Diseases Age, Occupation, Treat: & Remedies.
[illegible] zi
Aq Rosa zfs
c


Hospital Cases. Medical.
Wed Oct 3rd 1849
Case 1st
A man who had contracted a fever on the coast of Africa
in which all the crew with the exception of himself and captain
died.
Main points.
On percussion the spleen was found diseased
the dull and flat sound extending up as far the 4th rib and
as low as the 8th dorsal vertebra.
Treatment.
Case 2nd
Dysentery.
Main points.
Face pale, and anaemic.
Case 3rd 
Chronic Pleurisy.
main points
Right side enormously distended
both behind and before. Percussion dull from the beginning
to the end of the lung i.e. from the apex to the lower part.
Anemic;
Treatment. 
Blister. This to be changed as to its location 
before or behind
Remarks. This patient was very anemic, and this condition was 
a counterindication against bleeding. The distension was caused 



by a serous effusion.
Some pathological specimens were exhibited which were
rectum lower portion of the colon smaller [illegible]
nature of the stomach and a portion of the small intestines.
Rectum. and lower portion of the color.
numerous patches of
cicatrised ulcers.
Small intestines.
and enlarged
Duodenum.
Cicatrised patches of old ulcers
Stomach.
A portion of the coat almost 
transparent; owing to ulceration.
These specimens were from a patient


Surgical.
Wed Oct 3rd 1849
Case 1st
Granular lids.
main points.
anaemic in constitution.
Treatment.
Dropt about 5 drops of a 10 grs solution
of nitrate of solver into the eye.
Remarks.
The lids were very much infllamed and the 
vascular capillaries very much enlarged and distended.
The eye was very sensitive to the light.
Case 2nd
Granular lids.
main points.
There was nothing very striking
in this case. Except with regard to the causes. It was at
first thought by the surgeon to be a case of gonorrhoeal
opthalmia. But afterwards it was ascertained that 
the patient being afflicted with sore eyes washed them
in not only his own but others urine, and produced
granular lids.
Treatment.
30 gr solution of nitrate of silver.


Hospital Cases. Medical.
Sat Oct 6th
Case 1st
Typhoid fever
main points.
A very mild case. Tympanitis every slight 
every little prostration. mind rational coutenance florid. Tongue red
Treatment.
Spts. ammnia spts gallici vini. spts mindereri
Case 2nd
Thought to be incipient typhoid fever
main points.
Pneumonic rale. Percussion at the back
part of the chest flat. The symptoms were alltogether pneumonia.
Treatment.
Blister on the back part of the chest. 
below the scapula.
Pathology
1st Arteritis, of the aorta descendens 
in connection with a valvular disease of the heart.
Lungs
One congested the other almost normal.


Surgical.
Case 1st
Gonorrheal swelling of the knee [joint] of the left side
main points.
At this case Dr Fox made some remarks
upon the treatment of gonorrhoea. The urethra should
be syringed out first with cold water once or twice
before injecting it with liquor argenti nitratis. of this
solution one or two injections of the 10 grains solution is sufficient.
afterwards it is to be washed out with cold water
and the cold water injections to be frequently repeated.
Treatment.
Case 2nd
The following were the old cases of granular lids last time doing
well under the treatment.


Wed Oct 10th Hospital Cases. Medical
Case 1st
Pneumonia.
Main points.
The disease was in the upper portion 
of the lungs, both were affected but the right more than
the left as was shone by the greater resonance on that
side. The fore part of the chest below the clavicles was
the part percussed.
Treatment.
Blister and calomel
Case 2nd
Tubercle with chills.
main points.
Gargling sound, induration of the 
upper portion of the left lung.
Treatment
Case 3rd 
I do not recollect what Dr Gerhard said of this case
but there was an immense bulging of the back part
of the left side. The patient was shone to the class last
clinic, then his face was pale, it had now become ruddy.
Remarks Diseases of the heart may be divided into those whose tendency is to 
grow worse and those where there is no such tendency. In the former treatment
is absolutely necessary in the latter not so much so.


Surgical
Case 1st
Gun shot wound.
main points
The wound was caused by a musket ball.
Entered just below the right clavicle. It had no exit.
Treatment.
Cold applications.
Case 2nd
Gun shot wound
main points.
In this case the ball entered the
back part of the chest This was a little boy 
about 10 years of age
Treatment
Cold applications.
Case 3rd
Gun shot wound in calf of the leg. Dr Fox
introduced his finger into the wound but could not
detect any thing The aperture of exit was nearly opposite
to that of entrance.
Remarks.
There was no hemorrhage in either of these
wounds. Dr Fox remarked that seldom was there
any hemorrhage from these kind of wounds until after
the slough which forms had come away. This case was treated
in the same manner except that the wound was filled with a wad of lint 



Sat Oct 13th Hospital Cases. Medical
Case 1st
Typhoid fever.
main points.
16th day countenance had a yellowish 
red appearance. Subsultus. Tympanitis. Tongue dry and hard 
enlarged spleen.
Remarks
Typhoid occurs in pain at all seasons. but in this
country it is more frequent in the Sept and Oct.
It is not contagious. The brain and lungs are
very apt to be affected in this disease, as well as the intestines
which is the seat of the disease. There is always
diarrhoea or a tendency that way. There is generally 
delirium at night more or less never amounting
to much however. This symptom distinguishes it 
from typhus. The bladder should be examined every 
day. Pulse soft and compressible.
Treatment.
Tonics and stimulants.
Brandy. zviii a day
Aromatic. Spts. of ammia in preference to 
the carbonate. Wine whey. Beef tea as nourishment
blisters.
Venesetion and cupping At the former
part of the disease only ought general bleeding to be
adopted


Prognosis.
The flushed reddish yellow face was the best prognostic
symptom in this case
Hospital Cases. Surgical.
The brain and scull of a recent
autopsy were shown. The death was caused by a bullet
entering the left parietal bone, and after taking a
diagonal and downward course completely dividing
both sides of the brain, logged itself in the lower portion 
of the cranium.
Case 1st Case 3rd of the last clinic 
Patient a man 22 yrs old.
Mortification has set in at the aperture of
enterance of the ball. Dr Fox thinks he will have to lose
his limb, thinks this result owing to some important
vessels and parts being divided. The ball had a fractured 
the tibia and passed between that bone and the 
fibula, and came out about an inch below where 
it entered.
The patient looked very pale
The patient who during the summer
was brought in with a fracture and depression 
just above the supra-orbital ridge having
been kicked by a mule was shown and was 
doing very well.


Wed Oct 17th Hospital Cases. Medical.
Case 1st Typhoid Fever.
A man 45 yrs of age was previous to his entrance
in the hospital seized with chills which was
succeeded by an attack of typhoid fever.
main points.
Tongue moist and whitish.
A slight dose of oil caused a diarrhoea, sudamina
were observed upon the abdomen in great quantities
Remarks
In treating this disease, sometimes spts: vin: gall:
is too powerful a stimulus and wine whey is substituted.
Caution is to be observed with regard to opium 
injections in this disease. They are indicated in 
cases accompanied by severe diarrhoea.
Treatment.
Spts: mindereri
[foot] bash
wine whey
neutral mixture.
In this case a conditional bleeding was tired, the pulse
being large and full.
Pathology.’Dysentery.
Case 1st rectum, sigmoid flexure of the colon and
part of the lower portion of the ileum


Rectum.
Large ulcers one of which peirced under the 
mucous coat.
Colon.
Particles of lymph scattered here and there. Left
ulceration in the sigmoid flexure than in the rectum.
There was more however above in the ascending
colon. The mucous coat was of a bright red tint.
This intestine on the whole was the most diseased.
The part of the intestine occupied by the glands of [illegible]
was formed into ridges of lymph. these glands were
not at all affected showing a difference in the pathology
of this disease and typhoid fever.
Case 2nd
Rectum
Slightly diseased
Colon
Near the commencement of the transverse
colon was a large patch of inflammation.
Ileum (lower portion)
very red and inflamed, the [collour] was
almost of a lake collour. In this intestine
and the above patch were the most
prominent marks of the disease.
Remarks
From the above facts dysentery may be combined
with enteritis and colitis either singly or combined.



Treatment of dysentery in Penna Hospital.
Begin with laxatives. Castor oil or rhubarb with 
about xx grains of laudanum.
Ipecacuanha
To determine to the
surface.
Mercurials.
Poultices and topical bleeding.
Venesection ought seldom to be resorted to.
Acetate of lead is not much thought of in the Penna Hosp
in the treatment of this disease.


Surgical.
Case 1st
Amputation of the leg at the upper third the
tibia.
The disease was seated at the lower end of the
the result of a compound fracture. The foot was turned
almost at a right angle with the body
main points.
Flap operation cold applications to
the stump.


Sat Oct 20th Penna Hospital Medical.
Case 1st
Typhoid fever.
main points.
very mild, the only symptoms being
the sudamina and the tongue dry and coated, and
the characteristic hue of the face.
Case 2nd
Remittent fever.
main points.
Resembled typhoid fever very much.
Treatment.
Quinine.
Blue pil grs X
Rochelle salt zi
Pathology.
Typhoid fever.
main points. 
Glands of the [illegible] ulcerated. Large
red patches of inflammation in the mucous membrane
of the colon.
Enlarged spleen, 10 inches long and 40 [illegible] in breadth
left.


Surgical.
The man who received the ball in the calf of his
leg was thought strong enough to bear an operation
of amputation which was expected to day. He 
was not expected to live.
The black man who had his leg amputated
has suffered from haemorrhage. Dr Fox
ordered the charpie to be placed between the 
two flaps, and took up one or two small vessels.
This treatment checked the haemorrhage. Dr Fox here remarked
that this was the objection to flap amputations
the haemorrhage which always occurs from the
vessels being cut obliquely and therefore making a
larger orifice and from the fact, that vessels cut in 
this manner do not contract their orifices when 
cut.
Case 1st
A man who had been operated on for cataract
In the exhibition of this case the doctor took the opportunity
to speak of the diagnosis of cataract, depending
upon the catoptical experiment as a guide. This
is as follows. If a candle is placed before an eye affected
with cataract [those] images will be seen
one of which will be upside down the other two in 
their proper positions. Slightly affecting the mouth
with calomel is sufficient safe guard against inflammation.
Dr Fox remarked that in all cases of cataract 
he believed the retina more or less to be affected. In regard
to the condition of eye favourable to an operation, he remarked 



that the reason of so many failures in the restoration 
of sight after this operation was the fact that they 
were not operated on in the right time. No patient,
says he, should be operated upon if they cannot
distinguish darkness from light, day from night
Oct 24th Penna Hospital. Medical.
Case 1st
Hyperthrophy of the heart with dilatation.
main points.
The sound was flat from the nipple
to the sternum and beyond. There was epistaxis and 
haepnoptesis. Man 28 yrs old rather small stature. Pulsations
evident at the distance of six feet. Bellous sound
which increased to the rasping sound when the patient
walked or exerted himself.
Treatment.
This consist in case of lifting
heavy weights, absence of stimuli and tobacco.
Digitalis gtts X 3 times a day
biatart: potassae.
juniper berry (3 times a day)
The diseases of the heart are divided into organic and functional.
Case 2nd 
Congestion of the Heart.
main points
Lady 30 yrs of age. Had previously 
rheumatism, which disappeared when the heart became
affected. Dropsical effusions. Epistaxis and Haemoptesis.


Oct 27th Penna Hospital. Medical.
Case 1st
Dropsy.
main points.
Pallor of the skin. Oedema of the lower limbs 
when pressed with the indented mark remained a long
time after the finger was removed. Percussion clear to 
the level of the ribs.
Treatment.
Increase the strength with quinine
and iron as well as the other remedies.
Case 2nd
The man who contracted a fever on the coast of Africa
came before the class with ascites. Came into the hospital on the 1st Oct
was shown to the class on the third.


Oct 31st Hospital cases Medical
Case 1st
The man with dropsy and oedema of the lower
limbs, almost well under the quinine and iron.
Case 2nd
Acute Rheumatism.
Characteristic symptoms
Pulse strong and vigorous. Great tendency to perspire. Forcible
actions of the heart, bellows sound.
Remarks.
In these cases of rheumatism the heart is always
affected says Dr Gerhard; in this case there was endocarditis
The heart ought always to be examined when we are at
a doubt in diagnosis. When the joints are inflamed there
is effusion and fluctuation can be detected. Opium 
in substance or in tinct is sometimes applied to the joints
inflamed. Cups also may be applied. Blood was not much 
cupped in this case. When the attack is sudden it
generally lasts about 10 weeks.
Treatment
Venesection and purgatives.
vin: colchici zii
Calc: magnesia zi
Sulp: magnesia zfs


Case 3rd
Typhoid fever. 8th day.
Characteristic symptoms.
No sudamina or tympanitis, spleen unaffected, pulse frequent
and small.
Treatment.
Neutral mixture.
Pathology.
Peritonitis.
Liver
Right lobe hyperthophied left atrophied. Tubercles
Spleen
Tubercles on the surface only but not in the interior
Colon 
A mass of adhesion greyish collour
Small intestines.
Glands of [Peyer] and [Brunner] ulcerated
Stomach. 
An ulcer of large sise at the lower portion.


Nov Penna Hospital. Medical.
Case 1st
Acute rheumatism, with endocarditis and pericarditis.
Characteristics
Face pale, small stature. Friction sound over the region 
of the heart, dulness on percussion.
Treatment
Blister over the region and cups. Calomel
in alterative doses.
Remarks.
Palpitation and other diseases of the heart, generally 
occur in this disease in about three or four weeks after
it has set in. The friction sound along with dulness
upon percussion indicate the existance of pericarditis 
The natural sound of the heart may be explained 
by sounding with the mouth the words “[Lum-Tap]”
the first being long the last short. In a diseased
heart these two words cannot be distinguished
there is a confused intermingling of them thus
[illegible] [illegible] a lengthening out of the last
syllable.
Case 2nd
Tubercles in the upper lobe of the left lung.
Characteristics.
Boy about 15 yrs of age. Stout and apparently in good
health. Cheerful expression of countenance.


Remarks.
Dr Wood remarked, when this case was before him
the fact accounting for the deceptive tendency of this
disease. When tubercles are empty and purulent secretion 
going on there is great irritability but when the 
hollow in the tubercle becomes full, there is little or
no irritation and consequently the patient seems
to enjoy his ordinary health.
Treatment
Good cod liver oil.
Case 3rd
Pleurodynia.
Treatment.
Dovers powders
Calomel grs X
Vin: colchicum gtts XX.
Case 4th 
Chronic pleurisy
Characteristics.
Large swelling in the lower portion of the right side of 
the chest. Percussion exceedingly flat, resembling the 
sound of a board when struck.
Treatment.
Blisters, over the swelling.


case 5th
Palsy and parallysis originating in the spine.
Characteristics.
Patient unable to walk with crutches, and even
then with extreme difficulty.
Treatment.
Strychnia grs IV
Acetic acid zi 
Aqua font zi
Surgical
Case 1st
Wound in the hand from a pistol ball.
Characteristics.
The whole palm of the hand was more or less contused.
Poultice of flaxseed meal was applied to the hand 
and the hand firmly bandages to a splint.



Penna Hospital. Medical.
Case 1st
Typhoid or enteric fever.
Characteristics.
Second stage of the disease. Tongue red, dry, and marked
with small gashes. Stupor in a slight degree. Redness in the 
face. Puke full and compressible. Slight [illegible]
few red spots over the abdomen. Had slight epistaxis.
Treatment.
Oleum terebinth: gtts X in a gum arabic emulsion
every two hours and alternately a wine glass of sago as
thick as will well pour every 2 hours. Carb: ammia grs V
Case 2nd
Pthisis.
Cod liver oil.
Case 3rd 
Rheumatism.
Characteristics.
Swelling and fluctuation under the bursa mucosa of the
rist joint
Case 4th 
Dropsical effusion from intermittent fever.
Characteristics
Albuminous wine.
Treatment. 1st To prevent the return of intermittent [illegible]: pils grs V
Sulp: Quin: grs 2
4 times per day
2nd From the dropsical effusion.
Bitart: Potass: zi
Juniper berry tea pti
“To be well shaken, before taken”


Nov 7th Penna Hospital Medical
Case 1st
Typhoid case of last clinic
Characteristics
Tongue moist. More intelligent. Pulse stronger and more
natural
Case 2nd
Dropsy case from intermittent fever of last time
Characteristics
Oedema much less.
Case 3rd
Eczema
Characteristics.
Small eruption on the back of the hand. Not time for the Tar [illegible]
Treatment.
Gylcerine plaster with an occasional dose of
salts.
Case 4th
A young woman, who complained of general pain
over her body especialy in the stomach and heart.
The spine was examined by Dr Wood who detected
a sore spot about the middle of the dorsal region
to which he applied cupps and a blisters and the
patient was relieved.



Surgical
Case 1st
The man who was operated on for hydrocele was brought
in with his scrotum swelled up again
(Wed) Penna Hospital. Medical.
Case 1st
Typhoid case of last clinic
Characteristics.
Tongue moist, an apple, which he ate produced an
increase of the symptoms, which led to the supposition
of their being ulceration in the Peyer glands.
Treatment
Cal: gri
Ipecac gr1/8
opium gri
Not to allow salivation.
Case 2nd
Dropsy case of last clinic
Characteristics
swelling entirely gone, and the patient well
Treatment. 
Still takes the cream of tartar zi
juniper berry tea pti
Case 3rd 
Diseased mitral and semilunar valves of the left heart.
Characteristics.
The [Lum-Tap] not heard distinctly. Regurgitation 
heard over the aorta. Effusion within the pericardium.
Dulness upon percussion, over the arterial heart.
Has had the disease since he was 8 yrs old now 42 yrs of age



Wed) Surgical
Case 1st
Fungous growth around the anus caused
by rus radicans or common poison [illegible].
Treatment.
Application of nitric acid.
Case 2nd
A large ulcer upon the leg.
Treatment.
Nitrate of silver around the white border.
Penna Hospital Medical
Case 1st
A brain of one who had died of delirium tremens which
was found inflamed but not softened.
Case 2nd The old case of effusion into the cavity of the chest result of [pleuria]
Characteristics.
Shoulder elevated on the affected side
Flatness upon percussion high up the chest.



Case 4th Oedema of last clinic.
characteristics. 
legs much smaller. evacuations from the bowels
diminished from 16 or 17 per day to 7. Face thinner
Treatments
pil: carb: ferri. Quinine digitalis, squill.
Case 5th 
Dropsy from Intermittent Fever.
Treatment. pil: carb: ferri. cream of tartar. juniper berry 
tea.
(Sat) Penna Hospital Medical
case 1st
Phthisis.
Treatment cod liver zfs 3 times a day
Case 2nd phthisis with laryngitis
Treatment cod liver oil internally croton oil externaly
on the neck for the laryngitis
Case 3rd 
Typhoid Fever.
characteristics. 
Symptoms all in the first and mildest form 
Tongue moist and cracked. slight [meteonin].
Treatment.
Neut: mixture zfs three times a day
Case 4th 
Typhoid Fever
Characteristics. Tongue beginning to leave in the middle. Rose colloured spts
[illegible] [illegible]
Treatment. neut: mixt: if there is debility in the evening. wine whey and [illegible] if the tongue 
becomes dry


Case 5th 
Species of chorea.
Characteristics
Shaking of the head. Contortion of the features.
Muttering of disjointed words.
Treatment
Wine glass of the decoction of snake root four times a day
Case 6th 
Eczema eruption on the face of last clinic with amenorrhea.
much less
Treatment carb: potassa. and the local application of glycerine
Aloe. Tinct: of cantharides for the amernorrhea and tart: em: in nauseating
doses.
Case 7th 
Tenia lata
characteristics.
plethoric. uneasiness and pain in the bowels. irregular appetite
obstinate case.
Treatment.
Oleum Terebinth: zfs to a wine glass three times a day.
Penna Hospital Medical
Care 1st
Convalescence from typhoid fever.
Characteristics.
Abdomen tympanitic, tongue dry or disposed to be so
Treatment.
[illegible] arrow root and milk.
oil of turpentine gtts X
Case 2nd 
Pleurisy with effusion (the old case of [last] clinics)



characteristics.
Becoming resonant at the upper part of the cheek
Treatment.
Cal
Case [illegible]
Inflammation of the Pylorus.
Characteristics
Soreness and tenderness upon pressure over the pylorus
complained of vomiting a hot watery fluid.
Treatment
Nitratis arg: gr ¼ three times per day
Surgery.
A man who a week since was struck on the head by the butt of
a gun and had his scull fractured; and who was brought 
before the class at the last clinic, has since died and in 
the right lobe of the brain was found a large abscess from ½ inch
in dept and from 1 ½ wide and 2 ½ inches long before death 
the right side became parylitic
Sat. Penna Hospital
Case 1st
Typhoid Fever.
Characteristics
Tongue dry, [Sordes], abdomen tympanitic
pulse frequent
Treatment.
Neut. mixture. Sago gruel wine glass
every two hours. also the blue pill for the dried state 
of the tongue.



Case 2nd
Chronic gastritis.
Characteristics.
vomiting after meals, constriction 
and pain at the abdomen. Tenderness over the pylorus.
Treatment.
Nitrate of silver ¼ gr with 1/8 gr opium 3 times
a day with Colombo senna and ginger for the
dyspepsia symptoms.
Case 3rd
Asthma.
Characteristics.
Paroxysmal coughs.
Treat.
Tinct of lobelia zi
Syrup of seneka zi
Syrup of squill zi
Case 4th 
Paraplegia.
Characteristics.
A very bad case. the patient unable even to use crutches.
Treatment.
Strychnine 1/12 grain
Case 5th 
Chorea of the muscles of the face with muttering
of unconnected words.
Treatment
Cimicifuga an occasional purge
and constant blisters to the spine 


Feb 6th 1850 Penna Hospital Medical
Case 1st
Impacted foeces in the commencement of the
colon.
Characteristics
Hard, and well defined swelling in the right illiac fossa
Treatment.
Castor oil internally and a flaxseed 
poultice externally intends using the iodine oint
Case 2nd
Inflammation of the liver and duodenum
characteristics
Jaundice, very anemic insomuch as not to allow
abstraction of blood. Tongue black
Treatment
Blue mass gri
opium gr 1/12
every 2 hours
wine whey as nourishment
Case 3rd
Acute rheumatism
Treatment 
Dov: powd: grs V
cal gr i
every 4 hours



“Nature, and disease debate it at their leisure”
Cases recorded in the Philadelphia Almshouse
Case 1st Typhoid fever. Died. June 1st 1850
Wednesday June 19th
Respiration hurried. Pulse compressible
tongue dry. has had 12 cups ordered over the breast
“ “ 20th 
Respiration easier. Tongue dry in the middle
but moist at the edges.
Cases 2nd Diabetes Died
June 28th
Tongue clammy. Pulse small and
weak. complains of a pain in the bones of his legs (one, 
the left there is a slight roughness indicating
the existance of nodes?) Has passed about two gallons
during the night.
Treatments
Beef diet N.B. the rest of the treatment
I have lost by inattention
July 5th
For the last two or three days 
his mind has been torpid, and inactive
“ 5th
Has been up 2 in the night. Pulse rather
fuller. Has a blister over the epigastrium
“ 8th Still weak. Taking spts: vin: gal zii
“ 9th Extremities cold. Tongue cold and white.
“ 11th Extremities continue cold. Pulse very feeble
13th Has had diarrhoea in the night.
15th Pulse weak and small, passes involuntarily [illegible]


Case 3rd
Pneumonia suceeding mania a potu.
June 28th
The mania a potu was slight. The chief features 
of this case was the pneumonia that suceeded
pulse small, and weak; Drs Benton and [?ard]
distinguished crepitation on the right side in the
upper portion of the lung. Tongue a creamy white.
still complains of pain in his chest.
Treat
Has had a blister on since yesterday.
blood from his bowel with 
tenderness, and pain in the bowels to a 
great degree.
17th 
Pulse feeble, and weak. skin cold.
18th Pulse feeble.



Case of Gastritis (chronic)
July 6th
A young and interesting looking german, about
of age of a neuro sanguineous temperament.
Fatigue very red at the tip and in the places
where the thick sordes which covers it elsewhere
has been removed.
July 8th much better. Tongue cleaning off beautifuly
“ 9th Getting along well
“ 16th Tongue still red at [illegible] and covered with a brown
thick coat
13th 
15th almost well. tongue still too red.
16th


Case 4th
Secondary syphilis
James Collum [illegible] in June
all over from head to foot resembling spotted
varioloid so thick were the spots. They were
thickest around the [illegible] and elbows
accompanied by pains in his bones. Taking the
hydriodate of potassa and bicholride of mercury
July 5th 
Continuing the [biniodide] of mercury?
The spots fading rapidly. Take
[Biniodide] in the foll Rx
way
Iodide potassa zi
Bichloride of Merc gri
Aqua zviii
Siz zfs three times a day 
July 8th About as usual gradually gettes better.
“ 11th Continuing to improve
“ 15th Much better.
17th The spots facing rapidly
20th Gradualy regaining a normal appearance
31st Still in the wards, slowly getting rid of the eruption 
Aug 5th Still under my care


Effects of cod liver oil.
July 6th 
Young irishman, has had incip phthisis and
has been relieved; determine to put him on cod
liver oil this morning and watch its effects.
July 8th Has expectorated during the night blood and 
rusty colloured sputa.
July 9th Pulse large and strong. still expectorating 
pneumonic expectoration.
July 20th 
Says he is better. Treatment the same as on 
the preceeding days. being cod liver oil
and expectorant.
Aug 6th Found him to day in bed
Aug 8th Has a disposition to be in bed all day 
although seemingly better.
Aug 14th 
No blood in the cup, little [illegible]
Sept 3rd 
Has been complaining of an intense
pain in the right hypnochondriac region


Case Jaundice from a distended gall bladder
June 19
William Lucy aged
“ 19th 
A swelling the sise of an ordinary potato
in the region of the caput coli (gall bladder)
“ 20th 
“ has taken a purgative and is much better
the swelling less and not so hard.
July 6th 
Walking about and beginning to regain 
his usual colour of skin
“ 8th Still has yellow skin.
“ 9th Still in the wards, but not complaining.
“ 11th Still in the wards, and improving
“ 13th Still in the ward, but the yellowness of skin 
has nearly entirely disappeared excepting that
in the conjunctiva
15th Still improving regaining his natural
collour still yellowness of the conjunctiva 
reach underneath the tongue
16th Improving.
19th Almost well. He is natural collour not altogether
returned. The lump in his side which 
indicated, at the commencement of this attack, 
an enlarged gall bladder, has disappeared,
neither does he feel any pain upon 
pressure.


