce were puntured considerable discharge from them all till he went to Bed, Swelling considerably less [illegible] of the Abdomen Urine ℔ ij pretty good sleep - repr: Pill; Vin; & Cortex; 28th: Urine ℔s ivss scarce any running swellings increased again, some Headach good Appetite - Sumat _ Pill ij pro dosi - A Bit of Meat for Dinner 0 March 1st: no more running from the punctures, swellings as formerly, Urine ℔s iv no stool - Continue - 2nd: Hora 6ta: pomerid. heri repr: Vin ad ℔ j Urine ℔ ij 4 loose stools breathing so difficult since yesterday that he has been oblige to use a semierect Posture still, continue very uneasy - frequent shiverings since yesterday - Apptn: Emp: Epispast: bene Camp. in Scopulas - stat repr: Pill & Vinum P - 100 & strong (265 3rd: P - cannot be counted Hand & part of the forearm much swelld of a red Colour & some appearance of black spots - breathing exceedingly laborious, Blister operated well swellings of the Legs increasd stools & Urine come away insensibly, appears insensible - Continue - wine & Bark & omit pills - 4th: Died this Morning - 266) (267 Robert Monroe Œt 47 - A Guard Soldier February 10th: Complains of constant headach vertigo, Timitus, Anorexia, Dyspnœa cough & difficult Expectoration - His Hands, Arms, Shoulders & neck are affected with slight [Vertigo] Œdenea; the abdomen is enlarged with evident fluctuation he cannot lie in a horizontal posture but most comfortably on the left side - P - 96, Tongue natural, Belly costive Urine pass'd very frequently in small quantity & of a high colour, - sleeps ill & starts frequently from it with a Sense of Suffocation - These complaints have existed in a greater or less degree for two or three years & have been a gravated since the beginning of last summer - Inungr: Abdomen Ung Merc: ad ʒj vesp - & fricetur probe - sumat: Pil: Scillit: grs: x Mane & Meridic Habeat: Gin Punch ℔ i in die & Haust: Anod: com: H: S: - 268) 11th: Urine since 6 last Night ℥ xxxij & rather pale than high coloured, Cough troublesome towards morning, some sleep the former part of the Night from which he awakend with a start - Applr: Emp: Epispast: pectori: - Utatur: Mist: Mucilag: urgenti tussi repr: Pill: Ungm: & Gin Punch - 12th: P - 72 of natural strength & slightly irregular; Cough relieved, breathing rather easier bad sleep - Urine ℔ v - some spitting, brassy taste in the Mouth - no stools these two Days sumat Hora 2da: Pill: Scillit: ij reliqua ut antea - 13th: Urine almost ℔ vij Belly sensibly less fluctuation still perceptible Mouth as yesterday one natl Stool - repr: Ung: vesp: Pill: Scillit ad gr x Mane, hora decima, & meridic, - 14th: Urine ful ℔ vj, Abdomen slacker, slight nausea from the pills - One Stool (269 mouth scarce affected - repr: remed: ut heri præscripta - 15th: urine ℔s vj, Mouth scarce affected, no stool, complains of thirst repr: ung:, omittr: Pil: Scillit:, com - To use the squill pills of a particular preparation * 16th: Urine ℔s x 1/4 but has drank more than formerly - One stool rather hard, considerable nausea both yesterday & to day but no vomiting, Abdomen considerably less, fluctuation more obscure - Continue - 17th. Urine ℔ v ℥ij, no drink but a ℔iss of Beer & as much broth still nausea but no vomiting from the pills - He is to take 3 of the pills three Times a day Omitr: Ung: 18th: Severe vomiting yesterday Afternoon - Pills omitted to Day - Urine ℔ iij 3 thin stools bad sleep, Ptyalism, skin somewhat not & pulse quickend - Sumat: Cras Crystateas Tartan: ut pro Hunter prorscriptos - 19th: no more vomiting general relief - 270) Urine ℔ iij repr: Cryst: Tart ad ʒ ij - 20th: Urine ℔ iij, he complains of Cough & Headach, p - natl Continue - 21st: Urine ℔ iv 3/4 stomach easy 1 stool Abdomen more swelld repr: Cryst: Tart ad ʒij 6ties in die 22nd: Urine ℔ iiiss 2 stools rather thin Dyspnœa worse, swelling of the Belly no less - slight nausea as he thinks to day from the powr- Mouth well again Omitr: Cryst: post hune diem - 23rd: Urine ℔ iij one stool much nausea, some pain in his right side affecting his breathing ꝶ: Pulv: Ipec ℈i Tart: Emet grs ij ♏ ƒ Sumat Hora quinta & utatur Infus: Rad: Raphan: rustic ad promovend: Vomit: (271 Monroe - 24th: vomit operated well symptoms no better, Had not the Infus: Raphan: but Chamomile complains much of Headach & nausea tho he has not got the pills - Sumat cras mane Bol: & Jalap: c Merc: partit: vicibus ut pro Hunter nuper præscript: - 25th: Urine ℥xviij two thin stools with but little gripes, Belly slacker repr: cras Jalap; cum Mrec: - 26th: Physic has operated 5 Times much gripes which still continue, Urine not all Measured - Continue - 27th: Urine ℔ ij Abdomen as formerly, he complains of weakness want of Appee & pains Sumat pill: 1 Dr Trotter cras Mane Hora 10ma & Merid - 28th: Complains much of Headach pain of his Back and Cough with frequent rigor P - 72 and strong bad sleep, Weakness of his Limbs - Urine almost ℔s iij Contiue: March 1st: Urine ℔s iij Abdomen rather less no sensible Effect from the pills 272) Sumat; pill: ij pro dosi cras - 2nd: P: 96 rather weak Urine ℔ ij 1/4 nausea from his Pills - Continue - 3rd: Urine near ℔s iv ꝶ: Massæ Pil: Scillit grs xxv divide in pill. v Capt: tres H: S: & duas Mane - 4th: Urine ℔s iv - continue 5th: Urine ℔s v - continue - 6th: Urine ℔s iij ℥ij Belly in the natl state - Continue - 7th: Urine ℔ iijss Continue 8th: Urine ℔s iij ℥iv Abdomen rather less - It appears that he had a venereal Affection about a year ago with Tonsils are ulcerated & there are slight remains of Gonorrhœa Utatr: Ungt: Merc: ʒj omni nocte ad Crura & Fæmora - 9th: Urine ℔s iv - Symptoms as Yesterday Continue 10th: Urine ℔s iv - Abdomen less Mouth not affected - Continue - (273 11th: Urine ℔s iv Continue - 12th: Urine near four pounds mouth a good deal affected Omitr Ungt: - repr. Pill Scillit - 13th: Urine ℔s iv Abdomen lessening Fluctuation still perceptible complains of pain in his Limbs Throat much better Mouth sore Continue - 14th: Urine ℔s iv 1/4 mouth but slightly affected he complains of Cough & Stitch in his side increas'd on pressure appr: Emp: Epispast: lat: dolent: repr: Ungt: Pill & Mist Mucil - 15th: Blister not yet removed complains of costiveness - Urine near ℔ v Enema Com: vespere reliqura u: a 16 Many stools after the Clyster - Urine not measured pain almost gone repr: Ung: reliqura ut antea - 17th: Urine ℔ iij Belly no less Cough easier Continue 274) 18th: Urine ℔ iij no other change Continue - 19th: Urine ℔ v, Throat quite well pains about his Joints increasd on Motion plainly rheumatic, some pains about the Shin Bones their nature uncertain Continue - 20 - Urine ℔ v - Belly more swelld from flatulence - Contue: meat for Dinner 21st: Urine ℔ ivss - Abdomen as formerly - 23rd: Urine near ℔ vj swelling & fluctuation in the Belly still considerable pains about this joints continue Soreness of his Throat gone Continue - 24th: Belly as formerly pains easier Continue - April 4th: Urine ℔ iiiss still some swelling about the Genitals BElly slack, painful Pules about the Anus - Inungr: Mariscæ vis in die Lint: Hœmorhoid - Sumt: cras Mane Ol: Recin ℥j c Tinct: Jalap: ʒij part: bis 7th. No swelling about the Scrotum little of the abdomen the fluctuation if any very observe Urine ℔ j P - somewhat flutterd - Goes out releived - (275 Wm: Martin Œt 52 A Wright March 19th: The right foot Leg & Thigh are affected with a constant shaking & some pain stretching from the Ankle Joint to the Knee the shaking is worse at Night & prevents his sleep in some degree & he can only restrain it by setting the Weight of his Body on his Legs - Functions natl: & general good Health these Symptoms have been present for three Months without any Known Cause Has applied Blisters - Habeat Pediluv: H: S: - utatur strigili fæliter - Sumt: H: S: Pil: Stomach: ℈i & H: Anod: com - adeat Machin: Elect: et educn: Scint. elect: partibus affectis - 20th: Symptoms no better no Effect from the pills a Phlegmon where a Blister was applied above the Knee appr: Cataplas Emol: phlymon Sumt: Elect: peruv: robor: molan Juglunois vis in die 276) 21st: Pills have operated less Tremor - Cont 22nd Physic operated smartly symptoms no better - Continue - 23rd - Goes out by Desire - (277 Matthew Hunter Œt 63 a Taylor February 17th: The Feet Legs & Thighs are affected with a considerable swelling, the scrotum is also much enlarged to day for the first Time, no perceptible fluctuation the Abdomen; P - 112 & very irregular, Appetite pretty good, thirst much increas'd, Urine he says not diminish'd - Sleeps very well & lies easily in any posture, Dysnœa especially increas'd towards Morning - Belly very loose, has a large Ulver on the right Leg, occasion'd by sitting too near the Fire - Symptoms have been present 7 Weeks & were produced by cold, fatugue, & moisture - used no Medicines Sumat pulv: C: Peruv - ʒj 6ties in die - Gin: punch: ad ℔ ij in die Ung: Simplex ad Ulcus cruris - To have a dresser & a linnen Bandage A Bit of Meat for Dinner - 18th: Good Sleep swellings of Legs & thighs less from posture - Urine scarce ℔ ij much thirst - Sumat: Cryst: Tart: ʒj altera qq Hora - 278) ad 4am: vicem incipiat cras mane Habeat Tamained: ℥iv - reliqua ut heri - 19th. Urine ℔ ij 1/4, P - near 100 still irregular, bad sleep & much dyspnœa in the Night: Legs as yesterday Continue - 20th: Urine but ℔ ij - 5 stools but not very thin, swelling of his Legs in the Morning but has returned since he sat erect - Good sleep in the Night, more Dyspnœa than usual this Morning - P - more frequent, softer & more irregular Omittr: Cryst: Tart: repr: reliqua - 21st: Urine ℔ ij, 5 Stools not very thin, scarce any Sleep as he says, by the Nurses Acct some