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Capt Campbell aged 58 years, naturally of a very firm Robust
Constitution and in the former part of Life enjoyed a very good state
of Health, But by using too much freedom with his Constitution in the
Prime of Life, & by several severe and repeated Attacks of the
Gout which seized him first at 23 years of age, his Constitution is very
much shattered, and his Health so much impaired, that for these 9
or 10 years past he has been in a very Infirm and Valetudinary state
About 9 years ago was Confined for six months to Bed by a violent
fitt of the Gout which so enfeebled his feet and Legs, that he has not been
able to walk without the help of crutches or a staff since - And that
weakness has been encreased since considerably by two other fitts, by
each of which he was Confined for 5 or 6 months, besides lesser attacks
But this Disorder has been mostly confined to his feet, only sometimes
had little Touches of it in his stomach, and once in his head, in the
latter it occasioned no great Pain, but vast Confusion and Giddyness
and was releived he remembers by taking a Castor Bolus, in the former
it only once occasiond much Pain, which he recollects was a throbing
fluttering sensation - and gave him two or three very severe twit¬
ches , and was Imediatly removed by taking a Couple of Bumpers of
strong spirrets - at other times when it seized his stomach it only
occasioned an uneasie sensation with Loathing, squeamishness &
frequently a Vomiting - all which he has been extreamly subject to
for these 6 or 7 years past, in so much as to make him in capable
for Days together to take a bitt of Victuals, or even bear the sight or
smell of them, and when laid up could take nothing Considerable
for weeks & even months together, except wine, and other strong Liquors
of all sorts of which he always took a great quantity and which at those times
were his only sustenance, But even in his better Intervalls he al¬
ways took a great Deal of spiritous Liquors - for being much given
to Company and mutch in the way of it, he had contracted such
a habit, there was no doing without it - and often on such Occasions
he even carried it to Excess, which though he could not be perswaded
of it always hurt his stomach so much, that for weeks afterward
his appetite / bad at best / would be greatly worse, But barring these
Affections of his stomach viz that Loathing and squeamishness
which he had always in more or less degree, and sometimes a vom¬
ting - and sometimes a loosness with Grinding Pains which would
last for a Day, he otherwise enjoyed pretty tolerable health, as good
as Could be expected from so decayed a Constitution at his years
and when this weather Permitted used frequently to ride out
which he found of service - He Continued in this manner since
may 1770 when he recovered from the last violent fitt of the
Gout, by which he had been Confined for some Months

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till about the first of september last, after a hard fitt of Drinking
he was put to to Bed very much Intoxicate about three or 4 in the
morning, and by some accident slipt out of Bed over night, upon the
floor of a Low Room, where he sleept for some time, he does not know
how long, mostly naked, whereby he Catched Cold, and next Day he
Complained very much of his stomach, and on that, and for several
succeeding Days vomited a vast quantity of Ropy Bilious {illeg} (↑Phlegm↑)
But as he had been often subject to such Complaints on Catching
Cold, thought nothing of it - but that as usual it would go off in
a few Days, and as he had always an aversion to medicine did not
think of making application, or taking any thing for it - &
though I saw him in this Condition, and should have thought a
vomit proper to free his stomach from this Load of stuff it
seemed overcharged with, as I knew his Disposition and how
he stood affected to medicine I did not recommend it, only
desired him to drink a little warm water that he might throw
up the easier - which he declined, saying he thought he had thrown
up enough without it - Accordingly, after Continuing frequent for a
few Days the vomiting abated & gradually went off, so that he
was pretty well though not quite recovered, till the night of the
[Start of margin text]september 18th[End of margin text] 18th thereafter - After drinking a pretty hearty Glass that Day
after Dinner he went early to bed, and after sleeping sound
for some hours waked pretty easie and Drank a Tumbler
of Punch - and in a little afterward appeared more Chearfull
than usual & Inclinable to speak much - And all night afterward
rested very little , and being very thirsty toward morning, Drank
[Start of margin text]19th[End of margin text] a large draught of Cold water which he never used to take before
without having it quallified with wine or some spiritous Liquor
And was soon after seized with a violent vomiting which continued
all Day Incessant, throwing up every thing he took, even the
wine & water which he took for Drink did not rest a moment on his
stomach, when I saw him about 10 A:M: he had vomited up a
Great Deal of Bilious stuff - was much fatigued, Complaind of
his head being Pained, and had slight wanderings, but always
quite sensible when spoke to - had much sickness at stomach
Pulse small and quick, All which I thought might proceed from
the fatigue of vomiting & want of Rest - and with a view to rest¬
rain the vomiting & procure some Rest ordered the following
sedative Draught
He
vomited the first in about half an hour, then took the other
Portion which he vomited in a few minutes, when I ordered a
mixture of the same kind with some Tincture of saffron / with¬
out the Liquid Laudanum / in order ↑to↑ promote a Diaphoresis, But on vomiting
the first spoonfull Imediatly - took no more of it -