[Indian???]
Suicide. Cut throat. July 21st [1851] J. C. Elliott
July 21st Saw a man lying upon the floor of the Marion Co: jail
of Indianapolis, with his throat cut. Could make no 
satisfactory diagnosis, as he was not my patient and
did not therefore take the liberty of making the necessary
examination. But from a birds eye diagnosis I conclude
that neither carotids were cut, as it was a right
angled incision with the razor either above the
hyoid bone, or in the thyro-hyoidean space. I could 
say positively which, and such a cut would have to 
almost sever his head off before these vessels could be
reached. I saw him two hours after the act. The symptom
when I saw him are the following. Fixed determined expression 
of eye. Spasmodic gasping for breath. Colour of the
face natural. Intellect perfectly altered, could not talk but
wrote question & answers without trouble upon paper
Makes a shrill peculiar noise, with his efforts to speak or 
breathe. Pulse very feeble. I advised Dr Elliot to sew up ‘
around a trachea tube and if necessary and he
could swallow stimulate, as he was weak from loss of  
blood. He would not permit him to do any thing, until the next morning
at 9 ock. when Dr Kitchen put three stitches, leaving a 
space for the phlelm to run out. His physician diagnosed that the
larynx was completely severed, and the pharynx cut,
I did not think so, however my diagnosis may err. External jugular was not cut
July 23rd Has had afternoon fever, but slight. Pulse in the morning 80 soft, and regular
but in the evening, had, intermittent, 100 and quick. His great trouble is
an accumulation of phlegm, which is after an effort coughed up through the [illegible]
left in his wound. The deep part of his wound has a grummous appearance, a
dirty green colour which I think a little unfavourable. The idea is to heal by granulation.
Cold water, through a wet cloth laid over the wound consititutes the
treatment thus far, this seems to be pleasant to him. Injection & had an operation. Nutrition 


Case 6th General Dropsy
July 1st
Henry Boyle came into the wards, with the whole
of his body oedematous; some time ago says he had
intermittent fever. His tongue is white, and
moist. Put him on cream of tartar and cider mixture
“ 2nd 
About the same
“ 5th
Improved, penis, and scrotum not so large.
An irregular action of the heart detected. Tongue
white, moist pulse rather strong and of a good
sise continuing the same treatment
“ 6th Complains this morning of a sickness of stomach.
Tongue broad, and creamy. Pulse compressible,
continued the above treatment 
“ 8th Still complains of nausea stocking becoming
to loose for him
Bitart: potassae zi
Jalap grs vi
To be taken as a purge
Besides this powder he takes cider mixture
“ 9th Pulse 100. Thinner. Pulse 100.
“ 11th Improving very fast.
13th Giving the purge now less frequently
15th getting better
30th The dropsy has all disappeared except in the 
abdomen where it still obstinately remains



has been complaining of sick stomach and nausea
after swallowing any thing.
Aug 8th Has been very weak for the last two or
three days. The pulse small and feeble and 
the effusion almost entirely left him except
in the abdomen which still obstinately remains
Aug 10th
Gradually declining.
Aug 14 
Has lost his appetite. pulse can hardly 
be felt.
Aug 16th 
Yesterday was tapped. feels to day 
much relieved pulse is better.
Aug 17th
Pulse weak. Prognosis bad.
Aug 20
Pulse stronger. prescribed this morning 
according to Dr haines advice
Fel [bor??ium] grs sviii
Sulp: quinia grs xii
m ft: pils xii
[illegible]: one every 4 hours.
Aug 24th
Died last night


Case of mania-a-potu.
July 9th 1850
Tongue coated over with a substance resembling
mustard. Pulse 100. Eyes red and inflamed 
“ 11th Tongue still coated has had a nap and consequently 
much better
“ 13th Still continues to improve.


General Dropsy et Dysenteria
Aug 30
Came in with his whole body
swelled. ordered
Pulv elatrin gri
Scilla gs x to
Bitart potassa zi
m fr pulv viii
lg one every 6 hours
Aug 31
Has taken four powders complains 
of feeling very cold. A bellous sound
was detected over the region of the heat
ordered a blister over the cardiac region
Sept 1st
Not much diminution of 
swelling.
Sept 3rd
found him with symptoms
of dysentery. the swelling much less
stopt the powder and ordered quinine
and acet: plumbi and opium after each 
evacuation.
Sept 4
Stools running from him involuntarily
with blood. much tinner on account of the 
dysentery. (I think it will cure his dropsy)
Sept 5th
Died this morning of dysentery


case of debility and disordered condition of the blood,
the result of typhus fever (probably)
July 9th
James Brown came into the wards with his
legs and thighs marked with exanthemous
red patches resembling somewhat the
mark of a blister. very much emaciated and 
with a tongue exceedingly coated with a 
thick hard dry, and brown coat.
Giving him oleum terebinth: and beef tea.
July 13th To day erysipelas attacked his face.
“ 15th In the intervening days, he has been 
attacked with erysipelas in the face, which 
has promptly checked by the use of nitrate
of silver smeared over it. Pulse still feeble
20th weaker this morning by reason of a diarrhea which 
has set in ordered him this morning 
Hopes mixt ziv
[illegible] Krameria zi
“ opii zii
m ft. sol tablespoonful tres hourae
22nd Takes brandy punch zii every 2 hrs.
24th Stills stakes brandy with the addition of 
carb: amia his diarrhoea being stops the Hopes
mixture etc. was discontinued
Aug 8th Looks brighter this morning. always feels better
after being sponged all over with cold
water. His whole body is covered with a dry
scaly coat which separates from the cuticle
when even slightly rubbed.
Aug 9th Died last night from shere debility and [innutrition]



Mrs D’s Case Ind.
May 9 Missed the catamenia
May 11 sick at the stomach & bowels moved at 12 midnight.
May 12: morning nausea and bad taste
“ 13th ditto
“ 14 “ 
“ 15 “ Breasts tender to the touch
“ 16 “ No [Kiectine] after standing ten days
“ 17th “ 
“ 18 Not so much morning nausea
“ 19th “ “ 
“ 20th No symptoms now except absence of catamenia, and a 
burning spot over the last false ribs of the right side
“ 21st No morning nausea but thirst. Nausea and attempts to vomit after [illegible]
“ 22nd No complaints nausea after dinner, chill (slight)
“ at 9 ½ P.M. which lasted an hour or two succeeded by nausea
23rd Nausea through the day, chilliness.
24th No nausea or chilliness to day has been very well [illegible] for the
last week have been, according to her account, enlarging
25th Nothing, new.
26th Chills slight through the afternoon and night. A very severe head-ach just
before 6 o’ck, (left side) and back part). Nausea in the afternoon & night.
27th No complaints.
28th “ “ 
29th “ “ 
30th Nausea, and had taste in the mouth all day.
31st Slight nausea in the afternoon & evening, with bad tastes in the mouth
June 1st No complaints.
“ 2nd “ “ 
“ 3rd “ “ 
“ 10th Says her urine for the last 2 or 3 days is thinner & whiter than
usual. Passes it two or three times per nocte


Case of Acute Dysentery
Noonen a lad aged 18 three days before
his appearance in the ward was attacked
with dysentery. his case is as follows.
July 13th
Has been up very often during the night
tongue red, and marked with small white
spots. Pulse 100. ordered the following powders 
to be given him during the day.
Hyd: chol: [illegible] gra vi
Pulv: ipecac: et opii zfs
m ft: pulv vi 
one powder to be taken every three hours.
July 18th
ordered him this morning
Blue mass grs XXIV
Tannin grs XVI
Morphia gri
m ft pil: viii
July 20th In addition to the above pills
Mist: creta ziv
[Syr]: kino zi
“ opii zii
zfs tres hourae
July 24th 
Pulse frequent
Aug 6-7-8 has been sitting up is gradualy regaining health 


July 31st
To day sitting up. Pulse still feeble, and
irregular. looks very thin
Aug 6-18 Sitting up. Is gradually regaining health.
complains of his throat which we for the first
time on looking at it noticed an ulceration
beginning on the lateral half arches, applied to 
them a solution of nitrate of silver.
Aug 10th 
Throat better found him in bed.
Aug 14
Diarrhea returned. perhaps on
account of having got up too soon.
Aug 23
Has been in bed suffering a relapse. To day
prescribed
Syr: ferri iodidi zi
Sq 30 gtts 3 times a day.
Sept 1st
Emaciating very rapidly prescribed
Rx
Argenti nitratis
Pulv opii a a grs iv
m ft pil xvi
one every 4 hours
Sept 3rd Died after having worn away 
almost to a skeleton 


Henry Eisle Dropsy
Taking calomel squill in powder and
wild cherry bark and soda
Effusion within the chest commenced treatment
July 20th Put him in calomel powders grsi daily 
July 28th 
Gums, and mouth little sore. Absorption
not noticeable.
Aug. 7th
According the nurse’s account bled last
night zxii from the nose. which was
finaly stopt by plugging the nostril up 
with cotton soaked in aq: calcis. Stopt the
calomel.
Aug 8th 
No return of epistaxis
“ 9th His chest is gradually coming into its proper
form
Aug 14
Declares himself much better
swelling rapidly diminishing. Yesterday
had another blister which draws
very well
Sept 4
Chest symetrical. No respiration heard and
flatness upon the affected side.


Ind.
Cutting stomach [illegible]
Bilious diarrhea of a child 2 yrs old
Augst 4th
Called to see a child cutting the cuspidati
Its father said it has “flux.” Saw a a stool 
which looked very much like pieces of chewed spinage
floating in a mixture of urine and serum.
Skin natural. Blue eyes. Fair complexion. Healthy looking
child. Mother’s says it is disposed to be drowsy.
Saw no symptoms of metastasis to the brain
No heat of surface or fever. Very restless.
Ordered a mustard pediluvium and if the head became
hot, to apply cold to it, and use the mustard
pediluvium and if necessary mustard plasters to the
gastroenemia Ordered one of the following powders after
every passage. Magnesia calc each powder contains
3 grs of each Rhei
Acacia a a zfs
m ft: pulv: no X
Called 5 hours afterwards. had 3 operations and had taken 3
powders or 27 grs = 9 grs of rhei + 9 grs magnesia + 9 grs acacia
Pa and Ma very anxious about Mary. Ma said her
stools “were just like water.” “But the last one not so
green. Stopt the powders and ordered a mustard 
pediluvium at bed time.
Augst 5th
Found her bright as a button and Ma much
pleased. Stools almost natural.
Left some general directions and made my 
bow.



Typhus Fever.
July 20th 
Son muttering delirium, picking at the
bed clothes. Pulse very quick skin very hot
ordered him to be cupped back of the neck
and the head to be shaved and blistered
July 23rd
Pulse frequently and weak. Face flushed
Tongue very dry and hot. has been to stool three
times, during the night. No tenderness upon 
pressure over the abdomen.
“ 24th
Tongue moist, pulse frequent and weak,
delirium lessened still deaf.
“ 25th 
About the same pulse keeps frequent and
weak.
“ 26th
Tongue hot and dry. skin moist and warm
27-28th
Troubled with diarrhea. Pulse small and
weak. Tongue hot and dry peculiar typhus [illegible]
29th
Countenance more natural. Pulse [strong??]
and fuller tongue cleaning off and becoming
moist. Typhus odour not so perceptable.
31st Pulse softer and mor regular. Tongue becoming
clean, and moist perspires profusely.
Aug 1st Pulse quick and frequent, tongue does not look
so well having a few brown patches upon it
and not so moist.


Aug 3rd
A change for the worst evidently showing
that his system has been too much prostrated
by the fever to react from the attack of diarrhea
which set in about 2 or 3 days ago. Skin cold. 
No pulse scarcely at the rist ordered beef [illegible]
and wine whey.
Aug 4th Died this morning 9 o’clk


James Taylor, Scotchman.
July 23rd Came in with his back covered with 
an eruption which according to his own account
was contracted at sea. There did not
appear to be any itching. Put him on low diet
and gave a purge of salts
“ 25th
about the same ordered to day 10 gtts
of Fowler’s solution every three hours.
“ 28
Continues the Fowler’s solution.
“ 29 Complains of
a soreness about the stomach which I suppose
owing to the  arsenic and ordered it to be 
stopt
Aug 6th 
began the arsenic again. Itching gone 
and the eruption gradualy fading
Agu 8th 
Decided diminution of the eruption continued
the fowlers solution.



[Indianapolis]
July 26th/58 Fracture of the [illegible] parietal bone etc. Mr Gause
In this case after the diagnosis had been carefully and satisfactorily
made. Drs Thompson, Woodburn, & myself concluded 
that the outer table of the parietal bone, was thrown
off about 2 inches leaving the inner table, with two [fractures]
exposed. Enough of the os frontis, was torn away 
leaving the cerebrum exposed in a space, an inch long,
and half an inch wide. Pieces of the temporal bone, was
found loose, and extracted, this piece was about an inch & quarter
of an irregular shape. Another piece ½ inch squarish, from the 
supra-orbital ridge of the os frontis. Beside these there were 
several smaller pieces from the temporal, frontal, & parietal
bones taken out. No haemorrhage of any importance, on account
I suppose of the laceration. Stupor all the time; after these bones were
removed, his pulse full, but revived gain. Rigors occurred
once or twice during and immediately after the operation. Vomiting
of a dark bilous looking fluid took place once, or twice, while 
I was there. This accident occurred in the following manner.
He was attempting to sharpen a ploughshare upon a grind stone, 3 ft in 
diameter. when it suddenly flew in pieces, one struck him 
and his companion, and another was thrown 20 or 30 ft into
the back [shop]. This piece had a foot radius.
July 27th 5 ½ P.M. still insensible. Pulse 120. quick & feeble, skin hot, & [feverish]
Passes his stools & urine involuntarily latter natural, according to Dr Woodburn/
July 28th 12 M. Still stupor with a tendency to apoplectic stertor. Pulse weak. 130
Acting upon the bowels, and liver with large doses of jalap & potassae.
No difficulty in swallowing. Skin feverish. Temperature the same over his body.
I advised strong rubefacient linament for his inferior extremities
July 29th Died at 3 A.M. 3 days after its injury. Before he died, Dr Thompson
says, he had paralysis of the right arm (the left side of the head was the fractured one)
and subsultus of the inferior extremities.? Dr: Thompson says that he had his
hand on the back & side of his head, when he made efforts to vomit, and thought all
the bones, were loosened at their sutures on the left side, that of the fracture.



Case of Scurvey
July 28th 
20 or 3 purple spots on his right leg.
Gums swelled and very soft, and vascular insomuch
that when I slightly pressed them they 
bled. ordered him potatoes and citric acid water
to drink
Aug 5th still in the wards. Gums in the same
condition
Aug 7th still in bed. Gums still swollen and
soft and vascular
“ 10th
Remarkably disposed to lie in bed and
moped away his time; seemingly from shere
indolence.
“ 11th still, lasily lounging in bed. 
Appearances in a man a week after 
taking 40 drops of Fowlers solution.
April 28th 
vomiting this morning
April 29. Right limb oedematous. And an erysipelatous
redness on the posterior superior portion of 
the thigh extending almost down to the knee
May the 1st Two large water blisters in the upper part
large blue veins, traversing the fore part of the limb
limb swelled very much. Has been delirious in the
night. blueness extends down the foot. Discovered the same 
appearance in the other leg in the calf. Pulse very small and
feeble. ordered 16 z of [Brand] punch, died 2 ½ clk P.M.
May 


Vaccination Frank [illegible] Darrach
[1st day]
March 16th vaccinated Frank Monro Darrach.
2nd day
“ 17th 
3rd day
“ 19th Red areola [illegible] naturalise. Health good.
4th day
“ 20th Vesicles forming areola extending.
5th day
“ 21st “ larger and more defined [illegible] distinct very restless and [illegible]
[illegible] [illegible] [illegible] [illegible]
6th day
“ 22nd Rested better last night. No fever. Areola narrower, whilst the vesicle
have become one large one, sise of a small split pea.
7th day
“ 23rd Vesicles now entirely united into one as large as a middle sized 
pea. Areola very narrow and faint pink colour. Reddish
looking spot in the centre, looking like lymph. Restless first
part of the night. No fever.
[illegible]
“ 26th [Areola] suddenly enlarged to ¼ in ch vesicle [illegible] [illegible]
[llegible] seat enlarging
9th day
“ 25th vesicle becoming absorbed into the [illegible] (central) [illegible] yet
no [constitutional] symptom
10th day
“ 26th Vesicle giving [over] to the scab. Areola descending no [constitution??]
11th day
“ “ “ “ “ “ “ [illegible] [illegible]
12th day
“ entirely gone. Nothing new visible except a somewhat
faded areola
[13th day] 
30th Scab only, which is becoming more garnet coloured, still tight
17th day
31st ditto. Scab still tight
18th day
April 1st ditto
19th day
“ [2nd] ditto. Scab still tight
21st day
“ 3rd Scab loosening.
“ 5th Scab being very loose was [illegible] off. [illegible] the pus in the centre.




Case of Scabies where creosote ointment was tried.
Aug 3rd (Worst case in the ward)
John [Hiesenaur] came in to day with 
his whole body thickly covered with scabies
ordered him to be rubbed every morning
with the following ointment
Creosote zfs
[Adeps] zifs
Aug 7th 
Itching not so bad. says he is better.
Aug 8th 
Evidently better. Can now hardly perceive
the eruption.
Aug 10th 
Still, on a fair way to get well.
Aug 16th 
Almost well.
Aug 17th
well except over the shoulder
Aug 28
well except about the calves of his 
legs
Sept 1st 
well.


1858 Indianapolis
Continuation of J. C. Elliott’ case of cut throat.
July 26th Wound dry no supuration or granulation, water when taken
into his mouth runs freely through his wound, in fact the nurse
induces him to swallow water from his mouth, in order to wash
out his wound. Pulse at one time through the day 140 at another 90
Had a severe chill, in which the nurse says he became blue
all over. Starts suddenly when asleep. Muttering constantly 
in his sleep. Emaciating. Dr Elliott was talking of injection
15grs of quinine as an ante periodic, and introducing a stomach
tube, through which to convey his food. Beef tea,
coffee, lemonnade, [illegible] mouth, as some little got into his
stomach in that way, and injection.
July 27th Skin natural. Expression pleasant, & natural. Wound entirely opening & [gaping
outside edges dry. the bottom appears to be healing, aperture in his larynx
closing. Pulse soft, & regular. 80. Nurse says he slept better last night.
I have a better diagnosis this morning, am convinced of the folly of sewing up
such wounds. It must heal from the interior. I am also convinced of the difficulty
of diagnosis in such cases, as to whether the larynx is wounded and what bone 
of the traches, or cartilages. July 28th Pulse natural. one third of which he
swallows gets into his stomach, the rest runs out of the wound.
Skin natural. Wound looks much better. I have more bones of hi s
recovery to day than I’ve had yet. July 31st Granulating at the bottom. [Speaks]
much better. Skin natural, pulse rather weak, regular, and about 80, soft.
Talking about adding alcoholic stimulus to his diet this morning. Sustained chiefly 
by injections, about one third of water be drunk getting into his stomach. Augst 4th Thinner than when
I last saw him. Pulse weaker, articulates much better, can understand him. Wound looks
well, and Dr Elliot thinks is granulating from the bottom. Does not swallow
any better. Still injecting. Augst 6th Thinner. Opening still in the pharynx, I suppose
it is the pharynx subsultus when asleep. Aug 7th Pulse stronger. talks better, wound
about the same. healing very slowly. Augst 13th Pulse strong and natural. Thinner, has been sitting
‘up occasionally in his arm chair supported by pillows since the 9th Talks better, wound about
the same in appearance, swallows about ½ of his food still unable to take solid food.


Mania-a Potu  combined with Erysipelas.
Aug 3rd
Came in the wards about a wk ago
with symptoms of mania-a potu, which soon
afterwards developed themselves. AT the same
time erysipelas attacked the right cheek
The mania-a-potu was treated in the usual
way and the cheek painted with nitrate
of silver (solid stick)
Aug 8th 
Found him this morning very rational
and the erysipelas not spreading
Aug 9th
Found him sitting up in bed this morning.
Pulse rather feeble. His face looks to me about
the same speaks rationally.
Aug 10th 
Erysipelas checked. And altogether much 
better can now hold out his hand, with out
evincing the least tremor. Pulse though 
weak, is soft, and regular, wants to get
up and go to work.
Aug 12th 
Erysipelas and maina-a potu both almost
gone.
Aug 14th
Sitting up. No trace of either erysipelas,
except in the eye of the affected
side which is very red, but not accompanied
with any inconvenience
or pain, or mania-a potu. Reduce his 
stimulus.


Aug 22
Entirely well.
Enlarged liver.
Case March 9th
Dr Wm Hooper dispensary physician, was
kind enough to show me this case. The patient
was an Irishman, 46 yrs old. According to 
the doctor, this swelling became as 
extensive as when I saw it, in a weeks
time. The hypochondriac region of the left
side and as low down as half
the distance between the umbilicus and
symphysis pubis and almost to the
crest of the illium of the right side,
was dull, the patient evincing when 
pressed over the epigastric region.
(more than when pressed over the liver.
The tongue was thickly coated in 
the middle and back part with a 
white fur very white like chalk,
and was red at the edges. Stools
according to his wife were yellow.
Urine filled with [illegible] of ammonia.
Bilious temperament.


A very distressing case of boils covering the whole bod
Michl Sexton age 30 came in with his 
whole body covered with large boils
Aug 16th 
Covering the boils with flaxseed poultice
and giving
Decoction of Sarsaparilla.
Iodide of Potassa zi
Aqua zvi
Tablespoonful 4 times a day.
Aug 20
To day he is better.
Aug 28
Much better.
Sept 9th 
well
Continuation of Elliott’s Case
Augst 16th Nature doctoring slowly, surely, and effectually. Nature curate
Doctor curat.” Speaks very distinctly. walks now around his room.
Expression good. Cicatrix on each side ½ inch in length. Augst 24th Expression almost
natural. sitting up in his chair. Articulates much better, no difficulty in understanding
him. Swallow all his fluid food, by depressing the chin. Still a large gap



Case of Tinia capitis.
Sept 1st
Using ung. sulphuretum iodidi
Sept 11th
child well
Purulent Opthalmia
Sept 1st
child aged 4 yrs. Eyes entirely closed
and very much inflamed outside, when
forced open large quantities pure pus
flowed from them. Began the case with 
dropping a 4 gr solution of nitrate of silver
into the eyes every night and morning
also zfs of magnesia 4 times a day
Sept 3rd
Ordered two small blisters behind
the ears with the above treatment.
Sept 4th 
Substituted xx gr solution for 4 gr
Sept 11th
Can open his eyes, and looks about
him little inflammation left in the eyes 
yet


Typhus Fever
Came into the ward 4 days ago with headache
and pains in the back
Aug 24
Tongue dry and hot and rough resembling
a piece of rare beef baked in the sun
Pulse quick and of ordinary sise. Skin hot
and frequent. Constantly raving insomuch
that he is strapt to the bed.
Aug 25
Less delirium ordered him brandy punch.
Sept 1st
Much better, and wants to sit up.
Sept 2nd
Found him weaker, ordered wine whey 
Sept 9th 
Still doing well
Sept 11th
Not so well pulse weak, complains
of pain in the pubic region.
Case resembling Erysipelas Mrs Roe or Rose’s case
1859
Feby 21st Indianapolis. Mr Stewart visits for the benevolent Ro: sent word to me to 
call on Mrs Roe or Rose [illegible] 35 yr
widow with three children, oldest 12 yrs old. Found her lying in 
bed, at 2 P.M. with her arms swelled, skin tight over them, squamous
patches. Burning itching, and tingling like nettle rash. tells me her legs are like her
arms, also her neck, and head, it seems to affect her whole body. I found her
keeping constantly upon her arms by means of wet cloths, a solution of Alum
do not know the preparations. Could not make up my mind what it was. Prescribed cream tartar
Rhei griv
Ipecac grii
D.P. grs iv
m ft: pulv: No iv. S one every 3 hrs 
I did not weigh these preparations. Substituted the [aloe] wash for slippery elm



Feb 22nd 10 o’clk A.M. Found her sitting by the fire. Says she is no better or no worse, likes the
slippery elm wash better than the other. Took all the powders,
had two, or three, passages. Hardly know yet what it is, still inclines to the belief of
erysipelas in a mild form She has had this 10 days, says it commenced with 
burning and itching and swelling, Says she has an acid taste in her mouth
in answer to my question. Tongue clear. Pulse small and harder than [illegible]
she says she has a small pulse always. 80. Says she could go to work at [illegible]
if her skin did not burn and itch so. Prescribed half a teaspoonful of magnesia
for the acidity and Liq: pot: [illegible] zfs
Acacia pulv grs iii
Aqua menth: zfs
Aqua Destilled ziii
as a feeler. There are not enough constitutional 
symptoms for erysipelas, as
she has had it 12 days now.
4 ½ P.M. better, swelling legs, no change in treatment, except to intermit during the night
Feby 23rd 4 ½ P.M. Arms legs swollen and tender to the touch. Has taken about gtts xxx of [Fowler;s]
solution. No pain in the stomach. Still complains of burning, and itching in the
arms & legs. Prescribed the arsenical mixture 2ce daily. Still using the elm wash.
Feby 24th 4 ½ P.M. Up attending to her work. Arms less swollen, the disease still 
lingers about the upper third of the arm, in the form of an erythematous
swelling, tender to the touch. Complains still of the burning, and tingling, 
I think the Fowlers solution has done good service in this case treat: tablespoonful
twice a day after eating. March 3rd Arms well except a squamous 
eruption on the middle of the A.M. Looks well. Was scrubbing her floor. Is not
now and has not been taking any medicine since my last visit


September.
Case 1st Hepatitis.
Sept 12th
Pulse quick. Surface of the skin has
begun to assume a yellow tinge. Extreme tenderness
over the liver. ordered 12 cups over the
region of the liver and wild cherry bark & soda
Sept 13 Jaundice increasing
Sept 18th 
Tied down to the bed. very yellow. Face
has a very wild expression. very tinder over the 
hepat: region
Sept 20th
L Not so unruly. Tenderness over the liver
diminished. ordered a blue pil every 8 hours in 
addition to the above treatment.
Sept 27th
Much better. for the last 4 or 5 days has
had a diarrhoea for which he has taken
Dovers powder.


Sept 28
Came in with oedema of the legs. ordered
cider mixture.
Sept 19th
Was seised last night very suddenly 
with great dyspnea which threatened to 
suffocate him and an acute pain over the heart
ordered a blister over the heart and 12 dry cups
for the dyspnoea
Sept 20th
found him much relieved in every 
way excepting a pin, which he complain
of in the right shoulder.
This month; the chief diseases were
intermittents and dysenterys. in the [mens]
medical.


October. Surgical.



venereal. (mens)
Oct. 15th
Came into the wards with
his testicle of the left side enormously 
enlarged to the sise of a half a foot and
also a borrowing ulcer extending 2 or 3 inches
up from its opening into the cellular tissue
of the groin. Opening about the sise of a quarter
of a dollar. ordered the ulcer to be injected
with diluted nitric acid 10 gtts to zi
Oct 22nd
Stopt the nitric acid wash in 17th
and substituted for it, black wash, and
the wash to be injected twice a day, into
the ulcer. Has been under this treatment
for a week, and the sore begins to assume  	
a very healthy appearance, granulations
rapidly spunging up.
Nov 7th 
Was tapped yesterday and today his
scrotum is much smaller. The ulcer 
after having appeared to begin heal has
remain somewhat stationary
Nov 8th 
ordered the scrotum to bound with 
sticking plaster. to promote absorption of
the fluid.


[?as]: Surgical
Oct 16 Emma Hamilton age 27 came with 
erysipelas of the neck on the right-side. On
account of which her swallowing was much 
interfered with. along with this there was a very
fetid breath. Painted the whole of the swelled
surface with Lugols solution of iodine
which caused the whole of the painted
surface to be covered with blisters. the
next day. Exceedingly painful to the touch
Oct 20
Swelling not so large but gave for
the fetidness of breath
Aqua chlorine at ae ziv
Tr myrrhae zi
Ol: creasotii gtt viii
Oct: 22
Stops the creosote because of its making
her sick and prescribed
Aqua chlorinata ziv
Tr: myrrhae zi
m ft: garg
Oct 24
Fetid smell of the breath gone, ordered 
her to take a tablespoonful three times a day of the
following
Oct 2
November 1st
The opposite side, beginning to swell
ordered a flaxseed poultice and hydriod potassae


Nov 5th
The opposite side was lanced this
morning by Dr Graham and the poultice applied
N.B. This was at first supposed to be a case
of erysipelas.
Nov 10th
Complained of a cough for which she took
Rx
Syr: seneka
“ scillae
Liq: sol: morphia a a zi
Nov 11
Complained this morning of the medicine causing
a pain in her head and vertigo.
Nov 15th 
Still complains of giddiness, and vertigo in ‘
the head after taking the cough medicine.
There is still a running from the abscess of the neck.
Dec 3rd neck healed.



Case 3rd Margaret Russells Case.
Oct 15th came into the surgical wards
([illegible]) with her fore finger presented
the appearance of being lacerated, which 
upon examination proved to be the result
of neglected whitlow or felon. Upon inquiry
our suspicions were verified her whole
finger was one mass of lacerated surface
having sponged it, ordered a carrot, poultice
Nov 4th
The continual application of the carrot
poultice has made the finger almost
well
Nov 7th 
The finger has all healed except in 
two little spots about the sise of a pea
continuing the carrot poultice.
Nov 14th
The dressing reduced to simple cerate.
Nov 16th
Looked this morning as if it was getting 
worse as if an ulcer was beginning to be formed 
on the end of the finger owing no doubt to some
indulgence in diet.
Dec 3rd Fungous like appearance on the end of the finger
Dec 5th Finger looks red and the ulcer becoming
larger. ordered bread and milk poultice.