Confusion or Delirium must doing P - more irregular, Fœtures sharpen omitr Gin Punct [repr:] Habeat: Vin: rub: ad ℔ j indie. Appr: Emp: Epispas - ad Latus utrumque Thoraris - Sumat: Julap: Sistent ℥iss Cuni S: S: (279 c S: S: gt xxx si Diarrhœa constuteid 22nd P - of good strength & almost regular at present about 100 Breathing easier, Voice stronger, Countenance more nall, Urine ℔ iss - 1 stool - copious & thick, [Sumat] ꝶ - Pulv e Julap. comp ʒij Calom eppt: grs: x true probe simul & add pulp: prunar ℥ss Syr: sim: q: s: ft: Elect crijus Sumat Cort: parv: omni Hora donu Alvus repondent - Incipt: stat: - repr: Vin: - Omitr: Haust: 23rd: Pabout 100 of natl Strength but irregular breathing easy little Cough 1 firm stool in the Afternoon & 1 thin one in the Night, swelling of the legs less more swelling about the upper per part of his Thighs Urine ℔ iis ꝶ: Pulv: Jalap: ℈ij Merc: Dulcis grs vj Conserv: rosar: q: s: ut ft Massa in portiones duas - sumart Unam stat alteram post horas duas - nisi prius - 280) 24th: 4 large thin stools yesterday afternoon, Urine ℥ xxxij - P - stronger very irregular about 100 - Countenance better voice stronger Dyspnœa continues swellings of the Limbs nearly gone that of the Belly not increasd - repr: Vinum - Sumat cras mane Pill Scillit * Dr Trotter mane & meridic - 25th: P - near 120 irregular, more Dyspnœa Urine ℔s ij 1/4 - 3 Hard stools legs more swelld he having sat up some Hours to day - Mouth somewhat sore, beginning Apthæ on the Lips & Tongue Omittr: Tamarindi - Utatur Tinct: Rosar pro Gargarism - repr Bol e Jallapa cum Merc - partit: vic incipt: stat - 26th: 4 thin stools with much gripes in the Afternoon 2 thicker in the night Urine ℔ iij - Much better Sleep - Gripes continue, Mouth easier, Apthæ not perceptible on the Lips but still on the Tongue - repr: Gargar: & Vin - (281 Hunter 27th: Urine ℔s v 1 natl Stool, P - about 100 of good strength but irregular pretty good sleep breathing easier, Thighs slacker Legs much swelled - Sumat: stat & repr: cras mane & Merid Pill: Scillit j Dr Trotter - 28 P - scarce 100 & more regular Urine ℔ viss two natl: stools good sleep, Breathing easy, Voice strong & clear, swelling almost gone from teh Abdomen, considerable [in] in the scrotum penis Lower Extremities - Continue - March 1st: Urine near ℔s vij, Swellings gone from the Thighs Legs still much swelld breathing quite easy Apthæ quite gone - Continue - 2nd: Urine ℔ vij 74 slept well 3 easy stools Continue - 3rd: Urine ℔s vij, 1 natl Stool, swelling diminishing - Continue - 5th: Urine 8 ℔s - Continue 6th: Urine ℔s vj two loose stools size of Legs diminishd - repr: Vin & pill - Omitr Gargaiem 282) 8th: Urine ℔s iij Swellings gone from every part & considerably less in them Pulse about 52 strong but irregular good sleep breathing easier little Cough Continue - 9th: Urine ℔s iiiss Pulse & Legs as Yesterday two thin stools some Nausea yesterday but none to Day Continue - 10th: Urine ℔s ii 1/4 Legs as before nausea after the pills last night & today omittr: pill: - 11th: Urine ℔s iij Legs as formerly Continue 12th: Urine ℔ij much gripes last night 2 thin stools this morning legs rather more swell'd some return of swelling in the Thighs Sumt: rediuntibus torminis Pot: Cret: ℥iij - Habeat opic grs. 1 H: S: - 13th: Urine ℔ iijss 2 stools one thin, [illegible] natl: limbs more swelld - Continue 14th: Urine ℔ iij one natl Stool preceded by gripes Limbs more swelld Affricn Ungt: Merc: Fæmor: ad ʒj vespere (283 repr: Pill Scillit: ad grs. x cras mane & meridic relique u: a - 15th Urine ℔ vj no Diarrhœa or gripes P - about 72 & more regular than formerly Thighs slacker Legs as formerly Continue 16 Urine ℔ vj Broth & drunk about ℔ ivss swellings greater, no nausea or Gripes body costive - repr: Pill: Scillit ad grs x. mane, Meric, & vespere - 17th: Urine ℔ iv no stool P - slow & irregular Legs much swelld - Omitr Opium repr: ung & Pill 18th Urine ℔ vss, 3 stools the last thin no gripes swellings as formerly Contue - 19th: speech more natural Urine ℔ iv 1/4 2 stools Legs as formerly mouth slightly affected - Continue - 20 Urine near ℔ v - much sickness & oppression of Breathing, 3 stools to Day the last thin - P - alt 60 & Irregular Omitr: Ung & Pil: Fovr: Crura prob: per hor 2° Sumt: arcintis ad Sudor: Pulv: Sudor grs: xv - 284) altera qq: horce ad 3am: vicem nisi prius sudav: Gin Punct ad ℔ij Omitr reliqua - 21st: P - 78 & less irregular good sweat Urine ℔ ivs swelling of the Legs much diminishd got but two doses of the powder - Habeat Indus: Laneum - repr: Pulv:: Sudor: Gin Punch & vin 22nd: Vomited with the first dose of the powder the next was divided & given at Twice much sweat Urine ℔ v swelling of the Thighs gone that of the Legs nearly gone breathing quite easy - repr: Vin, & Gin Punch, Sumt: Elect: peruv: rob: molem Juglar vis in die - Omittr reliqua - 23rd Urine ℔ v 1/4 some nausea Gripes & three thin stools since he began the Electuary - Legs rather more swelld [since?] he got up - P - 72 more regular than usual, mouth still affected - Omittr: Elect: per hunz diem repr: Cras - (285 Hunter 24th: Urine ℔ vss 2 stools the last of those thin swelling of the Legs rather less repr: Opium ad grs i H: S: Elect: robor: cras - 26th: Urine ℔ iv 3 stools thin but without Gripes other symptoms as Yesterday Omittr: Electm: 31st: Urine ℔ v Legs still smaller no Complaints but some weakness about his Breast - Continue Let him use the flesh Brush for his Legs & take Exercise on the Bank - April 4th: Urine near ℔ vjj with no more Drink than usual Legs almost well - 6th: Urine ℔ v - He continues almost well Continue 7th: Convalescent Urine ℔ ivss Legs less than ever Continue - so goes out Cured 286) (287 Henry Thompson Œt 54 - Coachman February 24th: His Legs & Thighs are affected a soft & inelastic swelling, the abdomen is is a little enlarged with a distinct Fluctuation complains also of Cough & slight Dyspnœa at Night - P - Tongue & appe natl. Belly a little Bound, sleep natl. These Complaints came on about 9 weeks ago attributes them to cold caught sleeping in a wet Barn ꝶ: Ungt: Merc: ʒi Axung. porc: ℥iij ♏ ƒ Affricr Crura Femora & Abdomen vespere Sumat pill: Scill: Doct Trotter * Hora decima & Meridic - Habeat Gin: Punct ℔ ij in die a Bit of Meat for Dinner - 24th Urine since bed Time ℥cix no sensible effect from the pills - Continue - 25th: Urine ℔s ix ℥ij swellings much less one natl: Stool some nausea to Day has much thirst drinks a good deal repr: remedia - Utatur Tamarind: ad sitem restringendam 288) 26th: Omittr Ungt: & Pil: Scillit repr: Gin Punct: H: Anod: H: S - 27th: Urine ℔iij some remains of Diarrhœa swellings still considerable, P, natural he loaths the punch Omitr Gin Punch Habeat Vin: rub: ad ℥viij in die 28th: no more Diarrhœa Urine near ℔s ii swellings rather less, much thirst & great Cough, Appr: Emp: Epistpast: pectori - Omittr: Tamarind: - Habt: Cerevis: Venuem ad ℔ ij in die - repr: Vin - March 1st: Urine ℔s iv 2 thin Stools Cough easier swellings less - Bad sleep he not having the Drat. thro Mistake Habeat Haust: & reliqua u: a - 2nd: Urine ℔ ij - P - natl with regard to quickness but rather low Blister not operated to loose stools - ꝶ: Bacc: Junip ℥j Aquæ: Font: bul: ℔ j ♏ ƒ Infus per horas quatur - & cola - Capt. huhus Inf ℥iv 4er: in die - reliqua u: a - (289 3rd: Urine ℔s iij 1/2 6 loose stools feels a warmth on the stomach after taking the Infus: repr: Haust: H: S: & Mane reliqua ut antea - 4th: Omitr: Infus - Sumat Mist: Cort: ℥ij quater in die et Habeat Vin: rub: ℥xvj in die - 5th: Pulse so weak they cannot be counted frequent involuntary stools - repr: Vin & Cortex - & Habeat Haust Anod - stat - Died at 5 O Clock - 290) (291 Barbara Orrock Œt 60 A Serv: - February 6th: - The Legs & Thigs are affected with a considerable swelling which extends upwards nearly to the Arm pitts & in the abdomen there is an indistinct fluctuation - Has often great nausea considerable Anorexia frequent pains in the region of the Stomach extending along the Course of the Intestines with frequent shiverings & prickling over her Body - P - 96 - Belly loose, Catamenia absent 12 Years, sleeps much disturbed - Had complaints similar to the above about 6 Months ago for which she was received into the House & after staying a few Days was dismissd releived - Her present Ailment supervened 2 [Months} Weeks ago - attributes them to cold - Habeat H: Anod: c gt: xxx - H: S - Sumat: pot: Cretac: ℥ij 4er in die - 7th: Less gripes no Diarrhœa frequent attacks of vomiting pretty good sleep; Swellings much less she not having risen to Day - 292) Matter vomited clear, viscid, tasteless - repr: Poto cretac: si diarrhœa redicu Omittr Haust - Habeat Vin: rub: ℥viij ut sumat ℥j subinde 8th: Three thin stools this Morning, not since she took the potion, good sleep - Abdomen rather more swell'd; rather more swelling of the Thighs - repr: pot: Cretae, post sing: dejec Haust & Vinum ut antea 9th. swelling as formerly, Diarrhœa severe this Morning - Omittr: Pot: Cretae & Haust: repr: Vinum - Sumat Julap: Sistent: ℥ss post sing deject: incipiens stat - Utatur: Ol: Cicut: ad inunguend femora & Crura mane & vespere Habeat Opii pur: grs ij H: S: - A Bit of Meat for Dinner - 10th: No Diarrhœa since the first dose of the Julap: Sistent - Urine ℔ iiiss Pulse Sleep & Appe: natl: Continue - 11th: P - natl: Urine ℔iij one natl Stool (293 spontaneous vomiting on rising the Morning Sumat Elect: Peruv: roborant: molem nuris moschati vis in die reliqua ut antea - 12th: Urine ℔iij ℥iv mucous vomiting this this Morning, slight return of Diarrhœa which was checked by one fose of the Julap - swellings rather increasd - Continue 13th: Return of vomiting & Diarrhœa this morning, urine ℔ iij - Swellings increasd especially about the pudenda - omittr: ol: Cicut & Elect: roborans - repr: Vin: & Julap Sistens - redcent Diarrhœa - Appr: Ung Merc ʒj abdom: vespere - 14th P: 90 much vomiting & purging since 9 last night bad sleep swellings rather less Urine not measured - repr: remedia - 15th P - natl in frequency & strength, 3 thin stools, pretty good sleep, Continue - Urine ℔ iis 16th: Urine ℔ iij Diarrhœa continues, no vomiting, but much sickness & pain of Stomach & Bowels, Abdomen more limbs less 294) swelld she having been much in Bed - P: 84 & small - Mouth begins to be affected - Omittr: Ung: & vin: & pill: Foveantur crura probe vespere, induat indusium laneum - Sumat: pulv: Sudor: grs: x omni Hora ad quartam vicem nisi prius sudaverit incepiens hora 5ta: Habeat: Gin: punct ad ℔ ij in die - repr: Julap: Sistens prownaly 17th: P - 90 no sweat, frequent violent vomitg & purging since she began the sweating powr: very little sleep - Urine not measu some Blood with the last stool - Omittr: pulv: Sudor & Gin: punct repr: Julap: sistens ad ℥j post ting deject: Opii grs: ij H: S: 18th: P - still frequent no vomiting or Du since 9 last night, Urine ℔ iss in 24 Hours swelling of the legs & thighs almost gone [illegible] of the Belly less has not been out of Be these two ays - Continue 19th: no more vomiting - Urine ℔ ij - legs begin swell - repr: ol: Cicut: ad Crura - reliqua ut hora (295 Orrack 20th: no vomiting, 1 natul Stool Urine ℔ iv bad sleep & much Cough, P - & appe: natl: repr: Pill & Ol: Cicut - 21st: Severe return of Vomiting & Diarrhœa yesterday afternoon continuing till this Morning - Urine ℔ iij bad sleep - matter vomited clear & insipid - Continue 22nd: Vomiting & purging bue less severe Urine ℔s iij ℥iv - P - natl: swellings less bad sleep & much Cough Applicr: Emp: Epispast: pectori Utatur Mist: Mucil: urgent tussi - reliqua ut antea - 23rd Breathing much easier Cough almost gone pretty good sleep p - natl: no more vomiting or purging Urine ℔ ij Appr: Ungt: Epispast ad pectus ut ibi fiat Fontic - a Bit of steak Omn- 24th: no more vomiting & purging Urine ℔s v good sleep. Pulse stronger Swellings rather less - Continue - 25th urine ℔s v ℥ iv swellings less but still perceptible about the Thighs Sumat Pil: Scillit i Dr Trotter - Mane 296) 26th: Urine ℔ iijss no more vomiting & purging some nausea complains much of the Issue in her Breast Omittr: Ungt: Epispast repr: Pil: Scillit: 1 Dr: Trotter mane & merid: cras - 27th - Urine ℔s iv no vomiting or purging slight nausea from the pill to Day Cont 28th Urine ℔s v some Nausea from the Pill - swellings much less - Continue March 1s: Urine ℔s viiss Legs still a good deal swelld, sleep & pule nat Countenance better & Voice stronger Continue March 2nd: Urine ℔ vij swellings of her Legs & Belly somewhat less repr: Pill u: a - 3rd: Urine ℔ viiss - Continue - 4th - Had frequent vomiting last night Urine ℔ vij - Capt: Pill Scillit grs: xv H: S: & grs x [illegible] repr: Pill: ex opio - (297 5 - Urine ℔ viijss frequent nausea but less vomiting swelling of her Legs continue to diminish repr: Pill - 6th: Urine ℔ viij Pills have no Effect on her Belly - Continue - 7th: Complaints mending Urine ℔ viiss repr: Pill: Scillit 8th: P - 60 - Urine ℔ vij Swellings quite gone some Vomiting in the afternoon & night - Belly open Omittr Pill - 9th: Urine 6 ℔s no stool these two days much vomiting tho she had an Opium Pill last night Sumat vis in die Infus: Aman ℥ss repr: opium ad grs: ij H: S: - 10th: Urine ℥s. iv no return of swellings or Diarrhœa much vomiting in the Evening none since she took the pills repr: Infus & Opium - 11th: Urine ℔s. vss no swelling vomiting or Diarrhœa P - natl: Countenance more natl. great Weakness - Continue 12th: Urine ℔ vss - Convalesct: in every respect - 298) March 21st: Goes out Cured - (299 Arm Dick Œt 12 February 28th: The Abdomen is considerably enlarged with a distinct fluctuation & a constant pain in the right side a little above the Ilium with frequent Headach P 112 Thirst increasd Belly regular Appee & Sleep natl: Urine not diminishd - These Symptoms appeard about 3 Weeks ago without a known Cause - Has taken a purge about [ago] a Week ago - March 1s: Inungr: Abdomen Oleo Cicut & fricr: probe Mane & vespere Sumat: Cryst: Tart: ʒj Mane & Hora 10ma: & Meridic To take Exercise & her Urine to be measured - 2nd: Medicine has had no sensible Effect repr: Remedia - Urine ℔i ℥iv - 3rd: Urine ℔ i ℥iv - repr: Cryst: Tart: addend: utrique dosi grs - xx - 300) 5th: Urine ℔s ij - repr: remed - 6th: size of her Belly diminishd Urine ℔ ij ℥iv - repr: remed: - 7th: Urine ℔s iij repr Cryst: Tart 8th: Urine ℔ij ℥iv 1 natl Stool daily repr: Cryst: Tart ad ℥ss 4er: in die 9th: Urine ℔s iiss Abdomen as formerly Omittr: Cryst: Tart: post hune Diem ꝶ: Ung: Merc: ʒss Axung: Porc: ʒiss ♏ ƒ ft: Ung ad Abdomen, Crura & femora Applm: best Sumat cras mane & meridic Pill: Scillit: i - 10th: Urine ℔ iss no sensible Effect from the pills - repr: Ungt: & Pill ad grs x pro die - 11th: Urine ℔s iij Abdomen rather less - Conue: 12th: Urine ℔ iiiss Abdomen still less - Belly natl: mouth not Affected - Conue: - 14th: Urine ℔ iij ℥iv Abdomen much less mouth not affected - Omittr: Ungt - repr: pill - (301 14th: Urine ℔ iij Abdomen as Yesterday 3 inches less in Cucumference than when she came in fluctuation still perceptible - repr: Ungt: & Pill - 15 Urine ℔ iiss no other change Continue 16 Urine ℔ ij ℥iv Abdomen no less Mouth not affected, nausea in the Afternoon Omitr: Pill: & Ungt: Sumt: Vespere Pulv: Ipec: grs xv & Utatur Infus: Chamomil: - 17th: Vomit operated Urine ℔ ij Belly no less - repr: Ungt: vesper: &: Pill: scillit: cras - u: a - 18th: urine ℔ iss Belly no less mouth begins to be affected. - Continue - 19th: Urine ℔ ij Belly as formerly, Mouth sore - omitr: Ungt: & Pil: Fovr: Cruræ probe vespere, Sumt: (accineta ad Sudorem) Pulv: Sudor: grs x omni hora ad 3tian vicem nisi prius sudaverit - Habt: Julap Diaph ʒj 3tia qq hora ad promov: Sudorem - 302) 20: Copious sweat from the Time she took the first Powder - Sumt: pulv: Sudor: ad grs x deficcents Sudore - reliqua ut heri - 21st: Has sweated well Urine ℔iss BElly a ful Inch less - Omittr: remed: prœter Indusium - 22nd: Urine ℔ ij no more sweat Belly no less Mouth sore breath much tainted repr: Pil: Scillit ad grs x mane Merid: & Vesper. - 23rd: Urine ℔ iss Belly rather larger, Mouth still sore - Continue 24th Urine ℔ j - Omittr: Pill: - 25th: Urine ℔ j ℥iv swelling & fluctuation as formerly - ꝶ - Pulv: Jallap: grs xv Merc dul: grs: v Conserv ʒss ♏ ƒ & div: in partes duas quarum Sumt unum cras mane alteram post horas ij - 26th: Urine ℔ j one stool before she took the Physic none since both doses being thrown up Belly larger 303) Dick - 26th: ꝶ: Pulv: Jallap: comp: ℈iv Pulp: prun: Gallic ℥ss Syr simp: q: s ut ft: Elect - Cujris Sumt: cocche: parv: omni hora donce alous responduit incipiens cras mane - 27th: Took three Doses of the Physic vomited a little with the last of them 3 large thin stools with gripes - Urine ℔ j belly increased above two inches since the sweat - Inungr: Abdomen Ol: Cicut mane & vespere & fricetur probe - 28th: Urine ℥x some sickness to Day Belly no less bad sleep & much pain from the right side of the Abdomen - 30th: Urine ℔ j Abdomen bigger body continues open Appetite growing weaker bad sleep & some Dyspnœa - Contue: - 31st: Urine ℥x Belly of the same size April 1st Urine ℔ j Belly as formerly repr: Ol: & Chryst: Tart: ad ʒj quater in die ex lacte ebutyracee - 2nd: Urine ℔ iss no other Change Continue 304) 3rd: Urine ℔ iss Abdomen rather less Continue - 4th: Urine ℔ j ℥iv size of the Belly as formerly much pain low in the right side of it Continue - 5th: Urine ℔j Belly rather bigger pain continues fluctuation very obtuse seemingly from the great Tension Belly natl: - Continue - 6th: Urine ℥x Belly of the same size as formerly pain of the side with oppression on the Horizontal posture as formerly - Omittr remed: - Fiat paracen thesis Abdom: S: a Habt: Vin rub: ad ℥vj - 8th: Urine ℔ij in each of the two last Days pain of the side still severe P - 120 - Paracentesis heri frustra tentata, quamvis fistula ad Caput Stilus ad aliquot polices in Abdomen immissa nat - 9th: P - 126, great orthopnœa - Contue: 10th: Pain in the right side extremely (305 violent - P - 150 skin not much dyspnœa Urine ℔ j - one natural Stool very frequent vomiting - Sumt: Staim H: Anod ad gt xx & repr: vespere - 11th: vomited the first draught but retaind the 2nd: pain much easier good sleep - P - 130 one stool in the Afternoon some vomiting this Morning will not take the Tartan repr: Vin ad ℥vj in die H. Anod H: S: vel redieunte dolore - omittr Crystalli Tart: - 12th: P - 124 pain much easier she can bear considerable pressure on the right side frequent vomiting one stool urine not measured bad sleep - Omtr. H. A Habt: Pil: Theb: grs x H: S: Haust Sal: Efferves: urgt: nausea 14th: Bad Sleep very frequent Vomiting P - 120 & Small much pain of the Abdomen - Paracanthesis iterum pustra tenlata lateri dextro - Conue: - 16th: Goes out by Desire - 306) The Day after she left the House she died - On Dissection about ℔ vj of a Bloody dark coloured fluid were found effused into the cavity of the Abdomen - The right Ovarium was very much enlarged weighing with the fluid contained in it about ℔ xx - The different Chylopoietic Viscera were pushed up - towards the Diaphragm to which the Liver strongly adhered - The Uterus right Ovarium & Fallopian tube were in a natl Slate - (307 Catharine Baron Œt 23 - Married February 25th: Is frequently attacked with a disagreeable Soreness in the Epigastric Region at