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as I Imagined the vomiting might proceed from a fitt of the Gout
in his stomach, (which might probably have been Induced from by
Drinking the Cold water) as it used to produce the like Effects
there, though never in so violent a Degree, I ordered the followng
Cordial mixd - as he had treid wine & spirits already of his own
accord in order to drive it off, but with out Effect, always vomi¬
ting them Imediatly which he took a large spoonfull about 8 PM which he retain,d
about two hours and on taking the next spoonfull threw
it up Imidiatly ---- --- -- - -- - - ------

[Start of margin text]20th[End of margin text] Rested none all night - vomiting not so frequent, but still
Continues, sickness at stomach the same, head more pained
and very Confused, thirst greater, Pulse low, about 90 in the
minute - Complains of flying Pains through his Breast &
shoulders - which encreased toward night and suddenly fixed in his
right breast - but was removed in a little by applying a little
Ether - when it fixed in the shoulder over the scapula where
it remained for a little and then went off, only returning by fitts
on the Least motion, as it appeared a flying Rheum of the spas¬
madic kind and mostly externally, the Part affected feeling sore
to the touch, had it rubbed frequently with the following anodyne
Balsam

which always
eased it Considerably - having Rested none since night before
last & but little then, gave him thirty drops of Liquid Laudanum at bedtime which having no Effect
in two hours took 15 drops more which procured a good Deal of Rest -
and a Profuse sweat ----

[Start of margin text]21[End of margin text] Symptoms much relieved in all respects, till toward evening
when he became more feverish and very restless, and at his own
Desire had the LL repeated- thirty drops - being Costive these two Days
and refusing to take an Injection gave him one ounce of sacred Tincture
at bedtime -

[Start of margin text]22[End of margin text] Sleept a good Deal toward morning and as yesterday greatly
easier, the Tincture having no Effect took half an ounce more at 10. A.M.
which having no Effect and all the symptoms encreasing - with the
stitches more severe, with a stuffing & fulness of Breast & dificulty
of Breathing prevailed on him to take an injection about 4
Pitt which he returned in an hour without any natural Excrement
But in an hour more had a natural stool, but not much releiv,d
by it - Complains of much thirst , ordered the following saline
mixture

which greatly moderates his thirst - as he
Inclines to slumber gave him no opiate

[Start of margin text]23[End of margin text] Sleep,t some last night but not much refreshed by it nor the
symptoms any thing releived stitch & Breathlesness

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[Start of margin text]23 d[End of margin text] very troublesome at times, so much that he was obliged
to have the Door & Windows keept open for Releif - by which
has catched a little Cold, and got a short tickling Cough
Dozes & slumbers much - Continued the saline mixture
and for Releiving the Cough order,d some Ammoniac Julep
the second spoonfull
vomited him - took no more of it - had three loose stools
to Day, thirst abated - Pulse the same - as the stitch
to Day has been fixed in the shoulder apply,d a Blister to the
part affected -

[Start of margin text]24th[End of margin text] Rested little all night - sickness a little abated toward morn¬
ning - Cough troublesome - had 2 stools over night, being oblig d
to go abroad, ordered him some of the following Pectoral ano¬
dyne mixture

but on my return at Night
found he had taken none of it - And all the symptoms
worse, but the stitch which was removed by the Application of
the Blister - being very Restless toward night gave the
following anodyne Draught, (as I thought the Liquid Laudanum heated him
a little) - but having
no Effect about 2 in the morning, took twenty drops of Liquid Laudanum which procured
him some Rest by which he was sensibly refreshed ---