Dec 10th
The finger still looks obstinate and
undisposed to heal the loosened and
decayed nail was extracted was 
caused much pain.
Jan 15th
Up to this date the sore has not yielded
to any remedy the last thing used was 
a solution of chloride of zinc gri to zi Two days
ago I commenced, at the suggestion of Dr Page
to touch the sore around the edges with 
lunar caustic. Today I think it looks better.
Jan 17th 
The finger has improved under the caustic
touched it again to day.
Jan 20th 
Did not see her to day. Touched it yesterday.
Getting better.
Jan 24
Found her this morning with her face
swelled and very much salivated. She has
been using besides the pills, calomel in 
an ointment.
Jan 25
Face still swelled very much.
ordered lead water and pulv. tannin.
Jan 27th
Face better. Did not examine the finger
Jan 28 Face better ordered a poultice for 
the finger. Sore beginning to heal from the
circumference in the middle there is a slough
the sise of a twelve-pence.



Nov1st James Cox came into the venereal ward
with two large buboes in each groin, one
having broken before his admission. The
other I lanced ordered both to be injected
with aromatic wine.
Nov 5th
Yesterday the opening in the bubo on the
right side was enlarged by Dr Graham
This morning they both looked red, and
inflamed, with a healthy appearance.
Nov 7th
Bubo of the right-side filled with 
pus ordered it to be kept filled with lint 
soaked in aromatic wine. The buboes also
to be injected with the same.
Nov 8th
The buboes look very red and angry this morning 
Nov 15
No change in the appearance of the sore.
Dec 5th
The buboes look about the same except
on the right side which has been for
the last three or four days been touched
with nitrate of silver (solid) on which 
granulations are spunging.
Dec 10th
The buboes are showing a disposition 
burrow under the skin which was only noticed
to day.



Dec 18
Still in the wards. for the last four or five
days the buboes have been burrowing into
the skin until sinuses two inches in depth
have been made. These have been 
injected with 10 grs sol of nitrate of silver 
and then filled with lint soaked in 
vin: aromat. They are now improving
the sinuses are filling up and the sores 
assuming an healthy appearance.
They have been touched daily around
the edges with lunar caustic.
Jan 13th
Since the last date quinine in powder
has been sprinkled over the surface o f
the left bubo. It now presents a healthy 
character the specific appearance of the sore
having vanished. The right bubo which 
was accompanied with a sinus extending
down the thigh about an inch, has entirely 
closed up with the exception of an opening
the sise of a six pence. Treating them
now as simple sores with simple cerate.
Jan 17
Ordered a poultice for the left bubo as it run
a good deal of matter last night.
Jan 18
The sore on the right side healing around the
edges continuing the simple cerate. the other to be
stuft up with lint as there is still a hole large enough
to insert the end of little finger


Case of ulcer at the elbow joint.
Nov 3rd 
The ulcer was about the sise of a six pence
and had been according
to the patients account has been very 
troublesome by breaking out often it has
been healed over and after falls
upon the elbow.
When I first saw him, it was a little hole
through which you could see the periosteum
of the olecranon process. Ordered
his arms to be straightened and kept so
with a splint.
Nov 8th
Ulcer entirely healed over. Left off the
splint this morning.
Nov 9th
Still in the wards the cicatrix not having
yet become strong enough for the man to use
his arm much in work
Nov 12
Perfectly well, and left the wards to 
go to work.
Dec 1st
Found to day a little hole which extend
through to the bone. ordered nit: arg injected
into it (10 grs to zi).


Bubo and Oedema of the Prepuce.
Nov 7th Jas: Smith’s Case.
came in the wards with a bubo
and oedema of the prepuce. The prepuce
covering the glans penis and creating a 
kind of phymosis. I lanced the 
bubo and ordered it to be injected with 
aromatic wide. The prepuce to be injected
with black wash and a laudanum 
poultice to 
cal [illegible] i
Aq: calais zvi
be applied.
Nov
8th
Ordered cold applications
applied in addition to the black wash.
Nov 9th
The prepuce can now be drawn over
the head further than it could before 
the wash was used.
Nov 16th
Still continuing to improve.
December 2nd
The prepuce can now be drawn
over the glans. A large phagedena was
discovered on the inside of the 
prepuce and partly on the glans touched
it around the edges with lunar caustic.
Dec 3rd
The ulcer was touched this morning with
lunar caustic
continued on.


Erysipelas of the face and body.
November 30th
Catherine Dunphy came
into the wards with her eyes and ears
and whole face swelled and her
whole countenance much disfigured
with erysipelas. Painted the border of 
sound skin pretty freely with nitrate
of silver. (solid). and ordered her a purge
of
December 1st
found the disease extending over
the caustic mark and extending down
the back. No movement of the bowels
ordered her croton oil in pils combined
with other purgatives.
December 2nd
This morning we found the redness
extending still further down the back. and
under the arms. The pills which were given
yesterday have operated. To day the whole surface
extending from the back of the head down
to the 1st and 2nd dorsal vertebra was painted
with Tr: iodine. The pills were
Rx Ol: Tiglii gtts ii
Mass: Hydrarg: grs x
M. ft: pil iii
One pil every hour until a passage
P.S. The first, and second pills were given without
any effet.


December 3rd
The erysipelas is leaving the face
and extending down the body continuing
the iodine and giving internaly quinine & 
beef tea. She is now able to see.
December 5th
To day it is as low as the sacrum
Pulse 118. [illegible] with a hot, dry skin. Tongue
not so much furred. Touched part way
around with lunar caustic.
Dec 6th 
This morning says she is better
Pulse 100 tongue not so much furred, but
cannot yet protrude it with case. 
The redness has not descended any farther
down the body. Night before last was delivered
of a child.
Dec 7th
Dec 9th
Pulse 100 and cuick. Tongue moist and whitish
skin dry.
Dec 10th
The erysipelas spreading down.
The legs, painted it around with iodine Tr:
Dec 11th
Two little abscesses upon the upper eyelids
were lanced this morning seems very
languid and is constantly moaning
Pulse soft and of ordinary frequency. Tongue
moist
Dec 12th
Much better this morning. Pulse almost 



natural.
Dec 13th Complained last night of a painful
little abscess which made its appearance
on the back part of the scalp. ordered
a poultice. This morning still complaining.
The other symptoms however are
gradually leaving her. her eye looks brighter 
and her pulse feels more natural
Dec 18th
Another abscess forming just below
the scapula.
Dec 18th
The abscess on the back is all that
now demands attention. This has been
poulticed and shows an appearance
of suppurating.
Dec. 20th 
The appearances of the 
swelling this morning are I think
against my diagnosis of its being an
abscess. As the poultices which have been
applied, have not the least effect.
ordered one to be put on again to day.
Jan 13th
Up to this date my patient has been daily 
complaining of a pain in the left thigh. The 
The large hole which
was left from the abscess back of the head is filling up fast 


Bubo and oedema of the prepuce. (continued) 
December 4th
The phagedena is still extending
Touched it again with nitrate of silver.
Dec 6th 
The prepuce this morning could not be
drawn back over the glans so that the ulcer
could not be seen.
Dec 7th 
Nothing unusual.
Dec 9th
The ulcer was again touched with lunar caustic
Dec 10th 
The ulcer was touched this morning
pretty freely with lunar caustic.
Dec 11th
No longer extending. Touched it this
morning with lunar caustic.
Dec 12th 
Touched again to day with caustic.
Dec 13th
Complain of erections at night gave
him [camp] and opium. ulcers not burrowing
Dec 17th 
Had an erection last night notwithstanding having
taken grs ix of supuline and the same of
camphor with a third of a grain of opium.
The ulcers healing up under the caustic.



Dec 18th
Had another erection last night
in spite of the pills. The ulcer upon the
left side of the gland is better. Cold
cloths were also applied without any effect
ordered a slippery elm poultice.
Dec 18th
Has had no erection last night
The ulcer on the right side still looking
red and inflamed. the other healed over
entirely.
Dec 19th
Had another erection last night.
Dec 20th
Had a goo look at the termination 
of the largest ulcer, which as far as
I could see extended little below the 
coronal glandis. Touched it again with 
the lunar caustic.
Dec 21st
Oedema of the prepuce. touched the 
ulcer to day again
Jan 13th
Up to this date he has been fast improving
his penis with the exception of a scar the
sise of a five cent piece looks perfectly natural.
He has been using the simple cerate
only for the last week or two.
Jan 15th
discharged from the hospital, well.


James Cox’s Case continued (Buboes)
Jan 20th 
Keeping nothing on the rt bubo, but simple
cerate. And filling the left side with lint
and injecting it with aromatic wine.
Jan 21st
Bubo on the left side beginning to heal
around the edges and filling up with 
granulations. The other is healing very fast.
Jan 22nd
Found something like a sinus in the
right bubo The whole surface was painted
pretty freely with lunar caustic. so also was
the left.
Jan 24
Buboes look about the same as yesterday
Jan 25
No change perceptable from yesterday.
Jan 27th Still look about the same.
Jan 28 no change.
Jan 29
A narrow border of healthy skin was
seen this morning around the wide bubo
ordered the buboes to be washed once or twice
during the day with a one or two grs sol of 
silver.
Jan 30
The border observed yesterday becoming
larger cont. treatment


Secondary Syphillis.
Susan Wilhelm came in covered with
chancrous looking sores. Her throat also
ulcerated and a chancre in the left corner
of her mouth, The scalp was covered
with sores and abrasions. The bridge
of nose also had an ulcer upon it
The vagina was examined, and was
found covered with chancre, as was
also the labiae.
Dec 10th
The sores upon the scalp healing
under the application of lunar caustic
Seems much better in spirits.
Dec 13th
Complains this morning of her eye
The sores upon the scalp have all healed 
except one or two under the use of the
nitrate of silver (solid). Her throat
which was troublesome yesterday
to her has been relieved by the 5 grs sol of sil
applied by means of a camel’s hair brush.
Complains also of a hot fever at midnight.
Dec 17th
Scalp healed over. Eye feels very painful.
Dec 18th 
Scalp still continuing to improve. The eye
according to her own expression is neither better
or worse. The mucous membrane
much inflamed painful



it with a camels hair brush soaked
in a v grs sol of nitrate of silver.
Dec 19th
Eye the only thing that required attention
this morning, which was touched with
the solution.
Dec 20th
The eye better this morning. applied
the brush again.
Dec 21st
Applied the brush again this morning
Jan 13th 
All inflammation has left the eye, but
is very weak and can not bear the light
Jan 14th
Weakness in the eye yet.
Jan 15th
Eye still kept shut on account of the weakness
but says she can see better out of it today 
Jan 16th
Found her this morning sitting reading the
newspaper
Jan 17
The eye getting stronger.
Jan 18
Eye begins to look quite well.
Jan 21st Eye quite bright to day.
Jan 24
Eye almost well
Jan 25th Eye well but on her left leg discovered
an ulcer of a circular form 



about 3 or 4 inches [illegible] and another upon 
the calf of the leg somewhat larger than 
a dollar.
Jan 27
Did not examine this patient to day.
Jan 28th 
Did not see this patient to day. No worse.
Jan 29
Examine the ulcers on her leg to day.
found larger and getting worse under
the blk wash. ordered the surface of the 
sores to be sprinkled with calomel. And 
poultices to the scalp to remove the thick
scabs which were forming.
Jan 30
Ollis Ameys Case Mania-a-Potu
This patient came into the wards Jan 11th
with a slight tremor scarcely perceptable
in the tongue.
Jan 12th 
about the same.
Jan 14th
Tremor in the hands when requested
to hold them out. Tongue also more
tremulous, pupils somewhat contracted
ordered Spts: vin gal ziv
Tr: valerianae
“ assafetida a a zfs 
tablespoonful every 
2 hours.



and gtts of Acet: opii every hour.
Jan 15th 
More tremor over the whole body. Pupils
very much contracted very restless passed
a sleepless night. pulse small and
quick countenance a wild look
continued the above treatment.
Jan 16th
No sleep last night continually
talking about his affairs imagines
there is a woman who he dislikes in 
the cell with him, very weak and
shaking all over like an aspen leaf.
skin feels moist pulse small and quick 
increased the blk drop to every half hour
cont the other mixture as before.
Jan 17th
Found him this morning very 
restless and cowardly. imagines there is a 
company of soldiers outside trying to shoot
him. very weak. no sleep yet continually [illegible]
his trousers and imagining the blanket
on his bed is his new over oat which 
causes him to bery careful of it rolling
it up carefully and pacing it aside
his pillow. Pulse very weak but stringer
than yesterday Has taken from 200 drops
of Acet: opii. cont: heat:
Jan 18th
slept from 12 oclk yesterday untill
3 without waking with the exception frequent
starting and opening his eyes and looking wildly 


Erysipelas, [Cathn] Dunphey case continued on.
Jan 14th
Great deal of discharge from the sore back
of the head this morning. Complained of the
swelling in the back this morning for the
first time for two weeks. On examining it
found a diffused pinkness resembling
erysipelas.
Jan 15th
Opened the abscess on the back beneath
the scapula from which a pint or more of
bloody pus was discharged. The pus had
collected beneath the fascia of latissimus
dorsi muscle.
Jan 16th
Still complaining of the pain in her hip 
and thigh of the left side. The sore on the 
occiput healing up fast no more pain
in the abscess of the back.
Jan 21st
Hip and thigh still pains her. Sore on the
back of the head nearly healed over.
Jan 22nd
Examined the painful leg to day but
could not see any thing to account for 
the pain.
Jan 24th 
Still complains of pain in her left leg
and tenderness upon pressure.


Jan 25
Found her to day sitting up. Did not 
examiner her leg to day.
Jan 28th
Says she has no pain now, and can
walk better continued the liniment.
Jan 29th
Saw the sore back of the head which is
almost healed does not complain of her leg
found her sitting up.
Jan 30
Says she is great deal better.
Ameys Case. Mania-a-potu continued
Around the room. Skin in a warm sweat
pulse softer and fuller. drowsy. ordered
the brandy mixture every three hours with 
7 drops of acet: opii every 2 hours
Jan 19th 
has slept pretty well. much better
lays quiet pulse full and soft wild
expression fast leaving his face. [illegible]
a little yet in his sleep. stopt the opium
Jan 25th
great deal better. had him moved
to the light. slept well last night
Jan 26th
Treating him now for [dysentery]
of which he had when he came in.
Jan 29 Convalecent pretty well.


Cancer of the Mouth, Benson’s Case., 
Solomon Benson entered the wards Decr 2 1850
having been in twice before
& up to May 1st 1849 he has enjoyed perfect health
and worked hard at this time he had an
attack of pleurisy and gonorrhoea. he was
 discharged cured March 1st 1850 he felt a
 slight soreness in the roof of his mouth
soon two small ulcers were perceptable
The attending physical thinking it owing to decayed
teeth, had five pulled, but obtained no relief
he was again discharged, and again 
admitted August 1850. At this time having
become discouraged with medicine, would
not have anything done for him and left
the house in September 1850, and staid
out until his present entrance Decr 2 1850 
At this time
there was a fissure large enough in some
places to lay the points of your little finger
in, extending irregularly from one side of 
the mouth of the other. Dr Graham who had 
the wards at this time put him immediately 
upon the protiodide of merc and ptyalised
him, the fissure was touched every 
other day with lunar caustic. The sore
seemed to get worse under such treatment and
it was stopt by me I now having charge
of the ward. He was now given a gargle
creosote gtts iv
Aqua zviii and continued for two weeks 



scarcely any improvement being perceptable
I changed the gargle to acidum nitrici gtts viii
[Aqua] zviii
use as
Jan 16th
The outside of his face much swelled 
using nitric acid gargle. suffers a good
deal of pain and has no appetite.
Jan 17
Gave him the following to be taken internally
Rx
Zincae Chloridae gri
[Aana] zviii
Tablespoonful twice a day.
Jan 21st
Made an examination with the 
probe, and found the back part
of the mouth very much diseased.
applied grs sol solver by means of 
a camels hair brush.
Jan 22nd
Did not examine the throat to day.
complained of the gargle to making his
mouth sore. substituted gtt ½ to zi
Jan 24th
No so much pain in the side of the
face to day swelling gone down. Cont. treat
Jan 25
Did not perceive any difference in 
the appearance of the sore touched it with 


10 grs sol of silver applied by means of a
camels hair brush.
Jan 27 Did not examine him to day but says
it feels easier.
Jan 28
Examined the back part of the mouth
to day and think it looks better. The fissure
is not so large as it was
Jan 29
Did not examine his mouth to day but he 
is however no worse.
Jan 30
Found him this morning with the
left side of his face much swelled
up to his eye.


Acute Bronchitis
Nov: 29th 1860 Was sent for toe see Joseph [Ridley] residing
2 miles south of Napoleon. About 30 yrs of age. [illegible] sanguineous. 
Skin hot and feverish. Pulse 100 to 112. Was attacked
two or three days ago with a chill, thought he was 
going to have the ague. Cough dry and tight.
Costive. Took this morning a dose of salts and had a
operation. Pain in the breast physical signs between the 
clavicles loud bronchial respiration puerile [respiration]
when the ear was applied upon the front part of the 
chest. Resonance upon percussion, little more over the
left. Treatment Tart Em: gri
Pot: Not: grs x
Ipecac grs vi
to be dissolved in a [illegible] vi of water
of which 2 teaspoonsful to be given every 
three hours. Mustard plaster over the upper part of
the breast, to kept on 20’ Flaxseed mucilage with 
teaspoonful of pot. bitart to zviii of the mucilage.
Nov: 30th Frequent serous passages. Pulse [full] and gaseous.
Pain in the abdomen. Cough and pain in the breast
better. Physical signs about as yesterday. Stop the antimonial
mixture, and gave D.P. grs ii every three hours
and a 4 gr powder at ped time. Ext: hyos: grs xv m ft [illegible]
one at 12 M. another at 6 P.M. and the other at
10 P.M. Mustard plaster over the abdomen.
Dec 1st Tongue white cleaning at the tip. Pulse an irregular and 
soft [80] NO passage since the antim: was stopped. Slept
well last night. Skin more natural. Pain when sitting 
up over the hepatic region. Weak. Physical signs
[illegible] on percussion Treat. horehound tea and a 
teaspoonful of the antim mixture three times daily
Dec 2nd Found him sitting up in bed propt up with pillows. Did not rest so 
well last night on account of his cough, which appears painful and tight. Cannot locate
his pain this morning, says it is all over but chiefly in his back. Bowels again [the]


Cathn McHale’s Case. Femoral Abscess.
Cathn McHale aged entered Feby [26]th 1850, a year ago,
having had a fall upon her hip. about 
three years ago. she was not deterred from 
work however now then she felt pain 
in the hip especialy in changeable
weather. about October 16th 1850
a swelling about the sise of a goose
egg appeared about the upper third
of the thigh. This after an examination
was found to contain pus
which appeared to be underneath
the fascia of the thigh. It was opened
and has up to this time been discharged
pus and a [sa?ious] fetid matter.
Jan 20th
There are now four openings in the 
which at times discharged very freely 
Treatment is altogether constitutional.
poultices truly, as a local remedy.
Jan 21st
Complained of pain in the thigh
treatment same.
Jan 22nd’
Found over the old abscess a red space
from an half an inch long to a quarter of an
inch wide in which were 3 small holes from 
which a great quantity of matter was discharged
another opening on the lateral portion of thigh
which also discharges a thin looking pus.s


Great tenderness and pain over the [trocha??]
of the affected limb. also a constant pain 
there.
Jan 24
The abscess did not discharge as much 
last night. Troubled very much with night
sweats which have heretofore resisted both the
muriated tinct: of iron and sulphuric acid dil
put her on pl: [illegible]: aselli to day.
Jan 25th
Owing to a disposition to vomit, and
irritability of the stomach did not give her
the oil yesterday.
Jan 27th
Found her complaining of being
weak and a diarrhoea.
Jan 28thg
Found her better. pulse good still 
however weak.
Jan 29th
She is taking now and has been for
the last three or four days pills. every four hours
[balett] mass
Quinia sulphas a a grs x
m ft: pil viii
Jan 30
Complains very much of night sweats
still taking above pills 



Caldwells Case. (Cold)
Jan 18th
Jan 18th
Observed a depression just beneath the distal
extremity of the clavicle; large enough to 
insert a silver dollar. immediately suspecting 
a cavity. put my ear to the 
spot and detected amphoric respiration
and resonance when the patient spoke.
examining lower down 
amphoric respiration was again detected
accompanied by a metallic tinkling
Pat him to day upon ¼ gr calomel every 2 hours
made into pills.
Jan 19th
Could not hear the tinkling to day
But in the place of it there was amphoric
respiration. perfectly flat on both sides.
Jan 20
heard tinkling again to day in the same
place. still flat over the left lung.
Jan 21st 
Resonance on the right and normal respiration.
on the left side at the summit of the lung.



just beneath the distal extremity of the 
clavicle I though I could detect amphoric
respiration.
Jan 22
Dr Haines thought there existed a dry 
cavity at the summit of the left lung
still taking pills first prescribed.
Jan 24
Could not hear the cavity this 
morning stopt the pills as his mouth
was getting sore and his gums tender and
soft and swelled.
Jan 25
Did not examine this patient to day
Jan 27
Did not examine this patient to day
did not think it necessary found his setting
up and looking worse and 
complaining of nothing.
28th
Did not examine him to day saw sitting
by the side of his bed.
Jan 29th
Sudden death in a case after
taking 15 grs of Ipecac
Indianapolis Jan 22nd [1850]
Simon [Rath] at 7 or 8 years. Supposed by his father to have
swallowed something, and was lodged in his nose
Found him lying upon his bed, breathing naturaly
face flushed. skin natural, pulse somewhat quick


and frequent and small. No appetite. Bowels [illegible]
[illegible] costive. Pain general especially in the back
Diagnosed either the case to be continued fever or [verminous]
irritation. Prescribed cal gri 
I did not weigh them Cal gri
Rhei gri
Morphia grs v [illegible] cal [illegible]
Rhei [illegible]
about these proportions
[illegible] ½ tablespoonful of castor opii to give every 3 hours
[illegible] [illegible] next day
Jan 23d
Slight operations. Face more flushed. Skin 
[???ngent] heat. Cough dyspnea. Pulse small frequent
and quick. Tongue heavily furred as yesterday.
Has been up. Gagging and making ineffectual
efforts at vomiting. Poured out about 75 grii ipecac
and attempted to give it to him but he resisted
His mother not being able to manage him
call’d his father who rather roughly pulled
him up, and placed him upon his lap.
while doing this fell into a profuse sweat 
head fell about as of one dead. I suspected 
nothing however, and left telling them to give
him two or three cups of warm water, until he
vomited. I had not gone 4 squares when
I stopt by a hasty, and allmost breathless 
[illegible] to return I did so, and found
my patient a lifeless one. what did he
die of is a query. was it the ipecac or the [illegible]
[illegible] or was he dying when I saw him and 
did not know it I can hardly think the [illegible]



Harry Hamilton Vaccination
March 21st Vaccinated. Mch 22nd
“
[illegible] day 6th Red spot as large as a buck shot. No vesicles yet
Napoleon
Mr Thackeray’s child Marasmus
Augst 5th Boy. 3 yrs, had been sick about a month
was first attacked with ordinary summer complaint.
Phenemonae. Pulse frequent feeble small and quick.
Much emaciated. expression of his countenance and
the character of his cry and voice like that of an old man.
Mouth covered with dark whitish looking
patches. Abdomen tender and sometimes tympanitic
Passages consist of small dark brown and whitish
lumps about the sise of peas. (large) very pale.
sleeps with his eye half open. Prescribed Arg: Nit: gri
to be rubbed all over three times daily. Pulv: Dov: grs xvi
with cod’s liver oil. teaspoonful three. m ft: pulv: xvi
Times daily. Half teaspoonful of mutton [illegible] every [illegible]
tea every 15 minutes alternately with the hours same quantity of
whiskey punch (one tablespoonful of the best, to two of milk)
Abdomen to be kept red with turpentine. Chlorate of potash as mouth wash.
Augst 6th morning Phenemonae external about as [illegible] day. Abdomen
more tympanitic, passages more frequent and feculent
no lumps. pass’d about a two quarts of urine, and half pint
of feculent matter. Afternoon. Passages more feculent of gross
green colour, a little at a time. Treatment as above except dropping
the turpentine as it ceased to have any effect on his skin or only slight 
and painted the abdomen with comp: tr: of iodine. Tongue half clear 
rom the tip. Evening suspended the powders became too much, stupor.
Augst 7th Mouth cleaner. operations less frequent and less green.
[coathed] the whiskey punch & mutton tea, and takes now coffee with cream & sugar


Thackeray case
and treat as before except as to the powders
which were substituted for quinine grs iv. 
D.P. grs iv
Arg: nit: grs ii
The quinine was
given upon learning that every other day
he was worse
5 P.M. voice stronger operations less frequent. Mouth and tongue almost
clean. Abdomen as before, only less tympanitic. Rejected rice water and
took beef tea and whisky punch. Last night ordered a warm salt and
mustard bath 5 minutes kept him four min in the bath
Augst 8th 4 or 5 operations in the night, about a teacup full of [solid] [illegible]
[illegible] matter with a yellow tinge through it, in a gallon of wine
Ridgely care (coloured)
Jan 18th 
Both sides flat has a short cough.
no respiratory murmur. heard over the lungs.
put him on zfs cod’s liver oil 3 times day
Jan 20th 
Still has cough no difference percentable
either
by percussion of auscultation. still [illegible]
cod’s liver oil. zf 3 times a day
Jan 21st
Distinguished a faint respiratory murmur
on the left side still flat on both sides.
Jan 22nd
Did not examine this morning.
Jan 24
No difference in percussion and auscultation 
lays he as well as ever he was and
looks strong and hearty.
Jan 25
Percussion still flat. Discharged as well.
Jan 28th Walking about the war apparently well. 


Suspected Schirrhous of the stomach.
June 3rd
came in with a circumscribed
rough and hardened space over the
region of the stomach. complains of lancinating
pains. very tender cannot bear the slightest 
pressure. over the epigastrium. Face haggard 
cheek bones prominent. Does not vomit. stools
natural except in collour being rather too white
indicating the want of bile. ordered iodide of potassa 
internally and the hardened space to be painted
over with tinct of iodine. The roughened space 
is from 3 to 4 inches in length and 3 inches wide the
long diameter extending around his body the
other parallel with linea alba it now
resembles the cicatrix of a burn.
June 5th
Complains of having no appetite. the swelling 
was thought by Dr Shively to be a little increased and running
over to the left side. he says he can not lie on the left 
side. the other appearances the same. ordered the part
to be blistered. the other treatment continued.
Thackeray case
the urine turbid. Pulse about the same Treatment. No change. 1 P.M.
Pulse 120 to 130 quite frequent & feeble. Operations about the same as to quantity & colour, thinner,
and not so lumpy, as last night. Cold sweat on the forehead, skin feverish. Takes about
a teaspoonful of nourishment an hour, because of sleep etc. etc. interrupting the regular times
of giving it. Augst 9th voice stronger. Pulse very feeble, scarcely perceptable. 5 green (grass])
concrete mucoid passages, a gt: of fluid and half tea cup of solid matter. Mouth as
yesterday Arg: nit: grsii
D.P. grs iii  Quinine
m ft: pulv: xii
Tr: iod: comp: to the abdomen
did not suit, there was an aggravation of all 
the symptoms. Did not bother him last night.