which Time she has a sense of Globus in the upper part of the Œsophagus severe palpitation & threatening Delirium. P - 100, Tongue Appee: & Calamenia natinal - These Symptoms have been present four Weeks & attributes them to cold & Fright she got at Time - Has used no Medicine - 26th: Less uneasiness about her Stomach but some Globus about her Throat Sumat vis in die surgent Globo - Œther Vit: ʒj ex Aqua Font: ℥ij Ediur: Scint: Elect: quotdie e Guttire & regione Ventriruli - 27th: Releif from the Œther some uneasiness about her Throat since she was Electrified Continue - 28th: Complaints easier some pain seemingly Rheumatic about the Neck Applir: Emp: Epispast: parv: nuchæ - 308) March 1st: Compts: worse Omittr: Œther & Elects: Sumat: Pil: Theb: grs x - H: S - 2nd: reo fitts nausea, repr: Pill: Theb. u. a - 3rd: no Fit - repr: Pil: u: a - 5th: Less attacked with Globus - repr Pill 7th: Catamenia adsimt complaints easier - Omittr: Pill: Theb: 8th: Cataa: adsunt - 10 Catamenia cessarunt; complains still uneasiness about her Throat sickness & pain of her Stomach & faintness - Appe: go Body open Sumat Julap: Fœtid ℥ss 4er in so To use Exercise on the Bank daily 11th: no sensible Effect from the Medicine continue 13th: Free from Complaints to day Goes out releived - To have ℥vj of the Julap fœtid with her (309 Janet Mc: Gregor Œt 16 - A Serv: - February 15th: The palpabræ & Tunica Adnata of the right Eye, are affected with redness & pain - Has also great impatience of right in the Eye with a considerable discharge of a thin and watry humour, sight much diminish'd particularly within this fortnight - P: 82 Tongue natural Appetite good belly bound Catamenia have not yet appear'd - These complaints have been present 8 Months, Her Eyes were both in the same state 12 Months ago & she has a brother similarly subject to these complaints - Neither her Father or Mother as she says nor any of her Friends were subject to scrophula Knows no Cause, has used no Medicines Admovr: Hirud: iv circa ocul: affect - Cataplas: Saturn: H: S: ad oculum - ꝶ: Ol: Recin ʒ vj Tinct: Jalap ʒij ♏ ƒ - sumat cras mane partitis vicibus - 310) 16th: Less pain of the Eye, other symptoms no better, no Effect from the Physic - Omittr: Cataplasma - Utatur Collyr: & Ung: saturnino ut pro Penman præscripto - Enema com: vespere nisi prius Incipiat cras sumere. pulv: peruv: ℈ij ter de die ex lacte - Full Diet - 17th: Physic operated frequently, Eye almost well, Eyelids much better - Continue - 18th: Convalescent continue - 19th: Eye rather more painful than Yesterday - repr: Ung & Collyr Educr: Scint: Elect: leves ab ocula affect; 20th: would not allow herself to be electified Eye rather better - Continue 21st: Eye & Eyelids almost well Goes our cured - 26th: - Readmitted - Lays that the Day she left the House the Eye began to be inflamed and continued to grow worse ever since is now in much the same state as in the first Admission, - (311 repetr: Ungt & Collyr ut antea prescript: ferit - 27th, Eye not better much pain through her Head - P - natural repr: Collyr & Ungt - Admovr: Hirud: 4r: Tempori prope Oculum - 28th: Eye less red, The sides less swell'd but still much pain & Impatience of Sight bad Sleep Habeat: Haust: Anod: e gt xxx Collyr: Ungt ut Antea - March 1- Eye much better good Sleep Headach remains - Continue 2nd: Pain of her Eye increasd complains of Headach Applicr: Cucurv: cercent: repr: Applices: Externæ 312) 7th: Physic not yet operated pain of her Eye somewhat easier repr: Collynr & Sat - 8th: Physic operated well good sleep Eye no Better - repr: Collynr: & Ungt - Educantur Scint: Electric: plurimæ leves ab occulo affecto - Utatur Ung: Antipsor: - 9th: Eye sensibly better but still painful Continue 10th: Eye continues easier but still much Headach - Continue 11th: complains still of pain in her Head Eye rather wore - repr: remed: - The Eyes to be kept constantly lightly cover'd 12th: Eye worse headache more severe Omitr Elects: - Admovr: Hirud: iij circa Œcea repr: reliqua 13th: Eye almost well to day - Continue 14th: Eye rather worse - Omittr: Collynr: Sa ꝶ: Aquæ Fontl. ℥ij Spt: Vin: Gallic ℥j ♏ ƒ: Utatr: pro Collynr: - repr: Ung: - (313 Janet McGregor - 16th: Eye no better ꝶ: Vit: Alb: ʒss solve in Aqua rosar ℥vj - ft: Collyr - repr: Cort: ad ℈ij 4er: in die 17th: repr: Collyr: Vit: c duplic: Aqua - 19th: Eye Worse not so much pain in the Head. - Admovr: iterum Hirud iij circa oculum repr: - Cort: - & Ungt: - omittr: Collyr - 20 - Instillentur gt: iij Tinct: Opii in acento affecto - 21st: Sight better pain of Eye & Head as severe as ever. 23rd - Eye no Better Omitr Landm: Scarifion - Ocul: levster d: A - & fovr: probe Aqua tepid cum lache 24 Eye no better only the Eyelid slightly; scarified - repr: Collyr: Sat: & Ungt: a 25th: Was attacked with Fever & sore throat of the inflammatory kind which yielded to the usual remedies [Wart?] the 4th of Apl: - 314) April 5th: Eye rather worse - Omittr Vimor & Cortex repr.- Collyr: Saturn: - 6th: Eyce still sore repr Collyr Applcr: Emp: Epispast: much a postea ibi fiat fonticulus ope Ungt Epispast: - 10th: Left Eye still sore beginning affection of the light - Repr: Collyr: & Ungt: Saturn: ungt: Epispast Mucha 12th: Eye still very sore issue in the neck runs well - repr: Cort: ad ter in die ex lacte - 14th: Pain & redness of the Eye almost gone sight of it important - A very sore scale of the Cornea & come dimness of the Humours - Goes out releived - To have some the Issue Ointment for dressing neck - (315 Isabel Mc: Pherson Œt 27 - Married February 17th: The Abdomen is somewhat enlarged & a distinct Fluctuation can be felt in it, says that he Legs & Thighs are frequently affected with a swelling at night but there is none perceptible at present nor do they pit in the least on pressure skin very itchy, Dyspnœa at night P - & Tongue natural, Thirst increasd, Belly & Catamenia regular Urine diminishd in Quantity, high colourd sometimes turbid & often feels a desire without bring able to pass it, sleep bad & often attended with frightful Dreams & frequent starts; feels no particular Inconvenient from lying - on either sides, the above symptoms have been present 6 Months & attributes them to cold, Has taken some purgatives with releif - 19th: Sumat: pill: Gummos grs. x ♏ ol - 20th: no perceptible fluctuation in the Abdn no swelling of the Limbs - Urine in 24 Hours only ℥xix - 316) Sumat pill: Gummos: grs: x - vespere adeat machin: Elect: vis in die ut Habeat ictus aliquos cira lumbos - 21st: Urine ℔ iss - Continue - 22nd Urine ℔ ij, complains still of sickness pain & Oppression about her Stomach says she formerly used to vomit easily but since her present Complaints can scarce be made to vomit tho she took Emet: Tart: Sumat vespere Pulv: Ipec: ℈j & repr: post horam nisi prius evomues Utatur: Infus: Chamomil - 23rd: The first dose operated well in about an Hour contents of Stomach acid Urine ℔ iss - good sleep, genl: releif Sumat ter in die Semen Sinap: ℥ ss To use Exercise on the Bank daily - 24th: Stomach easier Urine ℥xxv - Continue 25th: Urine ℔s ij some pains in her Limb Continue - 26 - Urine ℔ j no swelling, much nausea in night & vomiting before Break fast (317 Sumat: Pil: Scillit: Dr Trotter stat cras mane & Meridic Omittr: Semen Sinap - 27th: Urine ℔ j - Sumat pill: Scillit ij Dr Trotter - 28th: Urine ℥ix Anorexia & Sickness these two Days - Dimissd by Desire - 318) (319 Marion Mc: Phee - Œt 25 - unmarried February 7th: Complains of violent pains at times in the region of the Bladder extending to the Back & Loins & frequent numbness of the Thigs - These are attended with nausea vomiting of a watery & very acid Matter & of frequent sensation of a Bale arising in her left Side passing across to the right & thence proceeding along the Course of the Œsophagus to the Throat this she says produces great pain & a sense of suffocation of which she is seldom entirely feel - P - natural, Belly very costive, Catamenia appeard first 9 years ago during the flow of which she took cold & they have never been regular; seldom appearing oftener than once in three Months - Bad sleep, Urine turbid, diminishd in quantity & frequently stopt on a sudden when flowing in a ful stream, but is again renewed on a change of posture - Has been subject to Hysteric complaints her 9 Years but have increased within these 320) twelve Months - The calculous Symptoms appeard a year agone - Has used some purges & opium without releif - Injicr: Enema com: stat: - 8th: Sumat ter de die Julap: Fœtid ℥ss The Urine to be kept & examined - 2th: some pain about her stomach & bowels this forenoon, some Globus she says in the Belly but not rising to the Throat - some pain & Stranguary but no stopping of the Water when it flows Urine natl & with a slight mucous Sediment - repr: remedia - Exploratur vesica a Chisresgo more solito: secundum Artem - 10th: stil complains of pain in her Stomach - Globus in the Abdomen but [new?] rising quite to the throat - no Calculus in the Bladder - Urine passd freely Continue - 11th: Pains & Globus rather worse, no Hysteric Fit, Urine passd easily - Omit - Julap. Fœtid (321 ꝶ: Aquæ puleg: ℥v Aquæ: pip: Jamaic: ℥ij Syr: simp: ℥ss ♏ Sumat ℥j 4er: in dies - Sit in promptu - Haust: ex Ag: Font ℥ij Œthers Vit: ʒj - ingruente Globo sumendus - 12th: Complaints rather better - utatur pedeluv: vespere - Habeat scient: Elect: cira lumbos ad promovend: Menses - repr: remedia u. a To use as much exercise as she can daily - 13th: Complaints rather worse Contue: 14th: Symptoms no better, no Cataa: - Omitr: Œther: & Julap: Card: - repr: Pedilur: & Elect: vespre Sumat: Vin: Aloct: ad ℥j H: S - 15th: Compts rather better no Effect from the