[Start of margin text]25[End of margin text] Complained of a stitch in the small of his Back & over
the short Ribs & haunch of the right side, which was releived by
rubbing some of the above anodyne Balsam to the parts
affected - all the other symptoms rather better, Pulse not
so quick and more full & easie - Breathing easier - till
toward night, when he vomited twice - became very sick
& Restless , Pulse quick & Intermitting - took at Bedtime Liquid Laudanum
thirty drops in 2 ozs of the anodyne Pectoral Mixture -

[Start of margin text]26th[End of margin text] Rested some toward morning, and is greatly releived by it -
Pulse Regular & pretty Calm above 70 - as his fever had so
fair & Regular Intermissions would have gladly tried the
Cortex - but Could not prevail on him to take it - and un¬
knowing to him got him to take twice of a pretty strong
Decoction of it, but on taking the second Glass of it, the
taste proved so disagreeable, was obliged to give it up

[Start of margin text]27th[End of margin text] slept a great Deal over Night but not much refreshed by
it - Complains of great Depression & Lowness of spirits for
which took frequently a little Cinnamon water , which at Last
proved Loathsome to him - very restless toward

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[Start of margin text]27-[End of margin text] Night, took the anodyne & Draught at Bedtime ---
[Start of margin text]28th[End of margin text] Rested better last night, and to Day all the symptoms releived
[Start of margin text]30th[End of margin text] Much the same these two Days - took the opiate at Night, which gave
him some Rest - But rested Ill last night, and to Day worse
In all respects - vomiting, and stitches return oftener - (Pulse
regular and pretty Calm)- slumbers and sleeps much -
[Start of margin text] Octr 1st[End of margin text] Much as yesterday very Low & slumbers much except when
disturbed by the Cough which is pretty troublesome to Day
opiate omitted last night - for the releif of the Cough took the following
Pectoral mixture - opiate omitted ---

[Start of margin text]2d[End of margin text] Rested little over Night and this Morning vomited the
mixture about half an hour after taking it - and with it a great
quantity of Bile which gave some Releif - But still Complains of
of a Load & unneasiness at stomach - and Inclinable to vomit
more, for which took at 10 A:M: five drachms of Ipecacuanha Tincture which vomited him 3
or 4 times, and brought off a great quantity of Bile - which gave some
releif - After Drinking the wine & water for some Days, he be¬
came Loathsome and since that drinks very weak rum
Punch - Cough & stitches somewhat abated ----------

[Start of margin text]8[End of margin text] since the 2d has been much after the same way - stitches &
vomiting troublesome by turns - and when long Restless
took at Night six ounces of syrup De Mecon in aq Cinnam ℥i which always
procured pretty quiet Rest - for some Days has taken a little
Chicken Broth - these 2 Days has been Costive for which took
an Injection which had the Desired Effect - Pulse for these few
Days variable - but never very quick - and pretty regular --

[Start of margin text]9[End of margin text] Sleept some in the fore part of the Night but restless toward
morning - vomited twice & very uneasie at stomach -
Observed through the whole Course of the Disease, that his
skin & the white of his Eyes appeared tinged of a yellowish
Colour- with high Coloured urine - from which I should have
suspected some Degree of Jaundice - But as he has been
for some years past of a tawny Olive Colour, and his Eyes
likewise remarkably so - thought it might be only rendered
more Conspicuous by his being reduced by the Disease
especially as he all along vomited so much Bile - and
sometimes voided it by stool, and was generally rather loose
in his Belly - not very Common attendants of Jaundice
(New indeed to me), But the yellowness is now so much ad¬
vanced and so general, his urine high Coloured tinging a
Rag of a Deep yellow or rather arnetto Colour - that I'm
Convinced there must be a Partial obstruction of

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[Start of margin text]9th[End of margin text] some of the Biliary Ducts , or perhaps of the Cystic Duct -
for which he had the vomit repeated the six drachms of the Ipecacuanha Tincture which vomited
him five or 6 times, discharged a good Deal of Bile &
tough Phlegm and had two Loose stools -

[Start of margin text]10th[End of margin text] was pretty easie last night, but slept little - vomited twice
and had a stool toward morning - proposed he should take
some mild laxative Pills,

one or two
to be taken evening and morning as his stomach will
allow - not daring to venture on any thing more Power¬
full his stomach being so very Irritable - but Could not
prevail on him to take them - as he has for some time
Loathed the Punch he now Drinks weak wine & water