Inds
(Distinct) Small Pox Indianapolis Jan 13rh 1854
Jan 14th
Bennet Brookes aged 45. Full habit. Complains of not
pain. Bowels regular. Face covered with pustules
Pimples on the rest of the body. Breathing
free, throat not sore
Treatment. Room well ventilated. Solution 
of chloride of soda to be thrown about the room.
Lod diet [Thal] grs vi
Rhei grs x
Ipecac grs v
m ft pulv: no vi
one to be given every three
hours
Jan 15th Slept well last night. Nostrils stops up.
still breathes easy. Has taken
three powders, had a passage which his
nurse said smelt very bad.
Jan 17th 
Slept well last night. Pustules on the 
face scabbing off. no sore throat, says he is as
fine as a [trout]. Treat: stopt the powders as
they moved his bowels too freely. Still on low
diet. Ordered a roasted apple for him yesterday
which he relished very much.
Jan 19th Sleeps well. complains of nothing.
Bowels regular. No medicine.
Jan 15th
Has been rapidly convalescing
and now is well, except the scabbing of 
the pustules.
Remarks
This was one of the mildest cases; no
pulmonary, alimentary or cerebral derangement
occurred, and very slight cutaneous irritation



had him wash and scrubbed and washed in Liqr: sod: [chlor??]
discharged on 26th of Jan.
Indianapolis
Mrs Hamilton’s Case March 7th 1854.
I saw this lady for the first time, medicaly,
about a month ago the sympto0ms which 
then presented themselves were, an anxious
expression. very nervous.
Hysteria
from the least fatigue. Exceedingly 
troubled about her inability to attend to her
household duties. Large quantities of [illegible]
of ammonia passed from the kidneys.
Pain in the left shoulder, and also between
the scapulae; no appetite. Cough which was
slight, night sweats. Numbness of the legs, which 
she describes by saying that when she
attempts to draw down her legs in bed
she feels as if unable to do it.
continualy thinking of her children in 
Baltimore.
March 6th
Yesterday my patient had spitted 
of blood while at church. Today I examined
her lungs and found not much difference
between the two sides by percussion
But upon putting my ear at the 
subclavicular region of the right side
I detected cavernous respiration and
pectoriliquy, I immediately concluded 
that a small cavity existed at the
summit of the right lung upon inquiry
as to the character of the sputa my 


suspicions were confirmed. I immediately
ordered a small blister and cod’s liver
oil zi three times daily, and gentian and
columbo tea.
March 9th
Thinks the treatment doing her
good. Can take zfs of the oil.
March 16th
Had another nervous spell
and refused to take any medicine
two or three days ago. Has now
however resumed her medicine and
for the last two days has been
much more cheerful. The oil was beginning
to nauseate her and consequently 
she laid it aside, for awhile.
March 18th
Much better can walk farther. looks
more cheerful convenes and laughs with the
family, this change has been attributed
to exclusion from the kitchen and heat
of the stove. her cough is still harsh and
resonant sounding as if coming through
a brass tube. has an enormous
appetite
May 31st My patient has taken a travelling tour
and come home looking fat and hearty, but
had yesterday spitting of blood, is taking nothing.


Mr Gray’s child Aug 2nd 1854
Dysentery Indianapolis
August 2nd
Child 2 yrs. has had the dysentary stopt several times, but
not permanently. I gave it on my first visit the following
Rx Cal grs iii
Ipecac grs i
Morp: grs 1/20 m ft pulv: No iv [illegible] one every two hours. 
Warm mustard bath night and
morning
mist: creta zfs
Tr: [:rame??]
“ kino a a [illegible]
Tr: opii camp zfs
Aqua menth zfs
Sacch: [illegible] : zi
Mucilage Acacia zi
M f S. teaspoonful every 2 hrs
until the [illegible] [illegible]
Gave her 4 more powder at evening to be taken through
the night. ordered a [musk] poultice or red flannel
to be placed over the abdomen.
August 3rd Head one passage at day break which was more natural
had three in the night. Skin natural
Gave her Rx Quinine grs iv
Rhei grs i
Sod: Bicarb. grs i
Cal: grs ii
M ft. pulv: iv S. one every two hours.
Saw the child in the evening and found it had only 3 passages
through the day and only slightly streaked with blood
ordered in zi of castor oil and zfs of paragoric.
Augst 4th Slept better than it has for sometime, more blood,
and pain in passing . Ordered Rx cal grs iii
Rhei grs ii
Ipecac gr i
Sod: Bicarb: grs ii
Mass: sulp: gr 1/20 
M ft: pulv: No 4 S. one every 2 hrs
Rx
Plumbi acetas gri
Morp: sulp: gr 1/20
m ft: pulvi No 4
S. on every 2 hrs.
Ordered also a warm bath and [musk]
poultice and injections every hour
of cold water. and an injection 
composed Rx Plumbi acetas grs x
Aqua frigidum oi
every 3 hrs.
I think the child is
worse. The father says it has been sick 4 weeks. Did not give [illegible]
Augst 5th Saw the father on the street this morning
who told to me his child was better no passage
in the night and the last two more natural
one being yellow and the other green/
Augst 7th Less blood. Skin natural gave Cal. grs iii
Ipecad grs i
Sod: bicarb grs i
Quinine grs i
M ft: pulv vi S. one every 2 hours
These seem
to do more good than anything else.
at bed time I gave him Dov: powd grs v
Morp: sulp: grs 1/20
Aug: 8th Found him better the last stool more natural. Slept well.
Did not order any medicine today until I see him at 12 M.
Aug 11th No bloody stools is getting well. The father told me today he was pretty
well except a diarrhoea.



Stuheller’s Case syphyllis.
Herman Stuheller aged 22 Born in Germany
Single. Temperate. A skin dresser by trade
previous to this disease was a strong and
healthy man. he is of a light complexion and
has light h air. On the 1st of January he had
connection with an unclean woman and 
7 days after a bubo and chancre appeared 
simultaneously with the former being
at this time on the corona glandis about
this sise of a pins head. This healed
over. But the bubo after being poulticed
for 4 weeks at last suppurated at
this time he was admitted into the
Penna Hospital, The opening being
enlarged. Lime water black wash
and powdered calomel were successively
applied. In a week after the 
appearance of this bubo another on the
opposite side made its appearance
this was lanced but according to his 
account discharged no pus but blood
this bubo burrowed very much pills
of calomel were given and he was ptyalised.
No improvement in the sores.
Sys: sarsce comp were then given internally 
and the bubo dressed with S
He continued on this treatment for 7 weeks
He now left the Hospital unrelieved
and uncured. And was placed under
Dr Senderling, afterwards under 


under Dr Hartagin whose care he was
under for 9-10 weeks.
Herman entered the Almshouse Sept 3rd 1850
immediately after being under the case
of the last mentioned gentlemen. when
he entered the house his groins were much 
ulcerated and a sinus extended from 
the right side about an inch
and a half which gradually sloughed
away and left a large sore. On the
opposite side there was another sinus
running upwards which was large enough
to insert the thumb of common sised hand
into.
He ahs not improved at all since he has
been here. since he has been here Arg: nit
xx grs to zi and xx grs cup: sulp: zi have been 
alternately sued iodide of potassa et ext:
conii with sarsae decoct. Iodide of iron
iodide potassae et bichloridi hydrargi
Besides these he has used externally
Sabaraques sol: sulp: quinae solution,
creosote water
Jan 18
has been taking calomel pils and
his mouth is slightly touched
The groins are very tender and cannot bear the pressure
of the lightest poultices. The left side
is now nearly healed over except a an ulcerated
surface alongside of the scrotum which
extends around the perineum and is about 


an inch in extent. There is now on the right
side a large phagetanic ulcer about
two inches long and one inch wide
quarter of inch in depth encircling the
crest of the illium. This ulcer has grown
very rapidly since its first appearance.
The diseased surface of the right side now
occupies the whole of the illiac region of that
side. the ulcers vary from a sixpence
to two inches in length. separated by 
cicatrises of cold ulcers.
Jan 19
Found a sinus running from the right
side across towards the left side above 
the pubis, about the three inches in length.
ordered a light bread and water poultice
and the sinus injected with aromatic wide
His mouth is slightly affected by the calomel 
Jan 20
No change. The large ulcer over the crest of illium
seems large. cont the prescriptions of yesterday
Jan 21st
The large ulcer on the crest of illium seems
increasing. Could not bear the poultice on yesterday
so great was the pain.
Jan 22
Discovered that the sinus communicated
with the penis. running therefore in this
direction The ulcer looking worse especialy
the large one on the crest of the illium


Jan 26
The largest ulcer seem to be increasing.
cont: the last treatment
Jan 25th 
The ulcer is running down along the
crest of the pubis.
Jan 27th
Did not see his groin to day, he
being asleep.
Jan 28th
No change from the 25th ult, except
in the sinus which is filling up.
Jan 29
No change perceptable from yesterday
Jan 30
Seems to be some disposition I the sores
of the right side to heal. the largest ulcer on the
opposite side is no larger that it was yesterday
ordered as a drink marks ext of sarsaparilla
an zi during the day in a pint of water
Jan 31st
Hardly any change perceptable in 
the sores
The treatment in this case is very 
unsatisfactory.
Left the ward February 1st 1851 to take the 
womens medical.


[Wht] [illegible]: Med: 2-8th
Case 1st
came into the ward Feby 7th
complaining of pain in her legs and back
puse 80 tongue of a cream white and
moist
Feby 8th (morn)
Pulse soft and about 90, skin natural 
tongue moist and of a creamy white. Face slightly
flushed.
Feby 9th Morning
Pulse about 90 tongue cleaner than it was
yesterday. it is now red at the edges and tips, and down
the middle creamy white and slightly furred
did not complain of pain to day in her legs.
Bowels open.
Afternoon visit 5 ½ P.M.
Pulse 100. complains pain in the 
stomach. The pulse was soft and only little more
than of ordinary fulness.
Feby 10th morning visit.
Pulse 85 no headache no pain in back tongue
only slightly furred cheeks flushed, complained last night
by pain in her stomach ordered a dose of oil and mustard plaster
found her this morning with no pain.
Feby 11th
Complains cramps in her legs which I discovered was
something like rheumatism as she says it shifts
about from place to place
This was a case of rheumatism which resembled
a case of continued fever. 



June 6th
came in to day after a long
walk in a hot sun, with pains in his bones and headach
and general langour.
June 7th 
pulse rather quick face rather flushed skin feverish
still has the pain in his bones no tenderness over stomach
ordered brandy punch zxvi a day
June 8th 9 A.M. Pulse very slow and weak not more than 48 
per minute. No red spots. Tongue moist, and of pinkish
white collour. ordered punch zxvi again to day
[Mens] Medical
June 26
has been sick for two or three
days with looseness in his bowels. No pain or 
on pressure over the abdomen. pulse full and
regular. skin natural. Tongue slightly furred.
ordered 10 grs of cal: at once. and the following however
to be given through the day 
cal: grs xx
pulv: Doverii zi
m ft: pulv: xx [illegible] tris hourae.



Indianapolis
Neuralgia Facialis
veratria gr ifs
Morp: sulp: grs vi
Ceratum [illegible]: zi
m for Mrs Neff.
Indianapolis
May 16th 1853 Mr D. Yandis. Eyes red, and throat sore.
had a chil on day before yesterday. bowels not
opened for two or three days. ordered
Tart: em grifs
Pulv: ipecac: zi + grs v
m ft: [illegible].
Pulv. alum ziifs
aqua zvi
m ft: garg
Pulse 120
4 oclk P.M. Skin soft, and his pulse not so 
quick and hard. but frequent. Face flushed 
and eyes still red, throat still sore. has
vomited freely, and bowels opened. Says he is 
better, but contrary to orders has been up.
ordered Rx 
pot: bicarb zvi
Ant: et pot: tart gri
Spts: etheris nit zi
Syr: simp: g.s.
Aqua zvi
zfs every hour in afternoon 
to season his food 
with 
Sod. [phosph??]
Acidum citrici
Aqua aa g.s.
17th Pulse 80 soft and larger. Skin soft, and moist. No [decided]
measley spots. Tongue slightly [illegible]. Throat still
sore. Eyes still inflamed. had a slight fever yesterday
afternoon. bowels open. small pimples on 




his arms, but I cannot tell what they are as yet.
wants to get up. Ordered him zfs of the fever
mixture every hour when he has fever,
and at other times every 3 hours. Nose bled
this morning. 12 M. sitting up. Pulse feeble. Eyes still
red. No eruption. except the aforesaid pimples.
18th Throat still sore, found him sitting up. Pulse very
feeble. Told me I must not call him a sick man.
4 oclk P.M. found him out. 19th In bed. Tongue yellowish
eyes not so red. had a passage (natural) from pills. Pulse
small and feeble. bad taste. ordered Dov: powder
tonight. and one bottle of citrate of magnesia.
3 P.M. Sitting down stairs by the stove the day being
cold. Pulse still weak, and feeble. Tongue cleaner.
Eyes quite bright. bowels open. No eruption.
20 well without any eruption.
Remarks
I think the [eusetic] checkd the approaching
disease. It was just the minute of time to give it
Ind
Mr Hopper Age 26 spare.
symptoms. Frequent desire to pass urine. Pain in 
renal region. Costive. ordered Uva: Ursi zi and the following
pills Aq: Font oi
Calomel grs iii
Rhei 
Aloes a a grs xviii
Ext: colocynth grs vi
m ft: pil xii
one an hour before each meal.
Remarks. Met him a week after and said he was well, except
about the renal region. One pil operated.


Inds
George Owens June 28th
Received a blow from a brick, which caused
his eyes to become much ecchymosed and 
also cut his eye brow, about an inch in length
ordered cold water, at my first
visit, but changed it to slippery elm in the
afternoon. The parts were too tender for [illegible].
His pulse was in the evening full, and 
strong. ordered at my first visit jalap grs xii
Cal grs v
as a purge. In the evening there was no operation.
gave him every three hours
a powder containg 1/3 gr of cal and 2 grs Dov powder
July 1st
Swelling and blueness much less told me I 
need not come any more. His bowels
were not opened after he had taken in 
addition to the above jalap grs xii
Cal: grs v
Rhei grs v
The remarkable feature in this case was
the difficulty of getting his bowels opened
notwithstanding [illegible] care was taken that
there should be nothing on his stomach
at the time. This case strengthens me in the 
idea that simple measure are the
best. Finding the powders had no effect
he took a dose of castor oil. which 
operated.


Typhus Fever ([Farrels] Case)
May 1st Has been in since the 28th Irishman, when 
entered had the ordinary premonitory symptoms
of typhus fever or ship fever. ordered an
emetic. today petechiae have appeared on his 
aldermen. Tongue dry. skin hot and pulse frequent
and gaseous. ordered punch (brandy) zxvi beef tea zviii
Turpentine mixture xzi every two hours.
May 3rd
Tongue moist. Petechiae increasing in numbers.
5th Tongue moist. other symptoms no worse. Cont: Treat:
6th No marked change.
Indianapolis Feby 2nd /59
Catarrhus Infantorum
was called last evening at 8 oclk to see a little
girl 9 mos: old. Fat and healthy looking child, symptoms
dyspnoea, skin hot, feverish, cough with expectoration.
Face flushed. Uniform heat over the body, one of the neighbours 
remarked that she had alternate flushings of heat
and natural temperature. Had two free operations from
some medicine, and had taken an emetic
of hive syrup. I ordered a warm bath, and a mustard
plaster to the chest, with directions if the feet became
cold, and head hot to soak the feet, in a hot
mustard bath. I also prescribed 2 [illegible] of hive syrup
every two hours and the following powders every three hrs
Rx D.P. f gri
Rhei pulv grs ii
m ft: pulv: v
in [illegible]
Feby [illegible] 10 o’clk A.M.
Breathing easier. Skin natural.
Discovered that two biscuspides were fording
their way through. Face not so flushed.
Had a natural passage last night. Has taken
three powders. Slept from 11 o’clk P.M. til 1 A.M. 2 hrs. Cough about 



the same. Saw the tongue imperfectly, whitish fur. Treatment To take the remaining
two powders, with about ¼ teaspoonful of cream of tartar dissolved in ½ pt of
water as a drink as she was thirsty. Reddened the skin with mustard.
over the breast. ordered it to be applied again this afternoon, and another
warm bath to day. 5 ½ “.M. feverish, sleep, bowels unmoved since morning;
had a warm bath, and a mustard plaster on her breast.
Prescribed nothing but the bath, and mustard on the breast. I was
tempted to give small doses of cal: rhei & magnesia.
as she has had only one passage to day, but did not.
Tomorrow will decide whether I was right. The mother and father
think she is better. Drinking the cream of tartar solution, which she
likes. Feby 4th Skin more natural. Cough looser, had two passages one, free and
the other more scanty, I saw the scanty one, and thought it tolerably 
good, rather darker than it ought to be. Slept well last night.
Picking at its nose. Tongue, whitish with a tint of yellow lues
on titty. Treatment continue the sinapisms over the breast as heretofore.
To take one of these powders every two hours cal: grfs
Rhei gri
Magnesiae calc: grs iv
m ft: pulv: no iv
S one every two hours in molasses.
To take one of these powders every two hours
These quantities were not weighed and 
therefore may be more or less than is [illegible] down. 6 P.M. Heard the mother singing
as I came in, and concluded rightly, that the child was better. Has
taken 3 powders no operation Cpoughs still, Has been much better to day 
the mother says, requested a teaspoonful of castor oil to be given at 10 ro 11
oclk to night, if no operation hope that time. Feby 5th Slept well last night.
Had an operation soon after I left last evening they did not therefore give
the oil. No fever tongue cleaner. Disposition to play. Treatment Hive syr: gtts iii
every three hours
with a hip [bath] (warm) and the breast kept red with sinapisms of mustard
Discovered an apthous condition below the lower incisors & biscupidati
prescribed Sod: [illegible] grs xx
Aq: distillat ziv to be used as a mouth wash.
m ft: sol
Feby 6th coughed a good deal last night, disturbed its rest. Skin natural, bowels rather too 
costive. Hive syrup caused it to vomit, stopt it and gr ½ of rhei every three hours.
Teething may be the cause of the trouble. Feby 11th Haven’t see her for 5 days
cough still hangs on, think it is the teeth. Prescribed Linimentum [illegible] zii
Spts: terebinth zi
Aqua: [Comp}: zi
S. M use as a liniment, [illegible] the breast red.s
Feby 18th Met her on the street with her baby, [illegible] well. 



Acute Inflammatory Rheumatisms, (Emma Dixon Case)
Feby 3rd
When I first saw this patient which was
the 2nd of Feby about a week ago I saw that
her rists and hands were
much swollen oedematous and very
tender, the least pressure causing intense
pain the patient is a young mother
about 25 yrs of age. ordered
the following.
grs 5 of [am??] phosphas in solution. with 
5 grs of Dovers powder 3 times daily. and a
liniment composed of ol: olivae. Tr. Canth.
ol: [cajeputi] etc. for her rists and hands.
4th
Rists very painful and
swollen ordered her to rub them with 
camphorated solution of [morphia]
about a gri of the sulphate to and zi of aq: camp
and to take a teaspoonful at night.
Feby 6
stil much pain, in the rists, and
now for the first I noticed that her feet
and ankles were much swollen
ordered a ½ doz leeches to be applied to each
rist and ankle. Cont the above treat
Feby 7th
Much better can now raise her hand
up. cont the above treat
Feby 8th
Complained of loss of appetite. ordered quinine.
complaining of much pain in her ankles ordered hop poultice


Feby 9th
Found much better. expressed great relief from 
the poultice to her feet. Bore a good deal of pressure
upon her hands this morning.
Feby 10
swelling the rists most all gone can use her rists 
and hands pretty well. bore a good deal of pressure this morning redness
all gone.
Feb 18th
Sitts up now and [nurses] her (blk) baby, got
much better on the 11th and has continued
so ever since not needing any attention.
Continuation of Mr Gray’s child’s case of 
dysentery.
Aug 12th 1854 Mr Gray called on me this morning to tell me his child
had several passages of a green collour, but no blood, in the
night. I ordered the warm mustard bath and the diarrhoea
mixture. So that the dysentery has been checked by the 
above treatment
Augst 12th Is now passing green watery stools every hour
which the diarrhoea mixture did not check I gave him 
1/6 of a grain of acetate of lead and 1/16 of grain of morp: every half an
hour and ¼ of a grain of quinine and 1/20 of a grain of morp: every
hour. These powders were given at 8 A.M. and after taking
3 or 4 of the lead powd and 2 of the others the child fell asleep 
and slept from ½ hour to an hour. At 12 ½ M. it was
better not having had but one passage in the course of the
morning. Skin natural and tongue clean. No pain but 
very feeble and anemic. Gave him Cal grsiii
Ipecac gri
Morp: sulp: gr 1/10
Quinine gri
M ft: pulv: No 12 S. on every 2 hrs
also
plumbi acet gri
M ft: pulv iv
S. one after a passage
and at [illegible] time
[illegible] [illegible]
Aug 13th Had 3 stools, in the night 
no blood, thicker and yellow. Skin rather hot pulse quick, and frequent. [illegible] the 
powders with [illegible] gri and in we used quiinine grsii making 2 grs in the whole.
Aug 14th Skin natural. stool less frequent more natural still streaked with blood. did not [illegible]
the powders until I should call in the afternoon I gave 5 grs of Dov: powd: last night at bed time.


March 6th Maria Johnsons family.
This family consisted of a mother and three
daughters ages mother 40 oldest daughter
25 second 15 yrs third 9 yrs and youngest 3 yrs
They all came directly from the ship which 
brought them from Ireland.
Mother Maria Johnson
March 6th
Skin in the morning not hot pulse
about 100. Diarrhoea. Tongue moist with a white
fur upon it. no petechia. not much head
ache. ordered chalk mixture
March 7th 9 A.M
Skin about same. Tongue still moist and
furred. Pulse 100. no petechia diarrhoea still
complains of sickness at stomach. According 
to nurse’s account was delirious all night
ordered effervescing draughts to be given through
the day.
6. P.M
Pulse 120. skin not very hot. Tongue as in morning
March 8 9. A.M.
All the symptoms about eh same no petechia
was up very often during the night. ordered
chalk mixture and starch injection. has been taking
to carb ammoniae. ordered [neut] mixture with vin ipecac
through the night and vin: [illegible]. for stimulus and diarrhoea
9th 9. A.M. Pulse 120. skin rather warm but not hot. Tongue
exceedingly dry and hard. Complains of headache and
drought. No petechia. Diarrhoea better. ordered vin [illegible]



to be continued. Carb. Amiae stopt and terebint: mixt to be given
instead. also a wine glassfull of infusion. made of
Rx Serpentaria rad
Coptis trifoliata a a zfs
Magnesia sulphes zi
to be given three times a day.
6. P.M. Tongue completely moist quite different from what it
was in the morning. skin almost natural. Ordered neut
mixture to be given during the night.
March 13th 9 A.M.
Tongue moist and almost natural collour
skin natural. Pulse about 80. Bowels only opened
once during the night still complains of 
headache. 1 P.M. tongue still very [illegible] bad diarrhoea
14th 9. A.M.
Tongue moist. The skin natural pulse
not more than at 100. little [deaf]. Bowels to day 
are better than yesterday The above tonic was
stopt 6. P.M. not much febrile manifestion
15-16-17th
On the 15th and 16th No diarrhoea but to day 
has it again. skin natural. Tongue moist
18-19th
Tongue very dry. Her husband is also in the
building and she frets a good deal about him. ordered 
turpentine mixture.
March 22
Yesterday the right and as far back as 
behind the right ear was attacked with 
erysipelas. ordered the parts kept wet with
lead water and wine of opium and quinine and [illegible] int
Today found the tongue very dry. ordered mist terebinth.


Fanny Johnson Age 9 yrs
March 6th
Pulse 120 skin soft and natural in the 
morning but very hot with a pulse 160 in 
the evening no petechia. A diarrhoea. Not much
head ache, a tolerable amount of strength
Tongue furred whit and moist.
March 7th morning
Tongue moist on the edges but dry and hot
down the middle. No petechia. the other symptoms
of yesterday not perceptably increased ordered cal et D. powd
6 P.M.
Pulse 160 no petechia skin not over heated
diarrhea less. stopt calomel et Dover’s powders
March 8 9. A.M.
Tongue moister. skin not so hot, as I expected
pulse 120. Puts her tongue out readily and promptly when told
6. P.M. not much aggravation of fever. ordered neut mixt
with vin ipecac through the night every hour
March 9th 9. A.M. Pulse 120. skin natural tongue moist
and not so much furred cleaning from the tip which 
looks red. No petechia. No diarrhoea. No headache.
6 P.M. Skin a slight degree hotter than natural. ordered
neut mixture in the night
March 13th 9. A.M.
Tongue moist and slightly reddened
Pulse about 100 skin feverish. face slightly 
flushed 1 P.M. Face flushed. Pulse 145
14th 9. A.M.
Tongue moist and natural (little redder). Pulse 120
skin natural no stupor 6 P.M. no increase in symptoms


15-16-17th
No symptoms have occurred since the 14th 
that would indicate a augmentation of disease
she is now fast
recovering. Giving reasons to suppose the crisis
was 12th
22nd
rapidly convalescing.
Indianapolis Continuation of Mr Grays child’s case
Dysentery. Aug 14th Change the treatment to the following
strychnia gr 1/12 m ft: pulv: No 12 S. one every 4 hours and syrupus
ferri iodidi gtts iv in 4 tablespoonsful of water teaspoonful
every three hours with port wine. Dovers powd grs v
 at bed time.
Augst 6th Call in, and learnt from the mother that the child
had been getting better until some of the neighbours gave
it some improper food, and the bloody stools returned
I ordered a dose of oil (zi) Have not given the Dovers
powder since the 14th
Aug 17th Had one passage since the taking the oil
with a little blood. Continued the treatment.
Aug 20th Better.
died some two weeks after this with convulsions, according
to Dr: Kitchen who attended.


Elisabeth Johnson Age 15
March 6th
Pulse 120 in the morning but 160 in the afternoon
with a hot arid skin. Tongue moist and
furred white no petechia
March 7th
skin very arid and hot. Pulse 120
very drowsy complains of headache. Tongue white
and furred
6 P.M. skin not so hot. Pulse 160 Tongue as in 
the morning still drowsy
march 8th 9. A.M
Tongue moist, and furred. skin almost natural
Pulse 120. No petechia
6 P.M.
Skin very hot. and pungent. Pulse 140. still drowsy
9th 9. A.M.
Pulse 12. skin natural (little hotter). Tongue moist 
and cleaning off from the tip. No petechia. No diarrhoea
and only little headache. ordered neut mixture
continued.
13th 9. A.M.
Pulse 90. skin natural. Tongue moist
complains of headache. ordered mustard plaster
back of her head.
1 P.M. Face flushed. Pulse 140
13th-15-16-17th
has been gradually improving. yesterday 
had a bad cough ordered 12 dry cupps and cough mixture
Syr: scilla
“ [revena]
Liq; morphii sulp a a zi



18-19th
Says she is better the morning. skin feels natural.
Tongue moist and natural.
March 22
rapidly convalescing
Thomas Mc Lennan case Indianapolis
Sept 23d Aged 49. Pale. Shortness of health. pain extending
from the lower and anterior part of the
right side of the chest, around the back towards
the left scapula. tight hacking cough. Flat
on the right side all over. while the left was
hyper resonant. the pain and [dysnoea]
was relieved by six cups took ziifs
of blood. Blister to the superior anterior portion 
of the right side, of the chest. Gave Syr [scillae] cinch
[illegible]
Tr: opii camp a a sfs
Mass: sulp gr fs
S. zzi every 3 hours
Sept: 27th Pain shifted to the lower part of the right 
side of the chest much [better] otherwise for 
the last two days. This morning came to me complaining
very much of pain, and dyspnoea, the
pain being chiefly in the lower part of the right
lung, applied 4 cups (dry) too pale to lose blood. which 
instantly relieved him. Cough much easier. Dressed
the blister with basilicon. continued the cough mixture
and gave him rx Cal grs vi
Rhei grs x
Aloes grs vi
Ext: gentian 
“ [hyoscianni] a a
“ colocynth grs vi
M ft: pil No 9 one every 3 hours
Tongue covered with a thick
dirty white coating [illegible]
fetid.