Medice- repr: stat: Vin: Aloct: ad ℥j - 16th: very little effect from the physic symptoms as formerly - Complains still of acid Eructations. Sumat urgent: pyrosi Mag: Alb. ʒj pulv: Rhei ℈i ex Aqua Menth: piper: ℥ij - 322) 17th: Symptoms no better no Effect from the Draught. repr: Haust: stat: ut heri præscript 18th: Second Drat: operated well, pain of the Stomach releived, bad sleep - Sumat. pill: Thebaic: grs: x - H: S - Omittr: reliqua - 19th: Good sleep & much releif to her Stomach Continue - 20th: continues much better Goes our releived (323 Jane Penman Œt 32 unmarried - Feby: 5th: The Tunica ad nata of the right Eye is affected with redness, heat, pain & itchiness with a constant discharge of watry humour which excites in the parts over which it runs a sensation of heat - She has also lost the sight of the right Eye, has a constant pain of head chiefly confined, to the right side with the sensation of a cord band around it, great inclination to sleep from which she starts frequently - Pulse natural Belly very costive other functions natural The complaints first began about 12 Months ago with a rheumatic pain in the right foot which by degrees ascended from joint to joint chiefly of the same side till it reached the Head where it has continued ever since - About 2 Months ago the right Eye began gradually to be affected & grew worse untill it arrived at its present state - The Inflamation supervened only 2 Weeks ago - 324) Admoveantur circa oculum affect: Hirudines iv vespere - Applr: Emp: Epispast: tempor. dextro Sumat cras mane solut: Sal: Glaub: partitis vicibus - 6th: Leeches bled freely, much swelling of both palpabræ since they were applied pain much easier, no sight in the right Eye, Edges of the Eyelids gummy; Physic has operated well Foveantur oculi subinde Aq: tepid: cum lacte - Inemgr: paleb: H: S Ung: Simp - Capt: H: S: cum gt: xxv S: S: - Haust [illegible] 7th: Physic operated smartly till Night little sleep sometimes but seldom shooting pains in the Eye which is still closed from the swelling of the Eyelids P - about 90 some headach, swelling fallg more down the face & spreading to the other side Repr: Fot:, Ung, & Haust, Anod, 8th: swelling nearly gone off, pain of the Eyelid quite gone of redness much less (325 & she can now see right with it, Cornea quite clear bad sleep as she thinks from the Medicines - Omittr: Haust Anod, repr: reliqua remedia 9th: No more pain in the Eye, the degree of sight & redness as yesterday, good sleep Omittr: folus & Ungt: simplex - utatur unguento saturnino ad palpev: ꝶ: Sacchar. Saturn: ℈ij Aqua rosor: palid: ℥vj - solve & utatur sapius in dies pro Collyr - 10th: Redness of the Eye & sight no better no pain but slight pain on moving the Eye - Body open, appe: sleep & pulse natl: repr: remedia - u. a - 11th: Sight no better less redness no pain of the Eye or Head - Abradr: Capil: - repr: remed: - 12th: Eye less red & free from watering, much heavy due pain of the Head & Vertigo some Nausea - Mittr: Sang: ex Arteria tempor: ad ℥xij - reliqua ut antea 13th redness nearly gone, sight rather better no pain in the Head, scarce two ounces 326) of Blood got by the Arteriotomy adhiben: Cucurb: cruent: Temp: dext: & educr: Sang: ℥viij 14th: Thinks her Sight still mending no pain but some weakness as she calls it of the left Eye - Appr: Epispast: Capit: iterum saro si opus fuerit 15th: no Mange of Symptoms Blister has run well - Continue 16th no pain but sight no better - Sumat: pil: Merc: omni norte Educr: Scint: Elect: circa Ocul affect et Tempora - 17th: Continue - 18th: Eye no better - repr: remedia - To try the Effect of covering up the sound Eyes 19th: Eye rather more painful since it was Electrified, sight no better, Mouth not affected - Continue - 20th: Thought her Eyelids swelld after the Elects yesterday was not electrified to day - Swelling of the Eyelids gone, Eye less red Sight no better Omittr: Elects: repr: pill: (327 Penman 21st: Much gripes & three loose stools since The Visit - Omittr: pill - sumat: Julap: sistent: ℥j stat & ileum H: S - 22nd No diarrhœa nor Gripes since the first dose of the Julap the second dose not taken, sight no better, mouth scarce affected Breth tainted - Applicr: iterum Emp Epispast: Temp dext: et fiat ibi Fonticutus ope Ungt: Epispast - 23rd: Blister has run well less redness & uneasiness about the Eye thinks the sight occasionally letter Continue 24th: Continue - 25 No uneasiness about the Eye but the sight no better, the pupil of it is permanently contracted & motionless while that of the left Eye contracts & dilates properly repr: Electricitas - 28th: yesterday afternoon complained of Headach, Nausea Oppression & Heat & Weakness preceded by rigor - P - then 100 - Had the Antimon Solut which operated well by vomiting, Bad sleep, Headach: nausea & Heat 328) gone No appetite Body costive Enema Com: statim. - Cortex peruv: ℈ij 4er in die ex lack Julap: Salin; ut Antea March 1st: Sight from the Eye & motion of the pupil sensibly better - Catamenia fluernt - Contue. 2nd: Convalescent - 3rd: Complaints better - Omitr: Julap repr: Cortex 5th: Pupil contracts more naturally repr: remed: - 6th: Continues better - 8th: Sight of the right Eye continues Merid but slowly Omittr: Cort: repr: Electricitas - 10th: sight considerably better pupil of the right Eye much less than that of the lef object appear smaller to the right than to the left Eye Continue Electricity - 14th: sight continues to mend, pupil smaller than natl: but has considerable motion, Object seen with the right Eye appear still prates Goes out releived - (329 330) 331 - Wm: Reed Œt 24 - Septr: 10th. Complains of exquisite pain over the whole abdomen particularly severe about the Umbilicus, when it is accompanied with a sensation of twisting & wringing in the towels - The Abdomen feels tense & enlarged & the pain is much a gravated on pressure; he has almost constant nausea, & frequent vomiting of a bilious nearly stercoraccous matter; he has urgent thirst & refuses all sorts of food which is immediately rejected by the Stomach - Has had no Stool for nearly 3 Weeks & his other complaints are of that standing but have been much agravated within these four Days, attributes them to cold & has used no Medicines - ' 332 statim injicr Enema Salin: cL dup: Sal: Fovrar: stat abdomen per hor: ij. & Alvo solut: Sumat opii pur: grs: ij - - 11th: - a pretty copious stool containing Scyballœ was procured by the Injicn: he had releif from pain & had a tolerable night. - Since Morng: the pain has recurred but with less severity, nausea continues & he has had several attacks of vomiting - Pulse feeble - Injicr: quam primum per Anum Aquæ tepid: ℔ vj ad ℔ viij - ꝶ: Caloml: grs: xij Pul: Jallap grs xv Mucil Arab q: s: ut. ft: Massa in Pil vj divid - sumat i omni hor. - . - . - Vespere ni [crossed out] sublerr: color vel ni resss Alvus repr: Injic: necnon Opium ut heri 333 et adhiber: regioni Umbilici Vzaicat: - Habt: Juscul: bov: ℔j vel alterum nidies - - 12th: - About ℔ vj of Water were thrown up soon after the Visit which were soon returned of a fœculent colour but without admixture of fœces; during the exhibition of the pills some vomiting occured - Towards evening about ℔ viij of tepid Water were thrown up which being retaind for some time appeard to being off some fœculent matter - Blister has answerd well he has had an indifferent night & much gripes since morning but without vomiting P - 90 - ꝶ: Fol: Sen ʒiij. Sal: Glaub ʒvj Semen: Coriand: Contus ʒss Aquæ fervent: ℥xvj Infund per semihor: - 334 Sumt: ℥iij omni semipor: - Bihorio exacto ex quo Infus: sumr: ni prius plene respondt: alvus repr: Injict ut ant: - 13th - vomiting occured twice during the exhibition of the [Tinpeaus?] of Senor The Water injetion was given about 8 in the evening which was return without effect about 10 the smoke of Tobacco was injected per anum to sickness was induced; but this as well as a saline injection afterwards given procured no Stool - The Tobacco smoke was again repeated early in the Morning & Ol: recin: to the extent of ℥ij without ℥j of comp: ꝶ of Senor was also given but no stool was process Another Saline injection was repeaed about 7 - He has passed a very 335 uneasy night & complains now more than hitherto of pain & tension of the Abdomen - nausea generally Prevails & vomiting at times - P - 100 & more feeble - Habeat stat: Opii grs: iss om: hor ad iv m: vicem ni prius metescunt tormina [crossed out] - Cessante dolore repr: nyce: e fum: nicot: - - Hora nona P. M - soon after the exhibition of the opium the pain of the Abdomen remitted & the Tobacco smoke was used but without effect grs: ij of Opium were a gain given & the following purgative orderd ꝶ: Fol: Sen: ℥iij - infund ex Agu: fervent: ℥viij - adde Syrup: de Rhamno ℥j ♏︎ Sumt: ℥iij om: hora ad iij am: vicem - 336 Vomiting supervened soon after the first dose but he continued easier thro the Night & an injection of Water was given with the same effect as former - 14th - He continues free from pain but the Abdomen is still distended he is thirsty - P - 90 rather feeble Inter ambuland: affundetur subito Aqua gelid: cruribus - Vespere repr: Opium pop re nata . - - 15th - Soon after the dostring of the Water he had a fluid fœculent Stool a more copious similar one in the course of the Afternoon in the Even grs: ij of Opium & ℥j ol. resin. c - 337 ꝶ: Sen comp: ℥j which were retaind He had an easy night, 6 Stools which by report appeard to have been abundantly copious & to have containd scyballœ he is free of gripes & fullness of Abdomen much abated vomiting does not recur he has taken food P - 90 & Soft repr: Opii grs: ij vespere versus et cras Mane Habt: Pulv. e Jallap: comp ʒj - - 16 - The cathartic procured some loose stools & he feels free from pain with return of apetite - In a [crossed out] day or two a slight diarrhœa came on which was restrained by the potio cretacea & the patient was soon dismissd cured - 338 339 340 341 - Mania - The case of Jane Willie gave use to this lecture: some particulars of whose melancholy case it may be necessary to premise - The accounts given by her Friends appears to be these & strict inquiry confirms them - " She had been married for some " time when her husband left her & went " to Glasgow in quest of work - While " there he enlisted for a Soldier & went " to America where he remaind some years - " His wife whose case we are to consider " heard of his going off but had received no " sidings of him during his stay in that " country; she lived the whole time in the " most unexceptionable manner: imaging " however that some accident had befallen " him from so long as period having lapsed " without any intelligence received - She " at length formed a connection with " another man about 8 days before " before her former husband arrived - " The friends on both sides however " reconciled matters; the husband she " was lately married to gave up his " pretensions & she again lived the wife " of her first election who seemd to forgive " & forgot her conduct which cannot " be thought blameable - The " unfortunate Woman could not forgive " herself - She became melancholy " & thoughtful & this disposition increased " into real Mania - This " as often happens submitted for some " time & seems to have been brought " on again on being allowed to see " her child who had been very properly " taken from her sometime " before - This was really the case " & she had no fever or relapse of " it - 342 She seemd to have fixed her thoughts in a surprizing degree on the unfortunate situation to which she was reduced & to this I attribute the insensibility that manifested it & not to any compression of the Brain - you saw she could be pinched & a pin could be pierced thro the flesh without her shewing the smallest symptoms of sensation - We may observe nearly similar situations tho in a much smaller degree every day for when the mind is once deeply engaged on any one interesting subject we are by no means so sensible to external impressions as at others - It was evident from her Eyes following the light that sensibility was by no means destroyed & she was roused from this this situation when her child was again brought to her - she was likewise affected with that particular state of the muscles which has been called Catalepsis that is when the limbs remain in whatever posture they are placed - It is a suspension of the usual law of muscular motion; "that every contraction is followed by relaxation the muscles contracting yield to the force of their Antagonists - This affection is a very rare occurrence I have seen some approximation to it but never knew it present to the degree it was in this patient & there are many Physicians of 30 or 40 years practice who have never met with it - 343 Her stupor frequently alternates with fits of great fury & her pulse varied from the standard of health to 140 - I need not tell you that in this case indeed in every case of Mania the prognosis was very infavorable tho in cases of mania arising [crossed out] spontaneously & suddenly we may have some hope of spontaneous relief or cure, I've indeed seen cases as bad as this and arising from pretty similar causes & I did not expect the fatal termination of it so soon - I know no disease the pathology of which is so unsatisfactory as Mania & it is impossible from our total ignorance of the nervous system to accomplish it - as for motions, Vibrations &c - there there is not one proof of their existence & even allowing them to exist they will not afford one satisfactory explanation of the Phœnomena - We may however be allowed to say that a certain state of the nervous System is necessary for the performance of the different functions, the exercise of the senses Imagination, judgement &c - & this assertion is proved by the effects wch: diseases pressure &c have on these different functions when they affect the brain or nerves - There was a Man at Paris who had lost a great part of this Skull & & whose brain was exposed & when any pressure was applied to it a total 344 a total abolition of every function ensued & continued for the short space of time the pressure could be allow'd to remain, Violent concussions of those organs will be attended with similar consequences - I Knew a man who was thrown from his horse & whose head received a violent concussion from the fall tho' any organic lœsion was prevented by his having on at the time a stiff oild leather cap - The concussion however occasiond strong delirium which continued for a long time but at last spontaneously disappeard - Compression from Exostosis &c will produce nearly the same effect - I knew another gentleman who for sometime after her received a fall from - from his horse was observed to grow very melancholy tho he was before of a remarkably sprightly disposition & this at last rose to such a degree that he made an attempt on his own life - It was supposed that some organic lœsion had been produced from the fall & he was persuaded to suffer the application of the Trepan to that part of his head on which he was thrown - On examination a fissure was discover'd on the inside from which an Exostosis was produced the whole of which was by many Applications of the Trephine removed & he recoverd the Operation & soon after his former cheerful disposition - It is 10 Years since the accident & he lives free 345 from any compliant - Lumps on the brain itself will produce maniacal symptoms &c - sometimes particular degrees of hardness have been discoverd to produce the disease - Some have asserted that portions have been found perfectly a dust hard friable but this I believe to be a Mere fiction - Dr Cullen has made use of these facts to support a favorite theory on this subject but I really do not understand it - Effusions of various kinds - Apoplexies &c: have been found to induce a state of mind different from the ordinary one & so many of thus nature have occurred that physicians have been led to suppose organic organic lœsion present in every case of Mania - This supposition however is not well founded & in this very instance nothing preternatural could be discoverd on dissection - An affection of the Mind or delirium is often produced by disease, as fevers, & these inflamation is generally supposed to be present; but this too is ill founded as it often depends on debility & 100 ont 150 cases I have seen it was removed by the use of wine which should not be the case it, it depended on inflamation - The delirium produced by fever frequently remains some months after the fever is removed - I have Known a quartan which was attended x Jane Willie 346 with a high degree of delirium cured, when the delirium or Mania returned periodically for a considerable time afterwards - Mania has been produced likewise by the stoppage of usual evacuations as the menses the Hœmorrhoids Ulcers &c - We are not in all such cases to suspect effusion as it may arise from some lœsion given to the nervous System by the stoppage of such evacuations independent of any effusion or compression - other causes will also produce this disease - A temporary madness is produced by various liquors the nature of which differs as produced by various liquors - This Ale produces a very stupid sort of drunkeness; & Spirits a very violent species of this affection - Wine a more gentlemanlike intoxication than any - Many have died instantly from a great quantity of spirits & no Gentleman will I believe be so sanguine as to suspect organic lœsions of the brain - Opium produces different kinds of intoxication or Mania [or Mania] in different constitutions it being sometimes attended with the most agreeable Imaginations, & death has been [attended] occasion'd by it when taken in large Quantity tho not the least visible organic lœsion could be discoverd after death - 347 The nervous power is by all these substances affected in a Manner as yet incaplicable - Passions of the mind produce similar disorders of the intellectual functions & they were the cause of our patient's disease - Violent passions sometimes engage the Mind so deeply on one subject that there is no room left for the consideration of any other an instance of which this case also affords - I imagine however that no such effect is produced except in those prœdisposed to Mania - We find people exposed to the most violent passions without any such disagreeable consequences; while we find a loss of reason & mania produced by the most trivial trivial circumstances in those prœdisposed to such affections as such prœdisposition is frequently hereditary I made particular enquiry whether her father or mother were ever subject to any maniacal affection but could only learn that her father when intoxicated [illegible] remarkably outrageous - The effects of the passions as the causes of diseases cannot be clearly explaind, tho their effects in producing Mania are not altogether destitute of Analogy with their power on other parts of the body - In many cases of Mania produced by passions of the mind tho no in all we find evident Marks of 348 organic lœsion - I had one case of mania produced by causes pretty similar to these which occasiond the disease of our present patient & on dissection there was formd a great quantity of water in the head & a slight inflamation of the Membranes - As I mentioned before this is not altogether