[Start of margin text]11[End of margin text] Rested some till 12 afterward restless, vomited twice
Bile, & purged once - otherwise rather easier - But breath¬
ing difficult by turns --

[Start of margin text]12[End of margin text] Breathing easier, rested some over night, took one of
the Pills - with some Porrage & ale at Bedtime ---

[Start of margin text]19[End of margin text] No Alteration since the 12th has taken the Pills since
at the rate of one or two at night & one in the morning
which procured two or three stools Dayly - Continued
to take a little Porrage and Ale once or twice Dayly and
sometimes a little weak Chicken soop by which he has re¬
covered a little more strength - but still very weak &
much reduced - his Colour seems rather Cleared - but
still contineus to vomit frequently - and vomiting
generally Bilious - & stomach generally squeamish -
Pills Continued --

[Start of margin text] 25[End of margin text] since the 19th Continues much the same colour rather
better - but very little - with a view to strengthen his
stomach and render the Pills more Efficatious - added
to each Dram of the Pills one drachm of sal Martis to make a Mass and form twelve single one drachm pills, Take two morning and night and at the same time
proposed some antisteric Bitters -

but could
not be prevailed on to taste them -

[Start of margin text]30th[End of margin text] since the 25th much the same has taken ten of the
Pills only which have not kept his belly so regular or
Loose as those without the --------------------------------

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[Start of margin text]30[End of margin text] salt of steel - And last night has been violently purged
and vomited all Night, which he ascribes to his having
taken 6 of the Pills without Effect at the rate of
2 morning and evening: what he vomited was of a Dark Brown
yellowish stuff - and very bitter and Ill tasted ---
And what he purged had was of the same Colour ---
Both purging & vomiting went off toward morning but
is vastly tired & fatigued and sleeped much all Day --

[Start of margin text]Nov 3d[End of margin text] Has taken no Pills or any thing this two Days, Continues
rather easier than before the last fitt of vomiting ---
And now begins the Pills as at first without the sal Martis -

[Start of margin text]8[End of margin text] In all the same since the third - has took the Pills at the
rate of three at night and two in the morning which gave
two or three stools Dayly, Colour for some time the
same - Pills Continued

[Start of margin text]12[End of margin text] having been abroad since the 8th found him on my
return to Night very unneasie - having been much
troubled with vomiting these 4 Days & these 2 last Days was
also much purged and griped - by which means he discharg,d
a good quantity of Bile upwards and downards --
and his Eyes rather more yellow ----------------

[Start of margin text]13[End of margin text] Pretty easie & Rested a great Deal through night, stomach not
so squeamish as usual --------------------

[Start of margin text]14[End of margin text] Much the same till toward night, when he became very
uneasie, vomited thrice, some tough Phlegm mixed with bile

[Start of margin text]15[End of margin text] Continued very uneasie for the forepart of the Night, but slept
some toward morning - and this morning is pretty easie
Colour these two Days, rather Better & the white of the Eye
more Clear - His urine is always high Coloured, But some¬
times not so high, as with others during the sick fitts - and
sometimes let,s fall a very Copious Lateritious sediment
at others none at all -- the Rhubarb he takes in the Pills
makes no sensible Change on the Colour of his urine - being
the same these three Days, although he has taken no
Pills - but being rather Costive yesterday - took a Pill this
morning - to be repeated - so as to keep his belly open -
as they agree very well with him - and indeed I believe it is the
only form, in which he can be got to take medicine, in such quantity
as to be of any service - His stomach being so very delicate
and his taste so particular that he Loaths almost at

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every thing - Can bear nothing Bitter, or sweet, and though
[Start of margin text]15th[End of margin text] formerly he was so used to strong Liquors, and Indeed cared
for no other sort - he must now have three or four waters
to small white wine - But except for a few hours last
night, says he perceives, his stomach easier ↑these three Days↑ than since
[the?] day - and has some little appetite - yesterday drank
two dishes of tea & eat some Bread & Butter, which he thought
did not agree with him - and to Day has taken some
Porrage & ale - which is almost the only food agrees with
him hitertho, tried sago soop, but did not like it --