2nd year in Blockley.
Childrens Asylum April 7th
Case 1st
Elisabeth [?innock] 6 yrs old has been sick for three weeks
I first saw she was much emaciated and eat
nothing. never changed position all day but
lay all day with its hands by its side and on 
its back with its head thrown back on the pillow
has been taking the following as a standing
prescription Syr. sarsaparilla z
Pot. iodidum
Prunus virginiana
wine whey was also
given every now an then in small doses
This treatment I changed to the following
understanding that its bowels had not
been moved for two days I ordered the followin
powder
Rx Hyd: chl: mite gri
Pulv jalapa grs iii
which was to be repeated every third day.
also as a standing prescription to keep its
bowels regular
Rx Magnesia calc zfs
Tinct senna zi
Ol: carui gtts ii
Saach alba zfs
Liq: calcis zifs
Take a teaspoonful 3 times a day
The magnesia and lime water acting as a purge
and also as absorbents of any gases which owing
to the very deranged state of the alimentary canal
might accumulate. Besides as a tonic I prescribed
& retained the wine whey of the old treatment.


Rx Quiniae sulphas gri
Sacch alba gr
M ft: pil viii one every three or four hours.
April 8th
Found the child still laying in the usual
posture. on its back. the powder operated once a
still pale and emaciated pulse very quick and
feeble. continued the treatment. Has eaten more to 
day than before. Bowels opened twice.
April 9th
Pulse 120 very weak. still laying on its back with the
the same dull and listless expression of countenance. I touched
its abdomen this morning and it appeared to cause pain
the matter in the eyes collects and forms membranes
over the eye. Continued the same treatment. She has been
taking besides I forgot to mention a teaspoonfull of cods liver oil
three times a day. Cannot bear any part 
of her body to be touched
Ol: qec: aselli zi
ziii quotidie
10th 
Found her this morning lying on her side. with 
her head on her arm which I considered an evidence
of returning strength. Her bowels not having been opened 
yesterday I ordered again cal et jalap as before
this being the third day. Pulse very quick and the skin 
rather hot continued the treatment unaltered.
Afternoon visit. The powder not sufficiently purgative ordered
an injection of zfs ol: ricini which caused a thin watery stool.
11th
The oil injection did not operate more than once cont
treatment.
14th Bowels opened every day the matter does not collect above her eyes 
now. very tender can see every bone almost in her body she is [setting]


April 17th Appeared to be not so well has vomited every thing
she eat this morning according to the nurse account.
No perceptable difference in the general appearance
of the child. thinking this might be caused
by the ol: qec: ordered it stop if the sickness cont.
19th
Film collecting around the eyes. Becoming thinner
every day.
20th Died this morning
Cancer of Os Uteri
When I just saw this patient she was
in a most deplorable condition not
able to retain her water, and looking
very thin and pale. The stench arising
from the cancer rendered her an object 
of disgust to all around her. Her urine
dribled from her by drops, almost incessantly 
made an
Phthisis Pulmonalis
Nov 17th Elizabeth Whitehead Age 25.
Saw this patient to day for the first time
Eyes presented the peculiar appearance of phthisis
Blue line around the gums. said that she used 
to have sweat at night. Legs very oedematous
cavernous respiration on the left side. very 
anemic.
Nov 18th Day clear and cool. still anemic. ordered zfs of cod’s
liver oil 3 times a day in porter.


Nov 19th No new symptom. change the ol: Qec: [illegible] for [calas]
phosphas a remedy now coming into popular use in 
phthisis.
Nov 20th
Declare’s herself better. appearance of the patient the 
same
Indianapolis Diabetes May 2nd 1853
Mr a farmer phlegmatic, 46 yrs
of age has been to Dr Patterson who says
he has a diabetes, does not pass much
urine now. urine high colloured;
uneasy feeling across the abdomen
temporary paralysis in the left arm
becomes giddy when [illegible] slim
habit says is urine smells like
new hay
zi of Rad: quassia
Aq: [illegible] oi
zi an hour before each
meal into which dissolve ferri cit zi
walked to my office to day being fine
and appeared well. I am indebted to my
friend Neff for this case.



French 1854
Pertussis
August 8th child 3 yrs old, has had whooping cough
for sometime. I gave it Cal: grs iii
Sod: bicarb grs i
Ipecac gri
Tart: em: gr 1/12
M ft pulv: No vi S. one every 3 hours
Tr: valerian
“ castor
“ [illegible]
[illegible] nitratis [illegible]
Sacch: [alb] [illegible]
[illegible] [illegible] [illegible]
Aug 9
The powders operated six times on the bowels. Cough
better. besides the above I ordered a warm mustard
bath three times a day. Stopt the powders until  
the operating diminished.
Aug 10th Only coughed twice to day. They say the child is
much better. Had to stop the mixture because the
child would not take it on account of the
disagreable taste. I substituted Tr: valerian zi
“ opii camp zfs
Spts: etheris pulp: zi
Aqua ammonia gtts ii
Aqua camp: zi
“ menthae [illegible]
Sacch: alb: [illegible]
Aqua distilled zi
M S. teaspoonful 3 times a day.
Aug 11th Cough’s less. Its parents seem perfectly satisfied
with the treatment. The powders
have done all the good. I think, as the mixture
could not be taken on account of the taste. Took
the second mixture without any trouble, even smacked his
eyes. Is not taking any powder to day.
Augst 12th Continued the 2nd mixture. Cough much better.
NB The treatment in this case has been satisfactory to all.


James Caslin Ireland Age 17 yrs Came in 4-9
April 10th morning 9 oclk
Tongue dry and red gashed in the middle.
very dull and stupid complaining a numbness
all over. no headache abdomen tender on pressure
skin rather hot. ordered brandy punch zviii beef tea
zviii afternoon 5 P.M. No perceptable change skin perhaps
a little hotter.
April 11th 12-13-14 9. A.M.
Has been getting weaker. tongue not [illegible] dry 
this morning except in the middle tympanitic
skin rather hot no headache
April 15th 
Tongue becoming moist at the edges. Found
him this morning with one side of his face swelled
ordered 3 doz leeches to be abstracted from the part.
April 17
His face is now enormously swelled. the [illegible]
muscles are deprived of use. can not shut his mouth
ordered the border of the swelling to be painted with 
tinct: of iodine. the swelling seems to be confined
now to the two parotid glands. and the contiguous parts.
ordered half the quantity of punch and vin [illegible]
 zviii the face to be kept constantly wet with [illegible]
soaked in lead water, and opium.
19th
The abscess has broke inside the ear and matter
is continually running from left ear. he can
now open his eyes pretty well espeacaly the right
taking zviii punch. zviii beef tea and 4 z vin [illegible] [???ssings] as
above.


20th
Discharging a great deal from his left ear. his face
on the left is very much swelled. cont. treatment
22nd
The left side still much swelled. matter [illegible]
of his ear Tongue very dry and hot has
very high fever in the afternoon towards dark
ordered flaxseed poultice to the face and
the following to be given through the day
Rx Mass hydrarg grs xii
Pulv: ipecac et opii grs [illegible]i
M ft: pulv in iv one every 4 hours
Rx Vin antim zfs
Vin: ipecac zi
Sod: bicarb [illegible] ii
Aqua menth ziifs
Syr: simp zfs
Aqua Fort zi
Teaspoonfull every [illegible] hours
along with 4 z punch and zviii vin [illegible] [illegible] beef tea zviii
to support his strength.
22nd
Much better this morning can open the left eye found
him yesterday afternoon sitting up in his bed eating
with a spoon [head] soaked in 
tea. The left ear discharged a great deal last
night. Tongue still dry hot and red at the edges.
very red at the edges
23rd
Much better to day although his face is much
swelled on the left side. The matter is gushing incessantly 
out of his ear and also from an opening
which showed itself for the first time this morning
behind the lower portion of the ear. made the opening
larger and ordered the poultice again. no change in 
the treatment.
24th A large [illegible] came from the opening behind the ear


looks quite bright this morning. tongue red as before
but much more moist.
25th great deal discharged the external opening not much 
from the ear. Much better. cont treatment.
26th
Stopt the antimonial wine mixture and ordered
the quinine sulphas grs xii and protocarb ferri grs xii every 
three hours. Face still much swelled on the left
side. left eye entirely closed, smells very bad.
Discovered yesterday the matter running from the 
other ear.
28th much better. swelling gone down very much.
May 1st great deal discharged from the right ear.
is anxious to sit up and was allowed to do so being
tolerably strong.
June 8th Has been well and assisting in the ward
sometimes for one or two weeks.
Napoleon Continuation of [illegible] Riddle’s case. Acute bronchitis
Dec 2nd and frequent pulse not so strong as yesterday about 80-85
skin rather more feverish. Tongue not so white and furred
Grunts with every breath as if he suffered pain. Treatment Stopt
the antim: mixture again with the determination. not
to use it again in this case if I can help it. Substituted
D.P. grs ii every three hours, with ext: hyos: grs vi 
mustard over the breast and abdomen. He spat 
up two bright red clots of blood before I left. 3 P.M.
Found him much easier, diarrhea stopt, no cough or pain
D.P. and [hyoscya???] have changed him. No more expectoration
Dec 3rd Rather restless last night. until morning the opium appeared
to have affected him. Skin feverish, pulse 80full soft and
easily compressible. Smells better. Headach, cough less frequent
Treat Ipecac & quinine grf iecac gr ½ every three hours.


Typhus Fever.
April 20th Morning 9. A. M. (Harrington’s Case
Pulse 100. Tongue moist but disposed to be
dry. Face the peculiar typhus expression. Eyes very
dull and stupid looking. abdomen arms and
chest thickly covered with petechiae. Abdomen
slightly tympanitic. stools according to the
captain account very offensive (this he told without
my asking) ordered brandy punch zxvi beef tea xviii
Difficulty of breathing and cough ordered 12 dry cups
5 P.M. Skin very hot and pungent. all the other
symptoms as in the morning
April 22nd 9. A.M.
Tongue dryer than yesterday. Pulse 115 (not having
a watch I had to guess at this.) Face still has the peculiar
expression incident to typhus fever laying with his
eyes, half open. skin not very hot. covered from head 
to foot petechia. ordered zfs mist terebinth every
hour with 12 z of punch and beef tea zviii
22nd
Petechia not diminished. Pulse 120. Skin hotter
than yesterday at this time. says he feels little better
tympanitic, tongue moist. ordered as yesterday mist terebinth
Rx Ol: Terebinth
Spts Lavendul a a zfs
Mucilage acacia zi
M
Teaspoonfull 3 times a day
23rd Much worse. Tongue dry. Petechia still covering his
body. Sordes collecting around the teeth. some subsultus
this morning in the hands. ordered the turpentine to be given every
2 hours. Brandy punch zxvi beef tea zviii head to be shaved
and ½ dox cut and ½ dry cups back of his head. and afterwards 


a blister.
24th Tongue moist. Sordes still upon the teeth. skin very 
hot. Stupor less. petechiae becoming rather duller
Pulse 100 or 90. continued yesterdays treatment.
25th Tongue still moist but dryer than yesterday. very
thick sordes on the upper front teeth. Eyes little blood shot
and half closed. pupil very much contracted. very deaf.
The petechiae are disappearing. those that remain have
a bluish look. Cont. treatment head was
shaved yesterday.
26th Found him very sleep and stupid. eyes half open
when he looks at you. does not answer your
questions. cannot protrude his dry and hot
tongue. A thickness of sordes covers his teeth
petechiae almost gone cont: treatment.
27th Great change for the better. Tongue moist and
easily protruded. skin quite cool. Sordes still
about the teeth. not so stupid. Pulse regular 
and rather full. ordered turpentine mixture
every three hours. instead of every 2 hours.
28th Not so well this morning. Tongue dry and protruded
with difficulty. skin hotter. and more stupid
ordered the turpentine mixture every 2 hours again
29th Does not talk any. Tongue this morning was protruded
comparatively easy which moist and coated thickly 
with a white coat. skin cool. sordes nearly all gone.
cont treat:
30th Tongue moist, and cleaning from the tip. skin moist
and cool, pulse regular and full. spoken to me the first
time this morning for a week or more. asked to 
get up. cont treat:



May 1st Tongue clean, nearly half way up from 
the tip. skin and pulse natural is anxious to get
up. teeth white and mouth clean. cont: treatment
May 2nd becoming convalescent.
Thackeray Case
Augst 9th 3 P.M. Pulse about the same. 5 operations since morning, amounting
to a zvi not as much fluid. mouth still cleaning. Augst 11th
Pulse and voice better. Mouth cleaning. Abdomen status quo.
only one passage. much more consistent greenish
and slightly tinged with yellow. sleep much better last
night. 12 M. only one small passage this morning [illegible] [illegible]
[illegible] with Camp: tr: iodini. Augst 11th Slept until 4 A.M. when
[illegible] four operations in succession in all amounting to one healthy
[illegible] [illegible] quantity, better as to odour and appearance and [illegible]
[illegible] a dark green. Pulse very feeble. Abdomen little more swelled.
[illegible] and mouth better. No change in treatment. 2 P.M. Pulse very
feeble Mouth almost clean. 4 operations [illegible] and
[illegible] yellow. Abdomen not so [tumid]. Loathing his food, advised [illegible]
not to offer it until he expressed a desire for it. 7 P.M. No operations since
2 P.M. another [illegible] [illegible] Augst 12th [illegible] operations (as before.) Pulse
little stronger. Mouth nearly clean No change in treatment. Augst [13th]
[illegible] becoming white again. Other symptoms the same. No change
in treatment. 7 P.M. vomited a quantity of acid matter according to his
[illegible] account upon awakening out of a good sleep. 5 or 6 operations, similar to 
[illegible] [above] to day. Mouth threatening again. Augst 15h About as
yesterday and the day before, except had a more natural operation. No change in 
treatment 2 P.M. one operation since morning 5 or 6 small masses like [illegible] meat.
Urine natural. Painted with iodine. Vomited again yesterday after taking the powder
has taken now in all will when though [illegible] [illegible] 13 [illegible] [illegible]
8 P.M. he had 4 operations to day . 3 [illegible] dark [illegible] morning as before [illegible] 2 P.M. 2 stools today greenish yellow


Acute Rheumatism very satisfactory case in 
which 16 z of blood cured. (bloodletting the remedy.)
April 20
Jos Osback came in yesterday age 23 says he has 
been sick one week and never had rheuatism before
complains of pain in his knee joints and in his arm
had to be carried up stairs into the ward and lifted
into his bed. Found him this morning with a full strong 
and regular pulse, which did not correspond
with his face which was pale and also his body.
this pulse was therefore inflammatory. I took immediately 
from his arm 16 z of blood and ordered
pulv ipecac et opii grs v every three hours (each to 
be given at an hour’s interval)
Afternoon visit 5. P.M. Declares himself much better
can move his legs up and down the bed.
22nd Left yesterday for home much better could move
his legs as he pleased before he left.
Thackeray Case
Pulse much stronger. Mouth clearing off again. No change in treatment 7 P.M. had
two stools  today. Augst 18th 3 stools in the night thin and yellowed. Pulse [illegible] the [abdomen]
[apthous] [illegible] still [illegible] Renewed the [illegible]
making [illegible] [proof] [illegible] [illegible] Augst 19th Mouth still apthous. 5 stools greenish
and [semi solid] Petechia upon the back. 4 P.M. 3 or 4 stools one almost
natural. [illegible] Apthae still seen. 7 P.M. appears to [illegible] had a
[illegible] something gelatinous substance in small masses [illegible]
very restless and sleepless, appears to be suffering. changed the [illegible]
to day to chl: potassa et D.P. try abstaining from the arg: Nit. Augst 21st
Was called at 4 ½ A.M. had tossed and [illegible] nearly all night sleeping only 2 hrs.
Pulse very feeble and weak. No other change. Mouth appears better 9 A.M.
almost constant pain in bowels, [illegible] [illegible] grs [illegible] to be [illegible] every two hours. Had [illegible]
[illegible]


Wm H. Darrach’s Case (Teething probably)
June 26th
Wm is 6 months old. The hottest day of the season therm: 84 [degrees] at 3 P.M.
His bowels for two or three days have been irregular as to 
their action sometimes not moving for two days. This morning
they were moved 3 times and in the afternoon and evening
and during the night 12 times. They gradually became
thinner, until towards the last almost ran from 
him as thin as water, and almost colourless accompanied
with much pain, causing the little fellow to twist
and cry piteously. High fever set in about 4 P.M.
I had to walk the floor with him during the night
His stools for two or three days have been light coloured
indicating I though deficiency of bile. About 2 P.M
I gave him about gr ½ of calomel on the end of my finger
and about 10 o’clk P.M. gave him about 15 gtts of paregoric
He fell asleep at 1.15 A.M.
and slept until 4 o’clk A.M. His skin at 4 A.M. was hot
June 27th 
Awoke at 4 A.M. with a hot and dry skin, but
appears much brighter laughs and plays. Operations 
much less painful and towards evening became much 
better. Fed him to day on gum arabic water and boiled 
milk with cinnamon and cloves boiled in it, all of 
which he took with relish. The gum arabic water he liked
better when the fever was on him. Have heretofore been
mixing baker’s bread dried and rolled into powder (coarse)
Thinking there might be some ingredient in this bread which caused
his diarrhea. I stopt mixing it in his milk. Slept sweetly all day nearly
June 28th
Slept sweetly. during the night. No operation during the 
night. Skin natural. Had a good operation about 8 oclk A.M.
going to mix dried boiled flour in the milk instead of baker’s bread
(continued)



A very interesting case
Description of a case that occurred at Blockley
hospital June 24 1851. Caused by eating cherries
as was supposed by the patient rather an 
intelligent man.
June 23
Mich Hurley aged [?9] very diminutive in 
stature. eat some cherries this morning
which caused his bowels to become very loose
sent for me about 6 ½ oclk found him on 
the stool but did not see the discharge.
Pulse very small which I supposed
was his natural pulse as he walk from 
his room down a flight of stairs pretty 
steadily to me and stood pretty [illegible] on 
his feet. I sent him immediately to the 
medical ward where he was not seen
by a physician until an 8 ½ oclk 
at which time he was passing “unpercetably”
to use his own words. the characteristic rice
water discharge of cholera. also vomiting
the same. Pulse very small and attenuated and
feeble. beating about 60 according to Doctor Shively a
minute he was ordered a half a grain of 
morphia in a teaspoonful of aq: camp: and 
half an hour afterwards x grains of calomel. after 
taking this he vomited very freely this rice water
discharge. so that they supposed he had vomited
it up. consequently gave him 20 gtts of the following
mixture. Chloroform zi 
Tr: opii camp zvii
and ordered hot bottles to his
legs and face & mustard
to his stomach
I saw the second time about 10 o’clk
at which time he was laying in a reckless kind 



with his head leaning over the side of the bed
seemingly unconscious of any thing around
and caring less. he was very restless tossing about
from one side of the bed to the other. and
crying out with cramp in his legs. Tongue very
cold. constant thirst, asking incessantly for
water. skin on the back of the hand
and over his body clammy and cold
when [??inched] up into [pleets] remains so
for some time without relapsing int its natural
condition. complains of being very hot inside.
I gave him a teaspoonfull
of the chloroform mixture. before mentioned
10 ½ oclk. still very restless tongue and all 
the other symptoms about the same except the
cramps in the legs which are not so severe.
Passed about a tablespoonful of rice water discharge 
from his rectum. I now ordered a strong mustard 
sinapism to be applied directly to the whole
length of his spine, (the mustard in direct contact
with the skin) the same to the calves of his
legs and his rists. ordered a grain of calomel to 
be given every fifteen minutes and an injection 
of starch and laudanum every hour the
first injection to contain zi of Tr: opii to zviii
of starch mucilage.  the second 60 gtts to zviii
and the third without laudanum.
11 ¼ seems disposed to sleep. still restless and
thirsty has had but one inclination
to stool since 10 ½ o clk. The cramps appear
to have ceased. Tongue still cold. skin warmer 



Rheumatism. Phosphate of Amie
Case 1st (Cold)
Nov 12th Ann Master. aged 50 has had rheumatism
3 years. was at the time of her admission
not able to walk without crutches, and
cried out with pain on being touched
Dec 12th
Can bear pressure upon her limbs
and can walk about with the aid
little stick. In this case the Dovers
powder was given along with the
ammonia.
Jan 20th
still in the wards. much relieved
but not well.
Cold sweat on his forehead. Rept the mustard 
on an hour. We now left him with orders for him 
to have a gri of calomel every 15 minutes and
starch injections every hour untill he went to 
sleep. his pulse has come up. the tibial artery
artery on the maleolus can be felt beating
very distinctly.
June 24th
Found him very much refreshed from 
a good sleep. having fell asleep soon after
we left. which continued untill morning, and thanking
us for having saved his life. skin natural
tongue however still cold. and still thirsty [illegible]
warm tea for him to drink. and the calomel powders
through the day every fifteen minutes.
2 oclk P.M. Tongue still cold. but he is evidently better ordered cal gri
every hour


Case 2nd
aged 18 came in 
with rheumatism of the shoulder and
lower extremities.
Dec 12th 
Has completely recovered
and walks about the ward without
any trouble.
Case 3rd
Aged 76. Coloured came in Dec 11th
Dec 21st 
Has been gradually improving
since he came in.
Jan 13th 
Discharged about a week a go greatly 
relieved 
Case 4th 
Elizabeth Miller, cold, age 12 was
admitted Decr 21
Says he has had rheumatism for 9 yrs. was in 
bed one y ear.
Jan 17th
Complained of pains. this morning in the 
leg
Jan 19th 
walks much better than he did 
took yesterday 10 grs of Dov. powd 3 times repeated
which caused to sweat a great deal.
Jan 20th 


Did not see him to day, but heard no complaints
Jan 21st
Complains only of pain in the elbow and
knee. gave him lin. ammoniae.
Jan 22nd 
Pain in the elbow and left
leg nearly gone.
Jan 24
Still has pain in the left leg.
Jan 27
Did not see him to day.
Jan 28
Great deal better although the day
is damp and rainy
Continuation of Hurley’s Case.
June 25th
Found his pulse full regular and soft
skin and tongue natural. complains of not having
any appetite has not had a stool since yesterday
morning ordered mass hydrarg: grs v to slightly relax
his bowels.
July
This patient entirely recovered and was
operated for hernia by Dr: Page. some six mos
afterwards.


Major Frisby’s Case. Blk.
Jan 21st
Came in complaining of pains all over his
body put him on Rx Ammonia phosphatis zi
aana zvi
M tablespoonful 3 times daily
Jan 24
Says he is better. this is a fine day
however, and it may be on account of the
weather and not the medicine.
Jan 27th
Complains of a little pain to day
Jan 28
No pain. complains to day of a cough.
The day is wet and cold.
[illegible] [illegible] Med:
Case 1st Emma Dixon’s case, acut articular rheum
phosp amia et pulv. ipecac et opii. Case among
the [illegible] medical cases, in another part of this book
Case George Ross age 50 blk
April 23rd Has had rheumatism for 7 yrs. An extraordinarily
large man. weighs about 250. has been often relieved
by the ordinary remedies. complains this morning
pains in his legs can not get out of bed.  ordered 10 grs
of phosphate of amiae with 5 grs Dov. powd: three times a day.,
April 24th Better
“ 25 Still getting better
“ 26th better, but tender over the hips.


28th sitting up and looking pretty well.
May 1st Complains of pain this morning in the old place
in the hip: 
Inds 1854
Sprained Ankle
May 26th Mr [Boon] fell down into a
cellar 15 ft. Contused and cut the back part 
of his scalp, making a cut about ½ an inch
in length and also twisting his [illegible] [ankle]
He did not complain of his ankle when
I saw him Saturday night, but sent for 
me on Sabbath morning. I found the ankle
much swollen and exceedingly tender
Suffered much during the night. [illegible]
[illegible] leeches (American) and [afterwards] [illegible]
[illegible] poultice with hot vinegar poured 
on it. The leeches only applied 12 leeches
May 28th Less swollen and tender ordered
[illegible] blister over it to day and Rx Cal gr 1/11
Mass grs [illegible]
[illegible] [illegible]
M ft: pil [illegible]
S. one every [illegible] hours
Was cured
Thackray Case
9 AM Aug 21st
Another good operation. 2. P.M. was sent for to see the child. No stool since
9 A.M. Abdomen tympanitic. Hiccoughs. eyes roll under the lids. [illegible]
and throat breathing Pulse almost gone. Augst 22nd Pulse stronger more
lively and easier. Was given up last night for dead. Gave him [illegible] anodyne [illegible]
[illegible] motion of bowels seen through the cuticle. Not so tympanitic. Opii gri
Camp [grvii]
M ft: pulv: to iv
Easy and without pain. Tongue coated with a dirty [illegible]
[illegible] coat. Mouth still apthous. had 3 stools in his [illegible]. 7 P.M. [illegible] with his
eyes half closed. Stools [illegible] [illegible] [from] this afternoon. Augst 23d 3 stools more consistent
with yellowish streak through the [illegible] green. Sleeps with his eyes half open.  [No pain]
Pulse very feeble, skin hot. mouth cleaning. 7 ½ P.M. high fever. pulse [160] [illegible] [10 small]


John Sharpless 9 yrs standing. (wht) age 49
April 23rd
Has been taking phosphate of amiae 2 wks his
pain is in the muscles of his limbs. when he first cam in 
2 wks ago had to be carried up stairs. now runs about
ward when he chooses.
April 24th still continuing better.
Inds 1853
Mr Allen’s Case Age 64 (about) anxious face. hard to understand.
Came to my office about 6 wks ago complains of 
a diarrhoea which he says he has had for a 
year. ordered him injections for which according
to his description I though piles, of
cold water. and 15 gtts of Syr: ferri iodidi 3 
times daily an hour before each meal. saw
him 3 wks after this, better complained 
of acidity ordered chalk. Saw again
to day a month after the last visit
found him costive. no acidity. chalk
having removed it. according to his own request prescribed argenti nitras gri
Pulv: opii grs ii
Acacia grs iv
M ft: pil: No viii
one pil an hour
after meals. also to use 
the following as an injection 
as the cold water injections before ordered did
relieve his piles or ulcers as he calls them
having as he says a yellow discharge 
from them. 
Acet: plumbi grs ii
Aqua zviii
M ft: injectio




John Kenneday. Art. Rheumatism April 18th Phosp: amiae
A case of marasmus Augst 9th 1853 Indianapolis
Aged 1 year was first attack with cholera infantum
which was in all probability 
brought on by premature weaning, and feeding
upon arrow root, and mutton broth,
The cholera was apparently checked, but
owing probably to some irregularity in 
the diet, a diarrhoea set in, which 
could only be checked temporarily, and
continued up to the above date. when I 
first saw the child. The most striking
and characteristic symptom was the 
senile appearance of the face, when 
the child cried; together with extreme
immaciation. Two lower incisors were
through.
This case has undergone mercurialism, and
Dr Woodburne is now stimulating with
port wine, and nourishing with mutton
broth.
Query. Was the marasmus caused by the cholera
infantum or improper food.
Thackerey Case
semi solid greenish (spinage) not so much yellow as in the morning. Mouth [illegible]
again. Tympanitic (little) again. Appears to be easy. Stopt the brandy punch on account
of the febrile condition, to be sponged with tepid water. Aug 24th Renewed the punch
[illegible] poultice to the abdomen when pain is present there. Pulse very small and feeble
Augst 25th Eyes wide open when asleep; death upon his face. Augst [26]
Pulse very feeble 120 or 130. Gagging every now and then, [illegible] sinking.
[Stools] not so frequent. dark colour. During the past two or three days the 


[Ahead’s] case (child) Inds
October 18th 1853 Case of contusion in a child 5 yrs old.
This child was found by me, with its heel much 
contused, and lacerated by a heavy bench which
had fallen upon it. There was a cut extending
around the lower portion of the heel, and
a small round mass of muscle had been forced
through the skin. Thinking this had better
slough off I applied flax seed poultices.
Oct: 28th Stopt poulticing and using Turners cerate.
There is now a healthy ulcer with area
of a half inch. all the slough gone.
Nov: 1st Continuing Turners cerate and the ulcer
is bathed in laudable pus and 
cicatrising around the edges rapidly. Quickened 
granulation by lunar caustic.
Nov: 3rd Granulation had to be cauterised, continue the
Turners cerate & opium. General health from the beginning
very good. Throughout this case great attention has
be paid to keeping the foot elevated at an angle of 20’
N.B. This case was satisfactory. The wound healed nicely
and I got paid $10 as soon as I dismissed the case
Thackrey Case
feet swelled, [illegible] subsided. The stools improved also in appearance.
Mouth worse. Refused its nourishment and other little things
it was in the habit of taking Augst 25th ied sometime in the afternoon
The symptoms [illegible] [illegible] which rendered prognosis unfavourable were. continued
emaciation in spite of the rich food taken. Recurrence
of the apthous deposits in the mouth. Continued if not increasing debility.
Swelling of the feet. [illegible] stagnation manifested the petechia on the back
and shoulder.