destitute of Analogy - It shewed I think an increasd action of the vessels & we find that Shame by increasing their actions produces blushing; grief an increasd secretion of tears; Fear a great flow of Urine, Anger a great flow of bile & other passions an increasd secretion of the Semen - All those circumstances shew that the circulation is often changed by the the passions & a similar change may take place in the brain - tho I do not pretend by any means to give a perfect pathology of Mania on these principles - As to Dr: Cullens theory of this disease I cannot pretend to refute as I do not understand it - He talks of Obstacles to the propagation of motions &c. but I know of no substance less adapted to the propagation of any motion than that of the brain itself - There is however one part of his doctrine which well deserves alternation I mean the high degree of excitement wch: he says is present & I think all our practice tends to the diminution of it 341 The practice in this disease is as imperfect as the pathology, It is best I believe to do every little [I believe] except keeping the patient under restraint Valsalva was celebrated for his success in curing Maniacs & his practice was to keep them under restraint & to give them an infusion of Melon Seeds for drink - Sometimes great bleeding has been employed but few cases requires it; tho some wch: are attended with plethora, violent inflammation &c do - Blisters have been often employed but I have never seen any benefit arise from them Purging is the most frequent remedy - Emetics have been exhibited exhibited as giving a concussion to, & changing the state of the Nervous system & I have sometimes formd them usefull especially as a dose of Laudanum comparatively small as from 40 to 60 drops will after them operation produce rest, though double the quantity would have been attended with no effect before - "I have lately heard " that Opiates exhibited before the Emetic render a much less quantity of the latter necessary but I have had no Experice. except in one instance relative to the fact - We tried it this Winter 350 in the Case of Grey but it did not succeed as it required as large a dose of Tart. Emit to operate as would have been required had no opiate been previously administered - Warm Bathing sometimes succeeds by inducing sleep in this disease Cold has sometimes considerable effect in reducing the violence of Mania " There was a patient here who " ran from his keepers one night " when the Thermometer at 26° to " the north Bridge where he [vomited?] " the Battlements & suddenly stood " still. The people who followed him " in this situation were afraid to " advance lest he should throw himself " off; he stood quite still. The next Morning he was prevaild upon to return " to return home his fury being " remarkably abated but the moment " he again got warm & at his breakfast " he became as outrageous as " ever - My Colleaguw; " Professor Robinson " has told me that he once " knew a Maniac at Petersburg - " who escaped from his keeper & remaind " out in the snow from 6 " OClock at night till 2 in the " morning whlist the Thormr: stood " at 37° below 0 of Farenheit a " degree which would probably have " proved fatal to any person in " ordinary health under similar " circumstances for he had scarcely " any cloths on at the time - He " was in the morning taken perfect 351 " quiet but as soon as he got " warm he became as bad as ever - As to my Own practice in this case I really at first did not know what to do - I applied Sinapisms as stimulants to recover sensibility which was evidently much impaired & when danger seemed to advance I prescribed the other usual remedies tho I confess I did not much expect from it - As Wine is often useful in delirium attending fevers whether with or without stupor I prescribed some in this case as I found the next day the symptoms were growing worse I desired the head might be shaved that it might be ready for the ready for the application of some cold Substance or a blister - If great fury had prevail'd we would have applied the former - As to Blisters I believe they have been employ'd very improperly where a high degree of excitment was present - As a great stupor prevaild which I imagin'd proceeded from a Metaphysical rather than a physical cause, I orderd her child to be brought that it might have roused her from it - She grasped it with great eagerness but the Affection was not at all removed - I [crossed out] ordered a remedy wch: is often found successful tho it 352 frequently fails - I mean an Emetic as to its effects on the Stomach they were out of the question but it might have operated in several other ways, as by inducing debility - &c but my principal intention was that it might give a shock to the whole nervous System - The dose may appear large I orderd grs: x of Tart Emet without effect I have known my Father give grs: XVIII without effect & in another case I am told he exhibited grs. xxij - The Antimonial failing Vitriol. Album was next prescribed which is a very strong Emetic & has the peculiar advantage of quickly & in some cases almost instantaneously instantaneously - The second scruple produced vomiting not violent nor frequent The patient seemed relieved & her pulse was lessend 18 strokes the next day - I endeavourd to have the Emetic repeated but she could not be persuaded to take it nor the whole of the Anodyne, one half of wch: produced sleep - Findig her much worse I next prescribed a remedy which has been much recommended tho' I have little faith in it, I mean Soluble Tartar which operated more powerfully than I expected & after it she seemed to have recovd 353 her appetite - Being determind to give the Laudanum a fair trial I orderd 150 gtts. to be exhibited - I have in one case given between 200 & 240 in a short time which was accompanied wth the best effects as the patient was frequently perfectly free of Mania next day - Our patient's pulse was next day frequent & feeble - The lividity of Countenance was I think occasiond by impededed respiration owing to her hands being being tied too tight & close around her body for she was so furious that a strait waistcoat became necessary & accordingly her hands being loosed & cold Water applied to her face the lividity was in an hour after perfectly removed You will perhaps ask whether the Anodyne may have had any effect in bringing on death which happend soon after its exhibition - In my Opinion it had not: for I have seen much larger doses exhibited before without any bad effect - As to the Dissection - I never saw a sounder Brain - On removing the Cranium a slight effusion of a gelatinous matter was observed between it & the Dura Mat but it was in so small quantity as not to merit attention - In another part there was a small wrinkly of the Dura Mater but Infling 354 This upon the whole is an addition to our stock of knowledge as it proves that the most violent affections of the senses as stupor, rage Mania &cc may arise without any Organic Lœsion & it is an important piece of information both as to Theory practice - It encourages us to exhibit the most probable remedies & shews that such diseases may arise from a morbid state of the nervous system alone though it is probable that the nervous power will never be made a visible or tangible object - Anno 1791 - Dissection of a hyrol Girl - Œtatis 12 0 Short Healing of the disease - For a long time was affected with a cough - dyspnœa universal Emaciation hectic fever - without any Expectoration either purulent or bloody - Dissection - On opening the Thorax - The right lobe of the lungs was formd firmly adhering these [gout?] to the pleura costatis & Medeastinem - The Whole substance was approaching the consistence of the liver & no vestyes of [crossed out] Vessels to be formd - In the Cavity was formd effused about ℔ iij of a Serous fluid - The Abdomen was opend & the Stomach shewd a very singular Appearance it did not appears to be of more than one third of its natural seize its coats considering thickend, of a white colour & very much the Appearance of a tendon - The Intestines partook of this same diminution - 355 The Mensentery displayed all its glands very much enlarged - & the Liver has some schirrous tuberculous enlargements throughout its surface - The patient as healed by her Physicians as labouring under visceral Obstruction connected with Crthysical disposition - Mr. M. D. 1792 - Anno - Dissection of - killed in a fracas - Œtatis - 38 - I was called in haste to see a Man a few Minutes after he received a blow while engaged in fight - I found him lying on his back, his pulse & respiration had ceased & nothing but Vital Warmth remaining - On examing the Body found no Marks of Violence or the head or any other part - but the Abdomen appeard filld with a fluid - at the request of the Jury of Inquest I opend the body in their presence - no Injury was found done to the head the Thoracic Viscera were all sound but on opening the Abdomen it was filled with blood which being carefully evacuated the Cause of the sudden destruction of life was found to be produced by a considerable laceration of the internal concave 356 surface of the Spleen & a division of the splenic Artery - In this patient the spleen had been considerably enlarged as appears often in consequence of Intermittent fevers - it Adhered firmly to the Diaphragm & peritoneum & the stomach was very considerably distended with its contents - The blow was inflicted with Violence by the foot of the Assailant immediately on the region of the Spleen, its Ahehesions, its enlargement, & the distension of the Stomach, prevented its yieldings sufficiently & the