Cholera Morbus. Inds
Nov: 4th I was called to this case this morning Found
the child lying in the cradle pale and
with dark areolae around its eyes. Its 
mother said it had been vomiting and 
purging for the last 2 days, which had a 
sour smell. The vomited matter looked
like curdled milk and that passed from 
the bowels very yellow and tinged with 
greenish hue. [illegible] mustard to its
stomach 5’ as the child was only 8 mos
old and one drop of laudanum
to be repeated in three hours if the vomiting
did not cease, also a warm
bath. Left cal gri
Dov: powd; gri
Sod: bicarb grs iii
made into 
12 powders one every three hours 
Nov: 5th Vomiting and purging ceased, its mother said it
had fever in the night. sucks well. Eyes bright, and
plays with the children. has a bad cough. Areola
faded. has taken 5 powders. ordered the remaining
powders and another bath. Has had one stool.


[illegible] case
A very obstinate case of incontinence of urine.
April 20th 1849 Blockley Hospital.
This patient came under my care about the
latter part of last month he was then dribling
his urine incessantly and very irritable.
His trousers being continually wet and sometimes
marking his way along the floor when he
walked. He says he has had this constant
dribling for two years without and hours intermission.
he is very weak in consequence.
Before he came under my care he had been
taking the Tr: ferri muriatis 15 drops three times daily 
being very anaemic. and tinct catharides
this treatment was persisted in for a long
time (2 mos) without affording him the least relief.
according to this account. I changed his tonic for
Rx Quinia sulphas grs xii and also [illegible] an hours 
interval Ferri protocarb zfs the gr 1/24 of strychnia 
M ft pil xii unus quatuor horae
April 21st 
last night did not pass any scarcely
There is now no wet patch in his trousers
over his privates
April 22nd
Complains this morning as he [illegible] since he took
strychnia of numbness and inability to stand
on his legs. says he passed a good deal from his 
bladder last night by dribling. It seems to relapse 
backwards as he gets better and show a disposition
to be periodical. The urine the other day
did affect litmus very slightly 
reddened very slightly not near so much as my own did


or that of the apothecary (Mr Marks) both of us being
that day in good health.
23rd
Says he passed scarcely any last night. his trousers about
his privates no keep dry.
24th Did not pass any wine last night scarcely. cont
treat.
25th Did not pass any urine last night. can walk better.
26th Says he pass a little last night. but not enough
for the nurse to notice when he change his
bed clothes in the morning. keeps his trousers dry
and seems to be in better spirits. continued treatment.
27th Pass a good deal last night
28th Says he passed a good deal last night. compared
to what he has done within the last two weeks.
29th Pass a good deal last night. The patient very stupid
irritable will not answer questions put to him.
Cant seem care whether he gets well or not.
20th Pass scarcely any last night says “it comes by 
spells” to use his own words
May 1st
Discovered to day, that he has not taken strychnia
for a week or eight days. nor any medicine for
a tow or three days. ordered all medicine to be stopt
May 2nd Did not pass any last night scarcely.



Syphillitic [?upia]
Saml Williams came July 7th 1857 with
his face body arms and legs covered
over with sores and scabs some of which
were the sise of an American quarter
of a peculiar dark collour. and when 
pressed upon with the finger there
appeared to be from the elasticity
of the scab filled underneath with 
fluid some of them stand out from 
the surface of the skin, the 1/6 of an inch
some of the sores where the scab has
been removed presents a raw chancre
surface.to these are applied the red precipitate
oint.
and the patient is taking the following.
Rx Pot: iodidum zi
Hydrarg: bicholridi gri
Aqua zviii
Tablespoonfull 3 times a day
Rx
Decoct Sarsa
zvi per diem
July 15th
The scabs upon his face after having
filled up (as it were) are beginning to fall off
and leave sores covered with a thick yellow
pus. to which I apply the red percipitate oint.
he complains of [illegible] pain any where
has a good appetite.
July 17th Nearly all the scabs have fallen of and
he says he is a good deal better


July 21st
Not a single scab remaining still continuing
the above treatment.
July 31
has been well for a week past
Inds Infantile Convulsions [sequelae] of dysentery.
March 20th 1855
Mrs Brewer at Little’s Hotel called on me to see her child 2 yrs
of age labouring under convulsions. Found the child [illegible]
breathing natural. Face flushed with an unnatural
dusky hue. Had convulsions every hour, insomuch the 
mother became alarmed and sent for me. The bowels
had not been regular natural since last summer
which the mother attributed to an attack of dysentery
the child then had. I ordered an emetic of
ipecac and tart: emetic and grs v of Dov: powd:
jalap ordered mustard bath and sinapisms to the ankles
and rists. The child since the dysentery attack has been [illegible] [illegible]
greenish
March 21st Much better. Left the following for the chronic 
diarrhea
cal brs iv
Quinine grs iii
[illegible] grs iii
Plumbi acet: grs iii
Mass: sulp: grs 1/8
m ft: pulv: No viii



Phthisis
Cases in which phosphate of lime have been used 
Nov 17th 
E. Whitehead age 26. Anemia large frame,
oyster shell eye. Adunque fingers. Blue line around
the gums legs very oedematous. has had night
sweats. Cavernous respiration in the upper part
of both lungs.
Nov 19th
Symptoms and feelings of the patient the [illegible]
put her upon phosphate of lime. a remedy now
coming into use 10 grs 3 times a day.
Nov 20th 
Says she is better still on the lime.
Nov 24
Much weaker. continued the lime.
Nov 26
Hectic flush more intense. pulse fuller and
stronger. did not examine her chest to day.
Nov 28th
Countenance more healthy, skin natural perhaps
a little colder than natural. Pulse soft and feeble
Same sounds heard in the chest as at first
says she is better. Continued the powder. is much 
stronger. Raised her self to a sitting posture with less effort
than yesterday.
Nov Dec 5th
Countenance the same. not much stronger
feet very much oedematous. yesterday there was
distinct cavernous respiration on the left side 




she also complained yesterday of difficulty in
passing her water. her bladder on perception
was found not to indicate a fulness
it was therefore inferred the kidneys
did not secrete or there was an obstruction 
in the ureters. This morning
much more dropsical, she is rather inclined 
to constipation.
Dec 8th
Did not sleep much last night but declare
herself much better to day. looks rather
more cheerful. her urine is very dark of a 
musty brown collour and very opake, and
thick.
Dec 11
No change in the patient to day
Jo: Riddle’s case
Dec 4th Pulse full and gaseous 100 Breathing rather short
and labored. Skin feverish. Tongue [illegible]
very weak. 3 operations since yesterday. The quinine
appears to have made him feverish. Treat. Gent:
and quassia tea. tablespoonful 3 times daily.
Dec 5th Pulse 80 regular and little hard. Operations less frequent. skin less
feverish. Stools yellow. complains of pain in the region of the 
diaphragm when he raises up. Treat: D.P. gr ½ every 6 hrs
tablespoonful 2ce per diem of the tonic tea.
Dec 6th Pulse 60. Sweat very much last night. One thin operation
Respiration better. Says he feels better, stronger and has a little appetite.
Stopt the D.P. and is taking a tablespoonful of tonic tea
3 times per diem Dec 7th Pulse to be regular and soft. skin little feverish 
No operation since day before yesterday. ordered [illegible] and molasses Respiration
good. No pain Slept pretty well last night. No sweat. Treat


Case 2nd Ellen Groves Age 45
Nov 20th symptoms in this patient indicating
phthisis are the eye night sweats swelled
feet (oedema) and a cavernous respiration at
the upper part of the left lung
Dec 5th
Has been using the phosphate of lime for
two weeks, without much benefit complains
this [illegible] of sick stomach and diarrhoea
with griping. (this diarrhoea I have cause to 
think is caused by the phosphate of lime, it 
being insoluble in water) may also be in 
the juices of the stomach. and therefore act
as an irritant to the stomach, causing
sickness, or to the bowels, causing diarrhoea)
Dec 6th
Signs indicating a cavity on the left side. loud crepitation 
over the left axillae. Diarrhoea less; renewed the
powders.
Diabetes Mellitus. Henry Lynch.
Has had the disease two years entered the
wards Feby 19th when the following
appearances were noticed. Temperament
a mixture of the bilious and phlegmatic
large frame. Broad face and features large
face pale, muscles flabby. The first complaint
was that of excessive thirst and incessant
voiding of urine, I desired him to pass some
into a bottle which he did without the
least effort about zvi of clear white urine
which upon being shaken up a thick white 



foam collected upon the top, which remained
some time, the odour resembled 
apples or new mown hay or limes. Sugar
in great quantity was detected by three
different tests. Before he came in said he vomited blood
Feby 21st
Complains of pain in his breast and 
small of the back. said every thing tasted
sweet, gave him some very sour vinegar
which he said tasted sweetish, which seem
to like, said he “could take any thing like
drink no matter how bitter it was,” these are
his very words, ordered his drink to be made 
one third vinegar. plenty of met which he craved
a wine glassfull of an infusion of 
gentian in which 15 gtts of Tinct: ferri
muriatis was mixed and given 3 times
a day. 10 grs of Dovers powders at night.
passed about 2 gallons last night.
Feby 23rd
No sleep. vomited blood, complains of
nausea after eating passed usual quantity
of water last night. The Dovers powder was not
given last night. Same treatment as above to be
continued.
23rd
Took Dov. powd grs x but did not sleep much
better passed usual quantity last night which
the nurse said had spotts on it as
thick as beer. took some salt and water
to check haematemesis. wants his meat half
cooked cont. the above treatment.


Feby 24th
No change still complains of burning
heat in the left side. cont: treatment.
25th
Better. Did not pass so much water. did 
not complain of the burning in his side
slept better last night
26
Slept well last night complains a severe
burning at the cardiac region could not
detect any thing abnormal there ordered
a blister for the pain. as he said it always
did him good. cont treatment.
March 13th
Up to this time the patient has been alternately
better and worse. often complaining of vertigo
and burning at the cardiac region. about the first of 
march the quassia was substituted for gentian. rest 
of treatment same. The treatment is now entirely changed
Liq: arsenicalis zii
Ammoniae hydrosulphas gtts xx
Tinct hyoscamus
Spts lavendulae a a zi
Infus diosmae zviii
except the Dov powder at 
night
Tablespoonful 3 times a day
March 13th 
Complains of weakness in small of back
[illegible] region his stomach which he says takes 
away his sleep. Quantity of urine still lessening 
passes [illegible] almost half the quantity he did at 



first. the patient is still kept upon 
old treatment. Quassia & Dovers powder gr v
the new medicine not obtainable
besides the medicine he is kept as strictly
as possible on meat diet, still poured
down him immense quantity of water
drinking sometimes seven quarts in 24 hrs
March 14
Complains this morning of pain in region
of the kidneys, which would not allow me to 
press upon this part ordered 6 cut cups
continued the treatment
March 20
Does pass as much urine, spat up blood zifs
last night
March 30th
Cannot keep bread from him but
notwithstanding much better.
Gonorrhoea Inds
Jan 12th 1854
Penis very much swelled, especialy the
gland meatus urinarius extra ordinarily large
A large prominence below the corona gland
on the posterior portion of the penis.
Treatment
Cold water injections. 2ce daily succeeded
by an injection of nitrate of silver 5 grs to the zi
Jan 12th 
Had chordee last night, which would awaken
him out of a sound sleep


Jan 13th Penis much less swollen no running.
less ardor urinae. Took 3 pills of the following.
last night on retiring and had no chordee but was kept awake, through mental anxiety
being a poor man and out of work. His right eye is much 
inflamed, this mornings an old complaint.
[illegible]
Camp: a a grs x
Opii grs ii
M ft: pulv. viii
Treat: applied the solution to the eye and ordered zi of salt
in the morning and powders of cal: grs ii an hour before
each meal. Low diet. (strictly) Dov: powd grs viii
m ft: pulv: viii
Inds 1853
Mrs Manus Case (coloured woman)
I found this woman through Dr Gaston’s
information in a miserable hovel
over the canal. They were too poor to buy
candles. I found her lying upon the
bed in a dark corner groaning as if
in labor. Dr Gaston having told me she 
was about to have an abortion, I was
led astray, and when I heard her
groans. I told her, she need not try
to deceive me for I knew she was in 
labor. she assented to this. 
The next
day I discovered my mistake. and
altered my course. I found that instead
of having an abortion she
had dropsy. This fact was discovered
first by an old Indian Doctor (coloured)
and he out doctored me because I 
relied upon anothers judgement
and not my own. I then, having found
her bowels not opened ordered her a
purge of cal: Rhei: and jalap: large doses 



her pulse was 120. skin feverish.
Tongue whitish and furred. slightly pain 
in the left side, and right thigh.
March 10th
Took besides what I gave her a
dose of castor oil, and when I saw her
found her passing thin watery stools.
Pulse 120. Tongue whitish and furred. I left her
yesterday some cal: and Dovers powder
and this morning found she had taken
all except one. Did not order any 
medicine to day.
4 P.M.
Finding she had griping pains at stool I 
ordered her cal: 
grs ii
Dov: powd grs xii
Morphia gri
M ft: pulv: xii
one to be taken every
three hours
March 11th
Pulse quick and frequent Tongue as yesterday;
has had no passage since bed time
last night Complained of ringing in the head
and crazy feelings last night which I attribute
to the morphia and Dov: powd: together, sweat
last night. The only symptom I dislike, is the pulse
which is too frequent, and quick. Stopt the powder
is taking no medicine now.
1 ½ o’clk Pulse softer says she is better.
March 13th 
Pulse hard and quick, 100. Tongue as yesterday
white and furred. Complains shortness of breath. slept tolerable.
stopt the powders for fear of salivation.
March 14th
Pulse softer and more regular had shortness of breath in 


the night bowels inclined to be costive. Fearing
the dyspnoea indicated water in the chest I 
ordered her cal: and morphia. Cal: grii
Morp: grs ¼
M ft: pil: No 8
one every three hours.
March 15th 
Pulse 110 hard full and quick.
slept well less dyspnoea. Bowels free took zfs of
oil.
March 16th 
Pulse softer and less frequent about 80
or 90 per minute. Bowels regular. Tongue cleaner
ordered for her juniper berry tea and cream of 
tartar and nothing else.
March 17th
Pulse 80. skin natural. Face brighter. Bowels
regular complained of a gristle rising in her
throat when she has these weak spells.
continued the tea.
Pulse more regular, and softer. Tongue whitish.
Skin natural. Slept well. Bowels regular. Urine
opake and deposit a whitish
precipitate, which was dissipated by a slight
heat. ordered the tea continued and added
a tonic tea. Gent: & Columbo
March 21st 
Pulse 100. soft and full Skin moist bowels regular 
Tongue much cleaner. Good appetite
strong enough to sit up a little while by 
the fire in a chair. cont: the treatment
March 23rd 
Pulse quick and strong. Tongue clean 


Bowels regular tells me the tonic tea prevents her fainting 
spells. only taking the tonic tea at present.
April 7th
Has been since the last date getting alternately
better and worse, being attacked with dyspnoea
at times so bad as to prevent her lying down
Has not been taking medicine regularly,
Found her this morning not able
to lie down and her breathing very short.
gave her elatri gri
Cal: grs viii
Jalap: grs xx
Rhei grs xx 
M ft: pil: viii
This patient died last night
Secondary Syphillis
Aug 13th 1854
Age 24 contracted a chancre and bubo some
months ago. Has swelling of the submaxillary 
glands, and excoriation of the side of the tongue
(stomatitis) prescribed Pot: iodidum zii
Aqua zii
Teaspoonful 3 times a day
Low diet.
Ung: [illegible]
also
“ hydrarg
z z zi
also Hyd: bicholor
grs xii
Aqua ziv
M ft: mouth wash.
Jos: Riddle’s case
Dec 7th Cough less frequent and purulent expectoration in 
small masses. Treatment. Tonic tea, tablespoonful three times
daily. Dec 8th Pulse. 72 skin little feverish. [cough] better
All say my patient is better. slept better. Feels stronger
No uneasy symptoms. No operation [illegible] day [before] [illegible]


Ulcer of the thumb resulting from exposure after 
being lanced for 
Oct 12th Barry (Irishman) Age 45 Full habit sanguineous,
Sandy complexion. Had his thumb lanced for felon, and
used [illegible] the same day, when I first saw him, his
thumb was much swelled at the ball, and a
large ulcer (new) with its middle filled with 
slough, ordered a head and milk poultice
Oct: 14
has been poulticing, and this morning I took
away a part of the nail in removing the slough
ordered the poultice again to day.
Oct: 17th Slough, all away, and the ulcer presents
a healthy appearance, ordered him to keep a
piece of lint spread with carbonate of lead cerate
zii to the zi Brought the edges together with sticking plaster.
Oct 20th Has been using the above cerate, which has caused
the ulcer to exude a great deal of pus, without appearing
to hasten the granulating process I sprinkled
powdered rhubarb over one side and, calomel over
to other and did not use the lead oint: did not remove the
strips.
Oct: 31st Strips still on, no union appears to be taking place
between the opposite sides, reapplied the powdered rhubarb.
stopt using the calomel, as the side upon which it was applied, indicated
no improvement the next day. The ulcer does not exude near
as much pus as when the lead oint: was applied.
Oct: 22nd Took the strips off to day, and found much improvement, 
reapplied them and the powdered rhubarb
Oct 23rd Did not come to day I suppose he thinks he is well
[pour] his thumb was doing finely though not well yet.
Thinks the flaxseed meal poultice done him most good.


Oct: 30th Still hanging to the Doctor, though much [better]	
touch it occasionally with nitrate of silver, and still
apply strips of adhesive plaster, much smaller,
and a great less painful
Continuation of Mrs Hamilton’s lease Inds
Jan 14th 1854.
Mrs Hamilton’s cough commence troubling her
about a month ago. Had a conversation with Mr Hamilton
last night, who told me he thought I was correct last winter
but now. thought it was not so; but thought it was her 
liver and not her lungs. When I look back upon my 
course, in this case. I [illegible] myself with a rashness
in venturing a opinion. I paid too much attention to a 
haemoptesis she had one Sunday at church, and her
own description of symptoms without seeing them myself. 
I am a good deal staggered this morning. Another
thing that enabled me to express an opinion was
the apparent good effects from cod’s liver oil. She
has asked me to get her some more to day.
Jan 23rd Has been taking cod’s liver oil in porter teaspoonful
3 times daily felt relieved immediately. Still has cough
Is easily depressed. Was [shaved] a small red line extends
along the outer edge of the fore finger as far as the 
rist, described the pain in it, as stinging and burning 
I told her the nerve was inflamed at least the neurolema. 
Coughed several times in my presence rather 
severely. I can see a great difference in her cough
She is much pleased with the oil
Feb 17th Is still taking the oil, finding it very beneficial to her cough.
The cough increases every time, she neglects taking the oil and is
immediately relieved upon resuming it again. There are several 
circumstances in this case which puzzles me, and at times, make me 



wish I had not ventured an opinion, and then again I
discover symptoms  which fortify me in my former [and]
first impression. The symptoms [illegible] other circumstances
which stagger me is the fact if her not loosing flesh
and as she coughs most when excited, I am inclined to
think her cough sometimes purely nervous, although the
excitement would produce the same effects in some cases
of phthisis. Mistaken or not in my diagnosis there is great
relief from cod liver oil. I still retain her assent, to my 
[first] opinion her husbands argument to the contrary
notwithstanding. She maintains and defends my opinion
on all occasions. It has now been a year since
my attention was first called to her and she looks now as
fleshy as then. Whether the cods liver has been 
the presence of her flesh I cannot say, very
likely it has. Jo: Riddle’s case
Dec: 8th Disposition to sleep all the time. Treat
tonic tea and beer, about half pint per diem.


Inds
Hemoptesis, Mr Jocelyn (Phthisis)
May 6th Found him sitting by the side of the bed
with a chamber in his hand [illegible] which he every
now and spat a mouthful of blood after coughing
told he had been walking and was attacked
when about a mile from his house. Thinks
he spat up 3 pints. Upon inquiring into 
this case I conclude he was labouring with 
phthisis. He said he had lost much flush
has had the cough for sometime, night sweats
dyspnea, and oedema of the lower limbs. I found
that the haemoptisis had stop in a great measure
but ordered him to keep on his back and
quiet, and to take every half hour Acet plumbi gri
Morph: gr 1/32
and a teaspoonful of the following every two hours.
called at 7 o clock 5 hours after and found Spts: Terebinth zfs
Tinct: kino zii
Sacch: alb: ziii
Aqua menth zfs
Aqua zfs
him with out any symptom. left grs x if Dov:
however for him to take at bed time.
May 9th Pulse full, and slow and easily compressible.
spat up about 3 ounces last night. Ordered him to 
take every hour Acet: plumbi grs ii
Morp: sulp: gr 1/24 Took about 3 ounces
by cupping and ordered a blister over the part. Thought 
several times of bleeding from the arm, but thought his pulse
too compressible and gaseous. Found dulness over the sub
clavicular region of the right side, and also over the middle 
lobe of the same lung. vocal resonance very distinct 
on the right side, immediately under the
clavicle, and also over the left lung at the upper and
middle portions. Pass the day without spitting any blood
[illegible] some small coagulated clots. At 9 o clock P.M. [illegible]
been labouring under great oppression and spitting up every
now and then clots of the sise of 25 cts piece. Pulse was full and 


and little hard, I proposed to bleed him but he objected 
His skin was hot and cough frequent. Ordered him a seidlitz
powder every two hours and a teaspoonful of
the following mixture every two hours until the
fever should slacken. Tart: Em grs ii
Pulv: ipecac grs iii
[Pot]: Nitratis zi
Aqua zviii
He also took zfs of castor oil combined with 
xx gtts of turpentine to open his bowels. For his cough
he took vin antim a teaspoonful every two hours.
syr scillae
“ tolu cam
Tinct opii camp a a zi
May 10th
Found him at 8 ½ A.M. Another with no fever, pulse soft and regular. 
Rested well after my last visit 9 o clock last night.
had several coughs and one rather severe and choking [illegible] [illegible] but
threw up at no time blood, except only enough to give the 
expectorated matter a rusty pneumonic tinge. The [illegible]
mixture nauseated him so that he refrained 
from it. The oil operated. Ordered him to day teaspoonful
of turpentine mixture every three hours and
acet: plumbi grs i
[illegible] gr 1/35
mixture, every two hours, and teaspoonful of the cough
not every three hours, if the cough is frequent and if
though rather gaseous. 4 P.M. pulse 80 soft and regular
[???tural] expectorated very little to day no blood scarcely
cough up frequent. He is much better and feels quite
comfortable. Ordered nothing for the night.
[illegible] To day feeling much better, very imprudently, get up
and walk over to my office (about half a square) and [illegible]
sat and walked about the house the rest of the day. 
May 12th In consequence of yesterdays exertion was attacked with haemoptesis 
about 3 oclock this morning which was checked by the usual
[illegible] (as above used) applied a bladder of ice to the neck, which threw
him into a chill and [???nding] to his wife had no effect upon the bleeding


Cod’s Liver oil. (Ol: Rubrum) in Phthisis Rheum etc.
Case 1st Mary Mooney Case.
Feby 6th 1851.
Had been in the ward some time, very thin
pulse small and hand and about 100. Spittle come up 
in small flakes with a mixture of frothy expectoration.
Flat on both sides when percussed. sound
at this summit of the right lung as if there was a 
cavity as large as a dollar or large. ordered
cod’s liver oil zfs three times daily.
Feby 7th
No change in the above symptoms. Cod’s liver oil
made her sick. stopt it.
Feby 8th 9th
On examining her spit cup did not see the little flakes
that I have seen heretofore but a mass of frothy white expectoration 
like that of beer. ordered her a zi of cods liver
oil in a wineglassfull of porter 3times daily. other signs the [same]
Feby 10th morning
Found this morning again complaining of cramps other
symptoms the same as yesterday. The oil nauseates her
afternoon. Did not throw up the oil to day ordered zfs in wineglass of porter
Feby 11th
Made very sick (I believe by the oil.)


Continuation of Wm H Darrach’s Case
June 29th Is now sleeping sweetly in his cradle having fallen asleep without
any coaxing. Drowsy all day and fretfull. 4 stools two last
greenish and greenish white lumps.
June 30th
4 operations first greenish mucous, las three
more natural being yellowish. No fever. Cry’s more
than usual. Drowsy. No medicine to day. Has had
more exercise in the fresh air, riding in his little wagon
July 1st
4 operations about the same as yesterday
with the exception of greenish mucous stools
Appears well except being too thin and too frequent 
stools. No sign of teeth yet.
July 2nd 4 operations, still thin and mixed with mucous
yellowish. very thin as to his body. Not as fretful to day
good appetite. Slept better than usual last night.
No teeth yet
July 3rd 5 operations mucous, and thinnish. In good spirits
all day. Sleeps as well as usual. No teeth as yet.
July 4th 5 operations. Have been feeding him a watery solution 
of arrow-root as we could not get milk. Took him riding morning
and evening. In good spirits has not pulled and bit at things so 
eagerly. No teeth.
July 5th 3 operations. Feeding him now on boiled flour and
milk, still thin otherwise well Had two good rides
morning and evening in his little wagon which
seems to do him a great deal of good. No teeth nor
perceptable prominence of the gum.
July 6th 4 operations. Rode in his wagon in the afternoon. Good appetite 
sleeps well, and appears in good spirits. No teeth nor
swelling of the gums passes water more than usual.
July 7th 4 operations thicker than yesterday. Thin and pale.



Case end Mary [Burns]
Feby 6th 
very thin. Pulse small quick and hard about 65 yrs of age
ordered zfs of cods liver oil 3 times daily. Flat upon percussion 
heard a sound resembling air rushing into a cavity at the
summit of the left lung.
Feby 7-8-9th 
No change stopt the oil as she became very sick
Feby 9th 
She says she is getting better. ordered zi ol: Sec: arell: in 
zii of porter 3 times daily
Feby 10th
Oil sickened her, and caused her to vomit the last dose 
(3rd) up. ordered zifs three times daily in porter. Say she is better not so much
cough
Feby 18th
Examined her chest to-day, found the same symptoms 
of cavity, that were first noticed. continuing the cods
liver oil as heretofore.
July 23rd Baby 5 days old. Inds
Was spending the day at Mr Hamilton’s in the country
when Mr Keely requested me to see his babe. 5 days
which he said was dying. Found a [illegible] baby, which 
would weigh I suppose 5 lbs lying with closed eyes
perfectly motionless. Bowels very loose running almost
incessantly. The father had given it a dose of cordial
which I suppose was the cause of the stupor
Had no feet bathed or rather soaked in rather warm
water, and had its spine and lower extremities rubbed
with flannel. This appeared to revive it, for a short time. Ordered
15 drops a solution of borax, a piece as large as a beech nut
dissolved in zifs of water. I ought to have said mother’s milk zifs
called next day and found the child better without my [illegible]



Matthews Case
April 14th 1851
Flat on both sides on the left cavernous respiration
a man of very large frame has been taking a zf of cod’s liver oil
three times daily for 6 wks.
19th
Not so flat; when he speaks the chest
resounds. Expectoration bloody and watery. Dulness
of sound over the heart. Can hear respiration very
distinctly over the cardiac region. caused him 
to walk up and down the ward about 5 minutes
as fast as he could, which was not very fast however
as he was very feeble, and then listened to his heart.
it seemed to beat faster and the sound was
very dull. could not be seen beating. outside
unless the finger was pressed upon it which it
raised up feebly. This seemed to me to be caused
by debility. it also beat very quick.
23rd Found him to day in bed complaining of hjs [illegible]
at night having had a very profuse one last night
he to weak to get up
25.
Sitting up to day Inds
John Hamilton’s case (a victim of homeopathy)
hard to say which. Active mind. About the first of April
(1856) on a rather warm day, (according to his mother’s account)
he was splitting wood in the open air, and becoming heated
took off his coat. Sometime the next day complained of
pain in his right thigh. They tampered with him 
for about a week, with home made remedies, and
still becoming worse, and sleeplessness coming on 



along with delirium they sent for a homeopathic
who fiddled and fooled with him about
a mouth and came to the wise conclusion that 
was beyond the reach of homeopathy and
requested his discharge. This case after passing
through all the stages of inflammation
suppurated and an abscess of the thigh
succeeded. Dr Bobbs and myself opened
the abscess in two places and both are
now discharging matter. The pus 
was very thin and watery. Chloroform was
given with the happiest result. Dr: Bobbs ordered
rich and nourishing diet, and poultices
to the thigh.
May 9th
has changed his physician. [illegible] Homburg
who has lowered his diet. I am afraid to
his sorrow.
May 29th
Has been kept close to his room which
is badly ventilated incessant discharge from
his thigh from both the upper and lower
opening
John died sometime in June or July 
of shere exhaustion from the purulent discharge.


Inds
Case of Mr Warner
August 10th
A young man 20 yrs or thereabouts. [Neuro], bilious. When first
seen had fever suffering with diarrhoea two or three
days. When I saw him, I found his pulse full and
very compressible. Tongue furred and of a dirty
white colour. 6 or 7 stools a day of a watery nature.
Prescribed Cal grs ½
Pulv: Ipecac gri
Mass: sulp: gr 1/8
M ft: pulv: 
every two hours
Plumbi acet: grs ii
Morp: sulp: gr 1/8
after every 
passage.
Augst 20th tongue still very much furred and keeps his
[illegible] Diarrhoea stopt, in a great measure though his 
stools are still thin, but their colour is now yellow.
Two or three days ago I gave him cal gr ½
Pulv: Doveri grs I every 3 
hours I have given him no medicine since.
His appetite is very scant and he is I think all
the better for it.
August 25th
Has been gradually improving since the
ninth day of the fever. To day his pulse was soft
and regular about 80 per minute. Skin soft
and natural. No operation of the bowels for two days.
Has been taking for the last two or three days a
teaspoonful of the following mixture every three hours
except to day. he now takes it every 4 hours.
Liq: amiae acet z
Tinct: cinchonae [illegible] ii
Etheris sulp: comp: zi
Tinct: opii camp: zi
The paregoric was added
to check a diarrhoea which
he had.
August 26th sitting up, eating his breakfast. Pulse soft and
rather quicker than yesterday at the same time.
Tongue clearing off Skin moist and natural temperature.
August 27th Was up yesterday walking his room. Tongue cleaning rapidly. nearly clean.
pulse at 9 o’clock 90. Bowels opened once daily. Skin natural. Expression natural.


April 28
Age. Much emaciated says he has
only been confined to the house 3 months. very 
flat on both sides of chest. night sweats
oedema of lower extremities. Phthisis eye 
can scarcely walk but manages to 
walk easily and slowly about the ward.
ordered a tablespoonfull of cods liver oil in porter
3 times a day.
25th
Found with his clothes on but very weak. detected
either an enlarged bronchi filled with mucous on 
a cavity at the summitt of the right lung. Feet
very oedematous. no change
Continuation of Wm H. Darrach’s Case.
July 8th 2 operations. Health good except too thin and pale.
July 9th 1 operation Do Do Do Do Do Do 
“ 10th 4 operations Do Do Do Do Do Do 
July 20th Had a high fever was very restless. Head
and superior part of his body hot and acrid while
the feet cold vomited up his milk several times
done well up to this time. Allayed the vomiting by 
a little pepermint and paregoric. Bathed his legs in 
a hot mustard water which appeared to believe
his head and break the fever. Repeated it
before bed time and he slept the second night
naturally and awoke well.


June 1st 1857 Vaccination.
Wm H Darrach age 5 months, in good health. Nervous temp:
was vaccinated at 10 A.M.
June 2nd The punctures a little redder. No areola perceptable 
No fever no perceptable deviation from health
June 4th The former vaccine did not take and had
to revaccinate him.
June 5th No perceptable change
June 6th Ditto these failures I attribute
to kay not drawing enough blood. having only 
produced a slight redness
1st day
June 5th Revaccinated for the third time. Took a little more blood
2nd day 
June 8th Faint blushing areola.
3rd day
June 9th Areola extending. Vesicular elevation perceptable.
Ring of small vesicles surrounded by a faint
and narrow areola. No constitutional disturbance.
4th Day
June 10th vesicles have united and become one large one.
more elevated. Areola not much altered either 
as to sise or colour.
5th Day
June 11th vesicle wider and more elevated. Areola
not much different. No constitutional symp.
6th Day
June 12th vesicle becoming more silvery and elevated
areola about the same. No constitutional symptoms.
7 Day
June 13th vesicle more developed having a small particle of
encrusted lymph in the centre. Commencing to pit
areola 6 times longer and redder.
8 day
June 14th No change except the vesicle more elevated and 
duller white not so silvery. The pit more marked.
9 Day
June 15th Areola no wider, commencing to fade, vesicle changing gradually


very fretful, may be on account of the heat
from the centre into garnet coloured scab
10th Day
June 16th Areola still fading. The garnet coloured scab has
encroached so upon the vesicle as to leave a 
vesicular ring around it, has also become
more deeply coloured and dryer
11th Day
June 17th Areola almost disappeared. Scab taking th e
place of the vesicle. Assuming daily a more
decided garnet colour.
12th Day
June 18th Areola entirely gone, also the vesicle nothing
now remains but the scab, which has 
not yet began to loosen.
13th Day
June 19th Areola and constitutional symptoms all gone I mean
restlessness which makes him pit and
cry through the day Scab still tight but 
show a disposition to separate from the 
surrounding tissue in which it is
imbedded.
14th Day
June 20th Scab still tight and drying fast.
15th Day
June 21st Scab still tight. Appears perfectly dry, except a little
oozing from the centre.
16th Day
June 22nd Scab still loosening around one edge. A little oozing
from the centre.
17th Day 
June 23rd Scab drying, and shrinking.
18th Day
June 24th Scab much smaller
19th Day
June 25th Scab still shrinking, and tight
20th Day
June 26th Scab still tight and smaller.
21st Day
June 27th Scab still tight, beginning to raise up. [illegible] compact.
22nd Day
June 28th Scab loose.
23rd Day
June 29th Scab lost, was lost some time in the night. Not pit
visible in the scar as yet.
N.B. On the [illegible] the day the local and constitutional symptoms
were at their acme.


Diarrhea
Jany 21st 1858. I was attacked with ordinary diarrhea
and made myself. some pills containing Acet; plumb grfs
[illegible]: sulp: gr 1/8
which I took every two hours. not regularly
however. No good ensuing I changed them for the following
misture Tinct: catechu zi
Creta preparat: zfs
Tinct: opii camp: zi
Tinct; cinnamon zi
M: teaspoonful every hour
Jany 23rd
Worse. Stools like serum and mucous. 3 or 4 
a day. Dieting strictly. Toast and tea & rice
Jany 25th Finding these remedies useless, I abandoned
them, and thought I would try tinct: mur:
ferri. not having a very good reason. for so 
doing, as my mind was very imbecile at the time
Jany 27thg In addition to the above. & grs viii of D.P.
twice before retiring. After taking the iron 
a [illegible] a zi alltogether in 3 doses. (more or less)
I took upon retiring grs viii or x of D.P. I did not
weigh it. Almost immediately upon taking the
D.P. I felt sick and had difficulty retaining
it. As soon as I laid down up it came
with the, I think, iron from the acid taste.
Jany 28th
I concluded I was not treating myself
right and that cal: & rhei was indicated
I accordingly took the following.
Almost immediate relief
and change in the colour
of stool.
Cal grs iii
Rhei grs vi
D.P. grs vi
M ft: pil: No xii S. one every hour 



Jany 29th 
Much better. took now cal: grs vi
D.P. grs vi
M ft: pil xii S. one
every hour.
Jany 30th 
Convalescent. took now Quinine grs vi
D. P. grs vi
M ft: pil: No xii
S. one every hour
Jany 31st Well. Not peration since day before
yesterday 2 days and a half. Had one
this evening making 2 days and a half.
I thought I would not taking any aperient
but let nature do the work. I was right
May I always do so.
“Natura sanat
Medicina curat” I hope 
will be my motto.
P.S. Astringents were the stumbling blocks
of nature in this case. cal: Rhei quinine
and the small doses of D.P. the adjuvants.
I consider it very important to notice, that there
was no symptom on the tongue, eyes, skin, or pulse
indicating hepatic torpidity.
Return of diarrhea after almost a year
Monday Decr 13th Was attacked similar to the attack of last Jany. Griping
pains at night, with operations sometimes almost natural as to 
colour & consistency but small as to size, and at others colour good but
consistency too much. I was troubled most a night. 2 operations 
at night. I attributed it to cranberries but may 
be mistaken. Painful [borboryni], with smarting of the sphincter



Have taken no medicine or altered my diet. A
month or thereabouts was attacked suddenly with sick
head, during which I vomited bile all night. No symptoms
of hepatic torpidity as before. I suppose I have 5 or 6 motions
in the 24 hrs. Decr 17th Diarrhea not getting any better, I took cal:
Rhei:
D.P. a a gfs
M ft: pil:
one every two hours beginning 2 hours after meals. No change in diet. Decr 18th operations 
much thinner & more bilious attribute it to the medicine, took 7 pills
= 3 grs of each. Griping about the same. No difference except
as to colour & consistency of stools. Intend taking Quinine gri
Pulv D.P. grs
Ext: Gent:
Ol: [illegible]: Nig: 
4 or 5 operations in 24 hrs. Attending to my business, No
alteration in diet. Decr 20th Took 3 pills of the last sett, but had to 
stop because of the griping and frequency of operations being no less
than before; did not take any medicine yesterday and to day am
much better. I think the first pills unloosed my bound up 
liver. If I had taken astringents as I did last year at 
this time, I think I should have had the same difficulty.
Il est tres necessaire, pour le medecin, d’etudies
beacoup, beau coup. La nature, en querissant
les malades. Il lui faut, l’etudies aved l’oiel
medicale, et ne [illegible] [illegible] point de detourner 
en routes [illegible] Observation et
la patience pourront nous guides [illegible]
les straites de son Labyrynthe.
Il est tres necessaire [illegible] [illegible] [illegible]
de [illegible]
G. M. Darrach




























Diseases Age, Occupation, Treat: & Remedies.
[illegible] zi
Aq Rosa zfs
c


Hospital Cases. Medical.
Wed Oct 3rd 1849
Case 1st
A man who had contracted a fever on the coast of Africa
in which all the crew with the exception of himself and captain
died.
Main points.
On percussion the spleen was found diseased
the dull and flat sound extending up as far the 4th rib and
as low as the 8th dorsal vertebra.
Treatment.
Case 2nd
Dysentery.
Main points.
Face pale, and anaemic.
Case 3rd 
Chronic Pleurisy.
main points
Right side enormously distended
both behind and before. Percussion dull from the beginning
to the end of the lung i.e. from the apex to the lower part.
Anemic;
Treatment. 
Blister. This to be changed as to its location 
before or behind
Remarks. This patient was very anemic, and this condition was 
a counterindication against bleeding. The distension was caused 



by a serous effusion.
Some pathological specimens were exhibited which were
rectum lower portion of the colon smaller [illegible]
nature of the stomach and a portion of the small intestines.
Rectum. and lower portion of the color.
numerous patches of
cicatrised ulcers.
Small intestines.
and enlarged
Duodenum.
Cicatrised patches of old ulcers
Stomach.
A portion of the coat almost 
transparent; owing to ulceration.
These specimens were from a patient


Surgical.
Wed Oct 3rd 1849
Case 1st
Granular lids.
main points.
anaemic in constitution.
Treatment.
Dropt about 5 drops of a 10 grs solution
of nitrate of solver into the eye.
Remarks.
The lids were very much infllamed and the 
vascular capillaries very much enlarged and distended.
The eye was very sensitive to the light.
Case 2nd
Granular lids.
main points.
There was nothing very striking
in this case. Except with regard to the causes. It was at
first thought by the surgeon to be a case of gonorrhoeal
opthalmia. But afterwards it was ascertained that 
the patient being afflicted with sore eyes washed them
in not only his own but others urine, and produced
granular lids.
Treatment.
30 gr solution of nitrate of silver.


Hospital Cases. Medical.
Sat Oct 6th
Case 1st
Typhoid fever
main points.
A very mild case. Tympanitis every slight 
every little prostration. mind rational coutenance florid. Tongue red
Treatment.
Spts. ammnia spts gallici vini. spts mindereri
Case 2nd
Thought to be incipient typhoid fever
main points.
Pneumonic rale. Percussion at the back
part of the chest flat. The symptoms were alltogether pneumonia.
Treatment.
Blister on the back part of the chest. 
below the scapula.
Pathology
1st Arteritis, of the aorta descendens 
in connection with a valvular disease of the heart.
Lungs
One congested the other almost normal.


Surgical.
Case 1st
Gonorrheal swelling of the knee [joint] of the left side
main points.
At this case Dr Fox made some remarks
upon the treatment of gonorrhoea. The urethra should
be syringed out first with cold water once or twice
before injecting it with liquor argenti nitratis. of this
solution one or two injections of the 10 grains solution is sufficient.
afterwards it is to be washed out with cold water
and the cold water injections to be frequently repeated.
Treatment.
Case 2nd
The following were the old cases of granular lids last time doing
well under the treatment.


Wed Oct 10th Hospital Cases. Medical
Case 1st
Pneumonia.
Main points.
The disease was in the upper portion 
of the lungs, both were affected but the right more than
the left as was shone by the greater resonance on that
side. The fore part of the chest below the clavicles was
the part percussed.
Treatment.
Blister and calomel
Case 2nd
Tubercle with chills.
main points.
Gargling sound, induration of the 
upper portion of the left lung.
Treatment
Case 3rd 
I do not recollect what Dr Gerhard said of this case
but there was an immense bulging of the back part
of the left side. The patient was shone to the class last
clinic, then his face was pale, it had now become ruddy.
Remarks Diseases of the heart may be divided into those whose tendency is to 
grow worse and those where there is no such tendency. In the former treatment
is absolutely necessary in the latter not so much so.


Surgical
Case 1st
Gun shot wound.
main points
The wound was caused by a musket ball.
Entered just below the right clavicle. It had no exit.
Treatment.
Cold applications.
Case 2nd
Gun shot wound
main points.
In this case the ball entered the
back part of the chest This was a little boy 
about 10 years of age
Treatment
Cold applications.
Case 3rd
Gun shot wound in calf of the leg. Dr Fox
introduced his finger into the wound but could not
detect any thing The aperture of exit was nearly opposite
to that of entrance.
Remarks.
There was no hemorrhage in either of these
wounds. Dr Fox remarked that seldom was there
any hemorrhage from these kind of wounds until after
the slough which forms had come away. This case was treated
in the same manner except that the wound was filled with a wad of lint 



Sat Oct 13th Hospital Cases. Medical
Case 1st
Typhoid fever.
main points.
16th day countenance had a yellowish 
red appearance. Subsultus. Tympanitis. Tongue dry and hard 
enlarged spleen.
Remarks
Typhoid occurs in pain at all seasons. but in this
country it is more frequent in the Sept and Oct.
It is not contagious. The brain and lungs are
very apt to be affected in this disease, as well as the intestines
which is the seat of the disease. There is always
diarrhoea or a tendency that way. There is generally 
delirium at night more or less never amounting
to much however. This symptom distinguishes it 
from typhus. The bladder should be examined every 
day. Pulse soft and compressible.
Treatment.
Tonics and stimulants.
Brandy. zviii a day
Aromatic. Spts. of ammia in preference to 
the carbonate. Wine whey. Beef tea as nourishment
blisters.
Venesetion and cupping At the former
part of the disease only ought general bleeding to be
adopted


Prognosis.
The flushed reddish yellow face was the best prognostic
symptom in this case
Hospital Cases. Surgical.
The brain and scull of a recent
autopsy were shown. The death was caused by a bullet
entering the left parietal bone, and after taking a
diagonal and downward course completely dividing
both sides of the brain, logged itself in the lower portion 
of the cranium.
Case 1st Case 3rd of the last clinic 
Patient a man 22 yrs old.
Mortification has set in at the aperture of
enterance of the ball. Dr Fox thinks he will have to lose
his limb, thinks this result owing to some important
vessels and parts being divided. The ball had a fractured 
the tibia and passed between that bone and the 
fibula, and came out about an inch below where 
it entered.
The patient looked very pale
The patient who during the summer
was brought in with a fracture and depression 
just above the supra-orbital ridge having
been kicked by a mule was shown and was 
doing very well.


Wed Oct 17th Hospital Cases. Medical.
Case 1st Typhoid Fever.
A man 45 yrs of age was previous to his entrance
in the hospital seized with chills which was
succeeded by an attack of typhoid fever.
main points.
Tongue moist and whitish.
A slight dose of oil caused a diarrhoea, sudamina
were observed upon the abdomen in great quantities
Remarks
In treating this disease, sometimes spts: vin: gall:
is too powerful a stimulus and wine whey is substituted.
Caution is to be observed with regard to opium 
injections in this disease. They are indicated in 
cases accompanied by severe diarrhoea.
Treatment.
Spts: mindereri
[foot] bash
wine whey
neutral mixture.
In this case a conditional bleeding was tired, the pulse
being large and full.
Pathology.’Dysentery.
Case 1st rectum, sigmoid flexure of the colon and
part of the lower portion of the ileum


Rectum.
Large ulcers one of which peirced under the 
mucous coat.
Colon.
Particles of lymph scattered here and there. Left
ulceration in the sigmoid flexure than in the rectum.
There was more however above in the ascending
colon. The mucous coat was of a bright red tint.
This intestine on the whole was the most diseased.
The part of the intestine occupied by the glands of [illegible]
was formed into ridges of lymph. these glands were
not at all affected showing a difference in the pathology
of this disease and typhoid fever.
Case 2nd
Rectum
Slightly diseased
Colon
Near the commencement of the transverse
colon was a large patch of inflammation.
Ileum (lower portion)
very red and inflamed, the [collour] was
almost of a lake collour. In this intestine
and the above patch were the most
prominent marks of the disease.
Remarks
From the above facts dysentery may be combined
with enteritis and colitis either singly or combined.



Treatment of dysentery in Penna Hospital.
Begin with laxatives. Castor oil or rhubarb with 
about xx grains of laudanum.
Ipecacuanha
To determine to the
surface.
Mercurials.
Poultices and topical bleeding.
Venesection ought seldom to be resorted to.
Acetate of lead is not much thought of in the Penna Hosp
in the treatment of this disease.


Surgical.
Case 1st
Amputation of the leg at the upper third the
tibia.
The disease was seated at the lower end of the
the result of a compound fracture. The foot was turned
almost at a right angle with the body
main points.
Flap operation cold applications to
the stump.


Sat Oct 20th Penna Hospital Medical.
Case 1st
Typhoid fever.
main points.
very mild, the only symptoms being
the sudamina and the tongue dry and coated, and
the characteristic hue of the face.
Case 2nd
Remittent fever.
main points.
Resembled typhoid fever very much.
Treatment.
Quinine.
Blue pil grs X
Rochelle salt zi
Pathology.
Typhoid fever.
main points. 
Glands of the [illegible] ulcerated. Large
red patches of inflammation in the mucous membrane
of the colon.
Enlarged spleen, 10 inches long and 40 [illegible] in breadth
left.


Surgical.
The man who received the ball in the calf of his
leg was thought strong enough to bear an operation
of amputation which was expected to day. He 
was not expected to live.
The black man who had his leg amputated
has suffered from haemorrhage. Dr Fox
ordered the charpie to be placed between the 
two flaps, and took up one or two small vessels.
This treatment checked the haemorrhage. Dr Fox here remarked
that this was the objection to flap amputations
the haemorrhage which always occurs from the
vessels being cut obliquely and therefore making a
larger orifice and from the fact, that vessels cut in 
this manner do not contract their orifices when 
cut.
Case 1st
A man who had been operated on for cataract
In the exhibition of this case the doctor took the opportunity
to speak of the diagnosis of cataract, depending
upon the catoptical experiment as a guide. This
is as follows. If a candle is placed before an eye affected
with cataract [those] images will be seen
one of which will be upside down the other two in 
their proper positions. Slightly affecting the mouth
with calomel is sufficient safe guard against inflammation.
Dr Fox remarked that in all cases of cataract 
he believed the retina more or less to be affected. In regard
to the condition of eye favourable to an operation, he remarked 



that the reason of so many failures in the restoration 
of sight after this operation was the fact that they 
were not operated on in the right time. No patient,
says he, should be operated upon if they cannot
distinguish darkness from light, day from night
Oct 24th Penna Hospital. Medical.
Case 1st
Hyperthrophy of the heart with dilatation.
main points.
The sound was flat from the nipple
to the sternum and beyond. There was epistaxis and 
haepnoptesis. Man 28 yrs old rather small stature. Pulsations
evident at the distance of six feet. Bellous sound
which increased to the rasping sound when the patient
walked or exerted himself.
Treatment.
This consist in case of lifting
heavy weights, absence of stimuli and tobacco.
Digitalis gtts X 3 times a day
biatart: potassae.
juniper berry (3 times a day)
The diseases of the heart are divided into organic and functional.
Case 2nd 
Congestion of the Heart.
main points
Lady 30 yrs of age. Had previously 
rheumatism, which disappeared when the heart became
affected. Dropsical effusions. Epistaxis and Haemoptesis.


Oct 27th Penna Hospital. Medical.
Case 1st
Dropsy.
main points.
Pallor of the skin. Oedema of the lower limbs 
when pressed with the indented mark remained a long
time after the finger was removed. Percussion clear to 
the level of the ribs.
Treatment.
Increase the strength with quinine
and iron as well as the other remedies.
Case 2nd
The man who contracted a fever on the coast of Africa
came before the class with ascites. Came into the hospital on the 1st Oct
was shown to the class on the third.


Oct 31st Hospital cases Medical
Case 1st
The man with dropsy and oedema of the lower
limbs, almost well under the quinine and iron.
Case 2nd
Acute Rheumatism.
Characteristic symptoms
Pulse strong and vigorous. Great tendency to perspire. Forcible
actions of the heart, bellows sound.
Remarks.
In these cases of rheumatism the heart is always
affected says Dr Gerhard; in this case there was endocarditis
The heart ought always to be examined when we are at
a doubt in diagnosis. When the joints are inflamed there
is effusion and fluctuation can be detected. Opium 
in substance or in tinct is sometimes applied to the joints
inflamed. Cups also may be applied. Blood was not much 
cupped in this case. When the attack is sudden it
generally lasts about 10 weeks.
Treatment
Venesection and purgatives.
vin: colchici zii
Calc: magnesia zi
Sulp: magnesia zfs


Case 3rd
Typhoid fever. 8th day.
Characteristic symptoms.
No sudamina or tympanitis, spleen unaffected, pulse frequent
and small.
Treatment.
Neutral mixture.
Pathology.
Peritonitis.
Liver
Right lobe hyperthophied left atrophied. Tubercles
Spleen
Tubercles on the surface only but not in the interior
Colon 
A mass of adhesion greyish collour
Small intestines.
Glands of [Peyer] and [Brunner] ulcerated
Stomach. 
An ulcer of large sise at the lower portion.


Nov Penna Hospital. Medical.
Case 1st
Acute rheumatism, with endocarditis and pericarditis.
Characteristics
Face pale, small stature. Friction sound over the region 
of the heart, dulness on percussion.
Treatment
Blister over the region and cups. Calomel
in alterative doses.
Remarks.
Palpitation and other diseases of the heart, generally 
occur in this disease in about three or four weeks after
it has set in. The friction sound along with dulness
upon percussion indicate the existance of pericarditis 
The natural sound of the heart may be explained 
by sounding with the mouth the words “[Lum-Tap]”
the first being long the last short. In a diseased
heart these two words cannot be distinguished
there is a confused intermingling of them thus
[illegible] [illegible] a lengthening out of the last
syllable.
Case 2nd
Tubercles in the upper lobe of the left lung.
Characteristics.
Boy about 15 yrs of age. Stout and apparently in good
health. Cheerful expression of countenance.


Remarks.
Dr Wood remarked, when this case was before him
the fact accounting for the deceptive tendency of this
disease. When tubercles are empty and purulent secretion 
going on there is great irritability but when the 
hollow in the tubercle becomes full, there is little or
no irritation and consequently the patient seems
to enjoy his ordinary health.
Treatment
Good cod liver oil.
Case 3rd
Pleurodynia.
Treatment.
Dovers powders
Calomel grs X
Vin: colchicum gtts XX.
Case 4th 
Chronic pleurisy
Characteristics.
Large swelling in the lower portion of the right side of 
the chest. Percussion exceedingly flat, resembling the 
sound of a board when struck.
Treatment.
Blisters, over the swelling.


case 5th
Palsy and parallysis originating in the spine.
Characteristics.
Patient unable to walk with crutches, and even
then with extreme difficulty.
Treatment.
Strychnia grs IV
Acetic acid zi 
Aqua font zi
Surgical
Case 1st
Wound in the hand from a pistol ball.
Characteristics.
The whole palm of the hand was more or less contused.
Poultice of flaxseed meal was applied to the hand 
and the hand firmly bandages to a splint.



Penna Hospital. Medical.
Case 1st
Typhoid or enteric fever.
Characteristics.
Second stage of the disease. Tongue red, dry, and marked
with small gashes. Stupor in a slight degree. Redness in the 
face. Puke full and compressible. Slight [illegible]
few red spots over the abdomen. Had slight epistaxis.
Treatment.
Oleum terebinth: gtts X in a gum arabic emulsion
every two hours and alternately a wine glass of sago as
thick as will well pour every 2 hours. Carb: ammia grs V
Case 2nd
Pthisis.
Cod liver oil.
Case 3rd 
Rheumatism.
Characteristics.
Swelling and fluctuation under the bursa mucosa of the
rist joint
Case 4th 
Dropsical effusion from intermittent fever.
Characteristics
Albuminous wine.
Treatment. 1st To prevent the return of intermittent [illegible]: pils grs V
Sulp: Quin: grs 2
4 times per day
2nd From the dropsical effusion.
Bitart: Potass: zi
Juniper berry tea pti
“To be well shaken, before taken”


Nov 7th Penna Hospital Medical
Case 1st
Typhoid case of last clinic
Characteristics
Tongue moist. More intelligent. Pulse stronger and more
natural
Case 2nd
Dropsy case from intermittent fever of last time
Characteristics
Oedema much less.
Case 3rd
Eczema
Characteristics.
Small eruption on the back of the hand. Not time for the Tar [illegible]
Treatment.
Gylcerine plaster with an occasional dose of
salts.
Case 4th
A young woman, who complained of general pain
over her body especialy in the stomach and heart.
The spine was examined by Dr Wood who detected
a sore spot about the middle of the dorsal region
to which he applied cupps and a blisters and the
patient was relieved.