Consequence was a triangular lacuation on the concave surface where the splenic Artery enters the Substance - Mr - M. D 1793 - Anno - Mange Jany - Dissections of a negroe Boy Œatis 15 killed by the bursting of a pesloe Barmea & receiving a Wound in the forehead - I was called a few Minutes after the Accident & found the patient lying motionless on the Ground - respiration slow - pulse very languid & very slow - On Examination I found a Wound inflicted on the protuberance of the frontal bone; part of which was torn away, the Brains protruding & much mangled On Examination with my finger I extracted several splinters of the bone that were driven into the brain - there was a considerable Hours a large from the Arteria dura Matris - On proceeding to lay the bone Bare I discovered a considerable stellated fracture [extending?] into the parietal Bone but no depression - The patients pulse were weak & from the nature of the Wound I did not think it necessary to attempt my thing called Dr J. M. who agreed with me in opinion - The patient lived 48 Hours after the Accident. The Symptoms during this time were for the fresh day 357 perfect Insensibility, absence of all motion, low weak & slow pulse, respiration very quiet & slow - on the close of the second day - the pulse mounted, the surface became Warm & respiration sonorous way symptom of fever - After Death I opend the head in the presume of Mr Wm. Murray pracr. of physic & the Students of Medicine collected - on removing the Cranium I found [crossed out] [crossed out] an irregular jagged to be in the frontal Bone with two fractures extending across the corronal Lecture some distance into the parietal Bone - (This patient had been subjects to Epilepsy; & I remarked on removing the Scalp an uncommon Appearance in the form of the Cranium, on the right like at the Subuia squamosa there was a very considerable indentation for about the circumference of a crown piece - On the left side the bones exhibited no peculiarities Queue? Could this inequality of pressure not have had some effect in distending the proper exercise of the functions of the Brain & be a cause of Epilepsia from peculiar organization? ) - The Membranes exhibited the usual Marks of slype Inflammation & there was a considerable effusion of coagulatd blood on the Surface of the Brain - On removing the flax Dura Matris and separating the two Hemisphere &C - The Corpus Callosum was observed to be perforated as well as the Centrum Ovale & beneath than a quantity of grumous & sanious Matter; on carefully removing this, lodged on the Clinoid processes of the sphenordal bone, directly in the Sella Turciae was found a piece of the Barrell of the pistol described by the Lines below - [illustration] which had penetrated [illustration] through the right [illustration] Hemisphere making a hold that would adenit of three fingers - What appears 358 curious in this Case is that life should be continued for 48 Hours after so great an Injury was done this important Organ - Mr. M D. nyroe James Œt - 45 - With Sceotae Hernia - Anno 790 Symptoms - pain in the right Side extending to the Shoulder - Slight Conge & fever Complaint supposed at fist from superficial examinations Cataul - V. S. paging Sects & Anod Sudorif pice - Manl 18th - The next Visri four or five days after pain contains, pulse small, jaundice, - on examination, the Liver formd evidently Framed - Capiat - Cal. gr. iij. Mane & Vespere & applur Emp [illegible] Sat - Ptyalism exerted & Continued - The Liver increases, pulse quiet & Small, no appearance of fluctiation - Tumor points toally in the Epigastric region - patient declines gradually death ensues - April - 30 Dissection in presence of the pupils - on openig the Cavity of the abdomen, the Liver presented itself fieldig the whole right Hypochendium, Epigastric region & great part of the left Hypochend - A Large Tumor parting directly under the Cartilage Ensiformis - or openig this Tumor it was formed filled with a 359 brown Matter of the consistence of Curds - Several smaller Motions of the nature were discoverd both on the Cornea & concave surface of the Liver - The Liver as was mentioned before was of an enormous size & very tender, slicing it in those parts least diseased the posi biliarii were discoverd full of a their greenish colord fluid - The Gall bladder & ducts almost obliterated resembling a flat Ligament - The Spleen was uncommonly small & pushed more one of its situation by the mereane of the Liver - The Stomach was not more than two fingers breath & had two holes digested through it; the circumference of each of which were black & exuded an inky liquor - This patient from his Account had her attacked with an inflammation of the Liver 15 years before which terminated in suppuration & was discharded by the Bowels - Mr. M. D. Doctor Horatio Belt - a Man of middle Age, fair Complexion & Hair & strong natural constitution Anno 1790 Was attacked in the beginning of the Month of February when in high health after a short side, suddenly with great dyspnœa & as he thought unattended with from or considerable pain - Under the Own direction & with the advice of an eminent Medical fuised at Batte- his complaints are treated as asthmatic he occasionally had pain in his breast, without much pain fever Cough or bloody expectoration - About the 10th. of May he came to Annapolis Symptoms - Dyspnœa, small oppressed pulse, swolen legs. pale Lips, interupted sleep, & scarily of Urine - His disease was conceived Hydrothorax & diuretics were administerd - on 16th. of May early in the Morning was seized with Vitriol [with?] pain in the side, Cough, bloody expectoration & pulse continued quick & oppressed with without feverish heat - Supposing inflammation present he was bled took tribe & Caloml & Nitre & squills; 1 ft. - the Sensorium became affected he talked when left alone incoherently, those Symptoms gradually increased, no feverish heat was 360 discoverd, Cough returns but seldom, He was bled six times in this Week always expressing relief to his Symptoms & was repeatedly blistered 26th. The Sensorium becomes more affected betters continually inarticulate sounds, cannot lay down countenance darkens & dies as from impoded correlation on 28th. of May - Dissection in presence of Dr Murray & the pericardium were turgid & this Bad found to contain about 3 or 4 ozs of Water, the Heart free from fat & the coronary Arteries & Veins uncommonly distended, the Anterior Auricle Times venosus preternaturally full - The left Cavity of the Thorax contained perhaps a quart of a yellow serous fluid - The Lungs the left Lobes were found ahering firmly to the pleura costalis, Diaphragm & pericardium they were in colour & firmness resembling the Liver & except inthe Superior part of the large lobe no appearance of Air Vessels could be discard. Where the adhesions were separated they exhibited almost the appearance of muscular fibre - The Lobes were found ahering firmly together - In the right Cavity was discovered but a small quantity of fluid & the Lungs tho they appeard of a dash colour & had many months of effused Blood, ut had not that firm texture nor where any ahesions discoverable. - 361 Emanuel a Strong Athletic Mulatto Man aged 45 - Anno 1796 Complained of considerable paid about the orifice of the Stomach, much increased on every effort to swallow & caplained it as if some dry substance was lodged there; he thought it might be a fist bone but had not eat fist for a fortnight, no fever pulse strong - Was bleed copiously directed to drink vinegar & Water - the next morning had puked some blood - had a dose of Sacts & directed to drink freely of cold Water - From the Operation of the Salts discharged a considerable quantity of pure florid blood by stool, in the Evening puked blood which continued in large quantity till 12 at Night when he died - Dissection - on Opening the Cavity of the abdomen found all the Viscera in a most healthful state, the Stomach was filled with a fluid & on examination of the Œsophagus for some distance up could perceive no injury - I passed a ligature round the upper & lower orifice of the Stomach & removed it on Opening the Stomach found it filled with fluid Blood - & a small crimson spot about the size of a six pence with the Internal coats of the Stomach corroded in the Center of it, this injury was within an inch of the Cardia - The Stomach in every other parts appeard sound & healthfull J. T. Shaaff Shaaff (John Thos.) MS B 51 corroded in the Center of it, this injury was within an inch of the Cardia - The Stomach in every other parts appeard sound & healthfull J. T. Shaaff Shaaff (John Thos.) MS B 51          Gregory. National Library of Medicine Bethesda, MD Condition On Receipt: All that remained of the binding was the extremely dirty and worn leather wrapper had been crudely attached to the spine fragments. The sewing was loose, and several of the pages were detached from the text block. The pages were torn, dirty, discolored, acidic, weak and brittle, particularly at the edges. The manuscript ink present was acidic and varied in intensity. Treatment: The volume was collated and disbound. The inks were tested for solubility. The pages were dry cleaned and washed and then buffered (deacidified) with magnesium bicarbonate solution. Tears were mended and folds guarded where necessary with Japanese paper and rice starch paste. The volume was sewn on linen tapes with linen thread. Windsor handmade paper ends with a linen hinge were attached. The volume was case bound in full cloth. Title information and lines were stamped in gold foil onto the spine. Northeast Document Conservation Center April 1986 SO: SO/JN/MW