Surgical
Case 1st
The man who was operated on for hydrocele was brought
in with his scrotum swelled up again
(Wed) Penna Hospital. Medical.
Case 1st
Typhoid case of last clinic
Characteristics.
Tongue moist, an apple, which he ate produced an
increase of the symptoms, which led to the supposition
of their being ulceration in the Peyer glands.
Treatment
Cal: gri
Ipecac gr1/8
opium gri
Not to allow salivation.
Case 2nd
Dropsy case of last clinic
Characteristics
swelling entirely gone, and the patient well
Treatment. 
Still takes the cream of tartar zi
juniper berry tea pti
Case 3rd 
Diseased mitral and semilunar valves of the left heart.
Characteristics.
The [Lum-Tap] not heard distinctly. Regurgitation 
heard over the aorta. Effusion within the pericardium.
Dulness upon percussion, over the arterial heart.
Has had the disease since he was 8 yrs old now 42 yrs of age



Wed) Surgical
Case 1st
Fungous growth around the anus caused
by rus radicans or common poison [illegible].
Treatment.
Application of nitric acid.
Case 2nd
A large ulcer upon the leg.
Treatment.
Nitrate of silver around the white border.
Penna Hospital Medical
Case 1st
A brain of one who had died of delirium tremens which
was found inflamed but not softened.
Case 2nd The old case of effusion into the cavity of the chest result of [pleuria]
Characteristics.
Shoulder elevated on the affected side
Flatness upon percussion high up the chest.



Case 4th Oedema of last clinic.
characteristics. 
legs much smaller. evacuations from the bowels
diminished from 16 or 17 per day to 7. Face thinner
Treatments
pil: carb: ferri. Quinine digitalis, squill.
Case 5th 
Dropsy from Intermittent Fever.
Treatment. pil: carb: ferri. cream of tartar. juniper berry 
tea.
(Sat) Penna Hospital Medical
case 1st
Phthisis.
Treatment cod liver zfs 3 times a day
Case 2nd phthisis with laryngitis
Treatment cod liver oil internally croton oil externaly
on the neck for the laryngitis
Case 3rd 
Typhoid Fever.
characteristics. 
Symptoms all in the first and mildest form 
Tongue moist and cracked. slight [meteonin].
Treatment.
Neut: mixture zfs three times a day
Case 4th 
Typhoid Fever
Characteristics. Tongue beginning to leave in the middle. Rose colloured spts
[illegible] [illegible]
Treatment. neut: mixt: if there is debility in the evening. wine whey and [illegible] if the tongue 
becomes dry


Case 5th 
Species of chorea.
Characteristics
Shaking of the head. Contortion of the features.
Muttering of disjointed words.
Treatment
Wine glass of the decoction of snake root four times a day
Case 6th 
Eczema eruption on the face of last clinic with amenorrhea.
much less
Treatment carb: potassa. and the local application of glycerine
Aloe. Tinct: of cantharides for the amernorrhea and tart: em: in nauseating
doses.
Case 7th 
Tenia lata
characteristics.
plethoric. uneasiness and pain in the bowels. irregular appetite
obstinate case.
Treatment.
Oleum Terebinth: zfs to a wine glass three times a day.
Penna Hospital Medical
Care 1st
Convalescence from typhoid fever.
Characteristics.
Abdomen tympanitic, tongue dry or disposed to be so
Treatment.
[illegible] arrow root and milk.
oil of turpentine gtts X
Case 2nd 
Pleurisy with effusion (the old case of [last] clinics)



characteristics.
Becoming resonant at the upper part of the cheek
Treatment.
Cal
Case [illegible]
Inflammation of the Pylorus.
Characteristics
Soreness and tenderness upon pressure over the pylorus
complained of vomiting a hot watery fluid.
Treatment
Nitratis arg: gr ¼ three times per day
Surgery.
A man who a week since was struck on the head by the butt of
a gun and had his scull fractured; and who was brought 
before the class at the last clinic, has since died and in 
the right lobe of the brain was found a large abscess from ½ inch
in dept and from 1 ½ wide and 2 ½ inches long before death 
the right side became parylitic
Sat. Penna Hospital
Case 1st
Typhoid Fever.
Characteristics
Tongue dry, [Sordes], abdomen tympanitic
pulse frequent
Treatment.
Neut. mixture. Sago gruel wine glass
every two hours. also the blue pill for the dried state 
of the tongue.



Case 2nd
Chronic gastritis.
Characteristics.
vomiting after meals, constriction 
and pain at the abdomen. Tenderness over the pylorus.
Treatment.
Nitrate of silver ¼ gr with 1/8 gr opium 3 times
a day with Colombo senna and ginger for the
dyspepsia symptoms.
Case 3rd
Asthma.
Characteristics.
Paroxysmal coughs.
Treat.
Tinct of lobelia zi
Syrup of seneka zi
Syrup of squill zi
Case 4th 
Paraplegia.
Characteristics.
A very bad case. the patient unable even to use crutches.
Treatment.
Strychnine 1/12 grain
Case 5th 
Chorea of the muscles of the face with muttering
of unconnected words.
Treatment
Cimicifuga an occasional purge
and constant blisters to the spine 


Feb 6th 1850 Penna Hospital Medical
Case 1st
Impacted foeces in the commencement of the
colon.
Characteristics
Hard, and well defined swelling in the right illiac fossa
Treatment.
Castor oil internally and a flaxseed 
poultice externally intends using the iodine oint
Case 2nd
Inflammation of the liver and duodenum
characteristics
Jaundice, very anemic insomuch as not to allow
abstraction of blood. Tongue black
Treatment
Blue mass gri
opium gr 1/12
every 2 hours
wine whey as nourishment
Case 3rd
Acute rheumatism
Treatment 
Dov: powd: grs V
cal gr i
every 4 hours



“Nature, and disease debate it at their leisure”
Cases recorded in the Philadelphia Almshouse
Case 1st Typhoid fever. Died. June 1st 1850
Wednesday June 19th
Respiration hurried. Pulse compressible
tongue dry. has had 12 cups ordered over the breast
“ “ 20th 
Respiration easier. Tongue dry in the middle
but moist at the edges.
Cases 2nd Diabetes Died
June 28th
Tongue clammy. Pulse small and
weak. complains of a pain in the bones of his legs (one, 
the left there is a slight roughness indicating
the existance of nodes?) Has passed about two gallons
during the night.
Treatments
Beef diet N.B. the rest of the treatment
I have lost by inattention
July 5th
For the last two or three days 
his mind has been torpid, and inactive
“ 5th
Has been up 2 in the night. Pulse rather
fuller. Has a blister over the epigastrium
“ 8th Still weak. Taking spts: vin: gal zii
“ 9th Extremities cold. Tongue cold and white.
“ 11th Extremities continue cold. Pulse very feeble
13th Has had diarrhoea in the night.
15th Pulse weak and small, passes involuntarily [illegible]


Case 3rd
Pneumonia suceeding mania a potu.
June 28th
The mania a potu was slight. The chief features 
of this case was the pneumonia that suceeded
pulse small, and weak; Drs Benton and [?ard]
distinguished crepitation on the right side in the
upper portion of the lung. Tongue a creamy white.
still complains of pain in his chest.
Treat
Has had a blister on since yesterday.
blood from his bowel with 
tenderness, and pain in the bowels to a 
great degree.
17th 
Pulse feeble, and weak. skin cold.
18th Pulse feeble.



Case of Gastritis (chronic)
July 6th
A young and interesting looking german, about
of age of a neuro sanguineous temperament.
Fatigue very red at the tip and in the places
where the thick sordes which covers it elsewhere
has been removed.
July 8th much better. Tongue cleaning off beautifuly
“ 9th Getting along well
“ 16th Tongue still red at [illegible] and covered with a brown
thick coat
13th 
15th almost well. tongue still too red.
16th


Case 4th
Secondary syphilis
James Collum [illegible] in June
all over from head to foot resembling spotted
varioloid so thick were the spots. They were
thickest around the [illegible] and elbows
accompanied by pains in his bones. Taking the
hydriodate of potassa and bicholride of mercury
July 5th 
Continuing the [biniodide] of mercury?
The spots fading rapidly. Take
[Biniodide] in the foll Rx
way
Iodide potassa zi
Bichloride of Merc gri
Aqua zviii
Siz zfs three times a day 
July 8th About as usual gradually gettes better.
“ 11th Continuing to improve
“ 15th Much better.
17th The spots facing rapidly
20th Gradualy regaining a normal appearance
31st Still in the wards, slowly getting rid of the eruption 
Aug 5th Still under my care


Effects of cod liver oil.
July 6th 
Young irishman, has had incip phthisis and
has been relieved; determine to put him on cod
liver oil this morning and watch its effects.
July 8th Has expectorated during the night blood and 
rusty colloured sputa.
July 9th Pulse large and strong. still expectorating 
pneumonic expectoration.
July 20th 
Says he is better. Treatment the same as on 
the preceeding days. being cod liver oil
and expectorant.
Aug 6th Found him to day in bed
Aug 8th Has a disposition to be in bed all day 
although seemingly better.
Aug 14th 
No blood in the cup, little [illegible]
Sept 3rd 
Has been complaining of an intense
pain in the right hypnochondriac region


Case Jaundice from a distended gall bladder
June 19
William Lucy aged
“ 19th 
A swelling the sise of an ordinary potato
in the region of the caput coli (gall bladder)
“ 20th 
“ has taken a purgative and is much better
the swelling less and not so hard.
July 6th 
Walking about and beginning to regain 
his usual colour of skin
“ 8th Still has yellow skin.
“ 9th Still in the wards, but not complaining.
“ 11th Still in the wards, and improving
“ 13th Still in the ward, but the yellowness of skin 
has nearly entirely disappeared excepting that
in the conjunctiva
15th Still improving regaining his natural
collour still yellowness of the conjunctiva 
reach underneath the tongue
16th Improving.
19th Almost well. He is natural collour not altogether
returned. The lump in his side which 
indicated, at the commencement of this attack, 
an enlarged gall bladder, has disappeared,
neither does he feel any pain upon 
pressure.


[Indian???]
Suicide. Cut throat. July 21st [1851] J. C. Elliott
July 21st Saw a man lying upon the floor of the Marion Co: jail
of Indianapolis, with his throat cut. Could make no 
satisfactory diagnosis, as he was not my patient and
did not therefore take the liberty of making the necessary
examination. But from a birds eye diagnosis I conclude
that neither carotids were cut, as it was a right
angled incision with the razor either above the
hyoid bone, or in the thyro-hyoidean space. I could 
say positively which, and such a cut would have to 
almost sever his head off before these vessels could be
reached. I saw him two hours after the act. The symptom
when I saw him are the following. Fixed determined expression 
of eye. Spasmodic gasping for breath. Colour of the
face natural. Intellect perfectly altered, could not talk but
wrote question & answers without trouble upon paper
Makes a shrill peculiar noise, with his efforts to speak or 
breathe. Pulse very feeble. I advised Dr Elliot to sew up ‘
around a trachea tube and if necessary and he
could swallow stimulate, as he was weak from loss of  
blood. He would not permit him to do any thing, until the next morning
at 9 ock. when Dr Kitchen put three stitches, leaving a 
space for the phlelm to run out. His physician diagnosed that the
larynx was completely severed, and the pharynx cut,
I did not think so, however my diagnosis may err. External jugular was not cut
July 23rd Has had afternoon fever, but slight. Pulse in the morning 80 soft, and regular
but in the evening, had, intermittent, 100 and quick. His great trouble is
an accumulation of phlegm, which is after an effort coughed up through the [illegible]
left in his wound. The deep part of his wound has a grummous appearance, a
dirty green colour which I think a little unfavourable. The idea is to heal by granulation.
Cold water, through a wet cloth laid over the wound consititutes the
treatment thus far, this seems to be pleasant to him. Injection & had an operation. Nutrition 


Case 6th General Dropsy
July 1st
Henry Boyle came into the wards, with the whole
of his body oedematous; some time ago says he had
intermittent fever. His tongue is white, and
moist. Put him on cream of tartar and cider mixture
“ 2nd 
About the same
“ 5th
Improved, penis, and scrotum not so large.
An irregular action of the heart detected. Tongue
white, moist pulse rather strong and of a good
sise continuing the same treatment
“ 6th Complains this morning of a sickness of stomach.
Tongue broad, and creamy. Pulse compressible,
continued the above treatment 
“ 8th Still complains of nausea stocking becoming
to loose for him
Bitart: potassae zi
Jalap grs vi
To be taken as a purge
Besides this powder he takes cider mixture
“ 9th Pulse 100. Thinner. Pulse 100.
“ 11th Improving very fast.
13th Giving the purge now less frequently
15th getting better
30th The dropsy has all disappeared except in the 
abdomen where it still obstinately remains



has been complaining of sick stomach and nausea
after swallowing any thing.
Aug 8th Has been very weak for the last two or
three days. The pulse small and feeble and 
the effusion almost entirely left him except
in the abdomen which still obstinately remains
Aug 10th
Gradually declining.
Aug 14 
Has lost his appetite. pulse can hardly 
be felt.
Aug 16th 
Yesterday was tapped. feels to day 
much relieved pulse is better.
Aug 17th
Pulse weak. Prognosis bad.
Aug 20
Pulse stronger. prescribed this morning 
according to Dr haines advice
Fel [bor??ium] grs sviii
Sulp: quinia grs xii
m ft: pils xii
[illegible]: one every 4 hours.
Aug 24th
Died last night


Case of mania-a-potu.
July 9th 1850
Tongue coated over with a substance resembling
mustard. Pulse 100. Eyes red and inflamed 
“ 11th Tongue still coated has had a nap and consequently 
much better
“ 13th Still continues to improve.


General Dropsy et Dysenteria
Aug 30
Came in with his whole body
swelled. ordered
Pulv elatrin gri
Scilla gs x to
Bitart potassa zi
m fr pulv viii
lg one every 6 hours
Aug 31
Has taken four powders complains 
of feeling very cold. A bellous sound
was detected over the region of the heat
ordered a blister over the cardiac region
Sept 1st
Not much diminution of 
swelling.
Sept 3rd
found him with symptoms
of dysentery. the swelling much less
stopt the powder and ordered quinine
and acet: plumbi and opium after each 
evacuation.
Sept 4
Stools running from him involuntarily
with blood. much tinner on account of the 
dysentery. (I think it will cure his dropsy)
Sept 5th
Died this morning of dysentery


case of debility and disordered condition of the blood,
the result of typhus fever (probably)
July 9th
James Brown came into the wards with his
legs and thighs marked with exanthemous
red patches resembling somewhat the
mark of a blister. very much emaciated and 
with a tongue exceedingly coated with a 
thick hard dry, and brown coat.
Giving him oleum terebinth: and beef tea.
July 13th To day erysipelas attacked his face.
“ 15th In the intervening days, he has been 
attacked with erysipelas in the face, which 
has promptly checked by the use of nitrate
of silver smeared over it. Pulse still feeble
20th weaker this morning by reason of a diarrhea which 
has set in ordered him this morning 
Hopes mixt ziv
[illegible] Krameria zi
“ opii zii
m ft. sol tablespoonful tres hourae
22nd Takes brandy punch zii every 2 hrs.
24th Stills stakes brandy with the addition of 
carb: amia his diarrhoea being stops the Hopes
mixture etc. was discontinued
Aug 8th Looks brighter this morning. always feels better
after being sponged all over with cold
water. His whole body is covered with a dry
scaly coat which separates from the cuticle
when even slightly rubbed.
Aug 9th Died last night from shere debility and [innutrition]



Mrs D’s Case Ind.
May 9 Missed the catamenia
May 11 sick at the stomach & bowels moved at 12 midnight.
May 12: morning nausea and bad taste
“ 13th ditto
“ 14 “ 
“ 15 “ Breasts tender to the touch
“ 16 “ No [Kiectine] after standing ten days
“ 17th “ 
“ 18 Not so much morning nausea
“ 19th “ “ 
“ 20th No symptoms now except absence of catamenia, and a 
burning spot over the last false ribs of the right side
“ 21st No morning nausea but thirst. Nausea and attempts to vomit after [illegible]
“ 22nd No complaints nausea after dinner, chill (slight)
“ at 9 ½ P.M. which lasted an hour or two succeeded by nausea
23rd Nausea through the day, chilliness.
24th No nausea or chilliness to day has been very well [illegible] for the
last week have been, according to her account, enlarging
25th Nothing, new.
26th Chills slight through the afternoon and night. A very severe head-ach just
before 6 o’ck, (left side) and back part). Nausea in the afternoon & night.
27th No complaints.
28th “ “ 
29th “ “ 
30th Nausea, and had taste in the mouth all day.
31st Slight nausea in the afternoon & evening, with bad tastes in the mouth
June 1st No complaints.
“ 2nd “ “ 
“ 3rd “ “ 
“ 10th Says her urine for the last 2 or 3 days is thinner & whiter than
usual. Passes it two or three times per nocte


Case of Acute Dysentery
Noonen a lad aged 18 three days before
his appearance in the ward was attacked
with dysentery. his case is as follows.
July 13th
Has been up very often during the night
tongue red, and marked with small white
spots. Pulse 100. ordered the following powders 
to be given him during the day.
Hyd: chol: [illegible] gra vi
Pulv: ipecac: et opii zfs
m ft: pulv vi 
one powder to be taken every three hours.
July 18th
ordered him this morning
Blue mass grs XXIV
Tannin grs XVI
Morphia gri
m ft pil: viii
July 20th In addition to the above pills
Mist: creta ziv
[Syr]: kino zi
“ opii zii
zfs tres hourae
July 24th 
Pulse frequent
Aug 6-7-8 has been sitting up is gradualy regaining health 


July 31st
To day sitting up. Pulse still feeble, and
irregular. looks very thin
Aug 6-18 Sitting up. Is gradually regaining health.
complains of his throat which we for the first
time on looking at it noticed an ulceration
beginning on the lateral half arches, applied to 
them a solution of nitrate of silver.
Aug 10th 
Throat better found him in bed.
Aug 14
Diarrhea returned. perhaps on
account of having got up too soon.
Aug 23
Has been in bed suffering a relapse. To day
prescribed
Syr: ferri iodidi zi
Sq 30 gtts 3 times a day.
Sept 1st
Emaciating very rapidly prescribed
Rx
Argenti nitratis
Pulv opii a a grs iv
m ft pil xvi
one every 4 hours
Sept 3rd Died after having worn away 
almost to a skeleton 


Henry Eisle Dropsy
Taking calomel squill in powder and
wild cherry bark and soda
Effusion within the chest commenced treatment
July 20th Put him in calomel powders grsi daily 
July 28th 
Gums, and mouth little sore. Absorption
not noticeable.
Aug. 7th
According the nurse’s account bled last
night zxii from the nose. which was
finaly stopt by plugging the nostril up 
with cotton soaked in aq: calcis. Stopt the
calomel.
Aug 8th 
No return of epistaxis
“ 9th His chest is gradually coming into its proper
form
Aug 14
Declares himself much better
swelling rapidly diminishing. Yesterday
had another blister which draws
very well
Sept 4
Chest symetrical. No respiration heard and
flatness upon the affected side.


Ind.
Cutting stomach [illegible]
Bilious diarrhea of a child 2 yrs old
Augst 4th
Called to see a child cutting the cuspidati
Its father said it has “flux.” Saw a a stool 
which looked very much like pieces of chewed spinage
floating in a mixture of urine and serum.
Skin natural. Blue eyes. Fair complexion. Healthy looking
child. Mother’s says it is disposed to be drowsy.
Saw no symptoms of metastasis to the brain
No heat of surface or fever. Very restless.
Ordered a mustard pediluvium and if the head became
hot, to apply cold to it, and use the mustard
pediluvium and if necessary mustard plasters to the
gastroenemia Ordered one of the following powders after
every passage. Magnesia calc each powder contains
3 grs of each Rhei
Acacia a a zfs
m ft: pulv: no X
Called 5 hours afterwards. had 3 operations and had taken 3
powders or 27 grs = 9 grs of rhei + 9 grs magnesia + 9 grs acacia
Pa and Ma very anxious about Mary. Ma said her
stools “were just like water.” “But the last one not so
green. Stopt the powders and ordered a mustard 
pediluvium at bed time.
Augst 5th
Found her bright as a button and Ma much
pleased. Stools almost natural.
Left some general directions and made my 
bow.



Typhus Fever.
July 20th 
Son muttering delirium, picking at the
bed clothes. Pulse very quick skin very hot
ordered him to be cupped back of the neck
and the head to be shaved and blistered
July 23rd
Pulse frequently and weak. Face flushed
Tongue very dry and hot. has been to stool three
times, during the night. No tenderness upon 
pressure over the abdomen.
“ 24th
Tongue moist, pulse frequent and weak,
delirium lessened still deaf.
“ 25th 
About the same pulse keeps frequent and
weak.
“ 26th
Tongue hot and dry. skin moist and warm
27-28th
Troubled with diarrhea. Pulse small and
weak. Tongue hot and dry peculiar typhus [illegible]
29th
Countenance more natural. Pulse [strong??]
and fuller tongue cleaning off and becoming
moist. Typhus odour not so perceptable.
31st Pulse softer and mor regular. Tongue becoming
clean, and moist perspires profusely.
Aug 1st Pulse quick and frequent, tongue does not look
so well having a few brown patches upon it
and not so moist.


Aug 3rd
A change for the worst evidently showing
that his system has been too much prostrated
by the fever to react from the attack of diarrhea
which set in about 2 or 3 days ago. Skin cold. 
No pulse scarcely at the rist ordered beef [illegible]
and wine whey.
Aug 4th Died this morning 9 o’clk


James Taylor, Scotchman.
July 23rd Came in with his back covered with 
an eruption which according to his own account
was contracted at sea. There did not
appear to be any itching. Put him on low diet
and gave a purge of salts
“ 25th
about the same ordered to day 10 gtts
of Fowler’s solution every three hours.
“ 28
Continues the Fowler’s solution.
“ 29 Complains of
a soreness about the stomach which I suppose
owing to the  arsenic and ordered it to be 
stopt
Aug 6th 
began the arsenic again. Itching gone 
and the eruption gradualy fading
Agu 8th 
Decided diminution of the eruption continued
the fowlers solution.



[Indianapolis]
July 26th/58 Fracture of the [illegible] parietal bone etc. Mr Gause
In this case after the diagnosis had been carefully and satisfactorily
made. Drs Thompson, Woodburn, & myself concluded 
that the outer table of the parietal bone, was thrown
off about 2 inches leaving the inner table, with two [fractures]
exposed. Enough of the os frontis, was torn away 
leaving the cerebrum exposed in a space, an inch long,
and half an inch wide. Pieces of the temporal bone, was
found loose, and extracted, this piece was about an inch & quarter
of an irregular shape. Another piece ½ inch squarish, from the 
supra-orbital ridge of the os frontis. Beside these there were 
several smaller pieces from the temporal, frontal, & parietal
bones taken out. No haemorrhage of any importance, on account
I suppose of the laceration. Stupor all the time; after these bones were
removed, his pulse full, but revived gain. Rigors occurred
once or twice during and immediately after the operation. Vomiting
of a dark bilous looking fluid took place once, or twice, while 
I was there. This accident occurred in the following manner.
He was attempting to sharpen a ploughshare upon a grind stone, 3 ft in 
diameter. when it suddenly flew in pieces, one struck him 
and his companion, and another was thrown 20 or 30 ft into
the back [shop]. This piece had a foot radius.
July 27th 5 ½ P.M. still insensible. Pulse 120. quick & feeble, skin hot, & [feverish]
Passes his stools & urine involuntarily latter natural, according to Dr Woodburn/
July 28th 12 M. Still stupor with a tendency to apoplectic stertor. Pulse weak. 130
Acting upon the bowels, and liver with large doses of jalap & potassae.
No difficulty in swallowing. Skin feverish. Temperature the same over his body.
I advised strong rubefacient linament for his inferior extremities
July 29th Died at 3 A.M. 3 days after its injury. Before he died, Dr Thompson
says, he had paralysis of the right arm (the left side of the head was the fractured one)
and subsultus of the inferior extremities.? Dr: Thompson says that he had his
hand on the back & side of his head, when he made efforts to vomit, and thought all
the bones, were loosened at their sutures on the left side, that of the fracture.



Case of Scurvey
July 28th 
20 or 3 purple spots on his right leg.
Gums swelled and very soft, and vascular insomuch
that when I slightly pressed them they 
bled. ordered him potatoes and citric acid water
to drink
Aug 5th still in the wards. Gums in the same
condition
Aug 7th still in bed. Gums still swollen and
soft and vascular
“ 10th
Remarkably disposed to lie in bed and
moped away his time; seemingly from shere
indolence.
“ 11th still, lasily lounging in bed. 
Appearances in a man a week after 
taking 40 drops of Fowlers solution.
April 28th 
vomiting this morning
April 29. Right limb oedematous. And an erysipelatous
redness on the posterior superior portion of 
the thigh extending almost down to the knee
May the 1st Two large water blisters in the upper part
large blue veins, traversing the fore part of the limb
limb swelled very much. Has been delirious in the
night. blueness extends down the foot. Discovered the same 
appearance in the other leg in the calf. Pulse very small and
feeble. ordered 16 z of [Brand] punch, died 2 ½ clk P.M.
May 


Vaccination Frank [illegible] Darrach
[1st day]
March 16th vaccinated Frank Monro Darrach.
2nd day
“ 17th 
3rd day
“ 19th Red areola [illegible] naturalise. Health good.
4th day
“ 20th Vesicles forming areola extending.
5th day
“ 21st “ larger and more defined [illegible] distinct very restless and [illegible]
[illegible] [illegible] [illegible] [illegible]
6th day
“ 22nd Rested better last night. No fever. Areola narrower, whilst the vesicle
have become one large one, sise of a small split pea.
7th day
“ 23rd Vesicles now entirely united into one as large as a middle sized 
pea. Areola very narrow and faint pink colour. Reddish
looking spot in the centre, looking like lymph. Restless first
part of the night. No fever.
[illegible]
“ 26th [Areola] suddenly enlarged to ¼ in ch vesicle [illegible] [illegible]
[llegible] seat enlarging
9th day
“ 25th vesicle becoming absorbed into the [illegible] (central) [illegible] yet
no [constitutional] symptom
10th day
“ 26th Vesicle giving [over] to the scab. Areola descending no [constitution??]
11th day
“ “ “ “ “ “ “ [illegible] [illegible]
12th day
“ entirely gone. Nothing new visible except a somewhat
faded areola
[13th day] 
30th Scab only, which is becoming more garnet coloured, still tight
17th day
31st ditto. Scab still tight
18th day
April 1st ditto
19th day
“ [2nd] ditto. Scab still tight
21st day
“ 3rd Scab loosening.
“ 5th Scab being very loose was [illegible] off. [illegible] the pus in the centre.




Case of Scabies where creosote ointment was tried.
Aug 3rd (Worst case in the ward)
John [Hiesenaur] came in to day with 
his whole body thickly covered with scabies
ordered him to be rubbed every morning
with the following ointment
Creosote zfs
[Adeps] zifs
Aug 7th 
Itching not so bad. says he is better.
Aug 8th 
Evidently better. Can now hardly perceive
the eruption.
Aug 10th 
Still, on a fair way to get well.
Aug 16th 
Almost well.
Aug 17th
well except over the shoulder
Aug 28
well except about the calves of his 
legs
Sept 1st 
well.


1858 Indianapolis
Continuation of J. C. Elliott’ case of cut throat.
July 26th Wound dry no supuration or granulation, water when taken
into his mouth runs freely through his wound, in fact the nurse
induces him to swallow water from his mouth, in order to wash
out his wound. Pulse at one time through the day 140 at another 90
Had a severe chill, in which the nurse says he became blue
all over. Starts suddenly when asleep. Muttering constantly 
in his sleep. Emaciating. Dr Elliott was talking of injection
15grs of quinine as an ante periodic, and introducing a stomach
tube, through which to convey his food. Beef tea,
coffee, lemonnade, [illegible] mouth, as some little got into his
stomach in that way, and injection.
July 27th Skin natural. Expression pleasant, & natural. Wound entirely opening & [gaping
outside edges dry. the bottom appears to be healing, aperture in his larynx
closing. Pulse soft, & regular. 80. Nurse says he slept better last night.
I have a better diagnosis this morning, am convinced of the folly of sewing up
such wounds. It must heal from the interior. I am also convinced of the difficulty
of diagnosis in such cases, as to whether the larynx is wounded and what bone 
of the traches, or cartilages. July 28th Pulse natural. one third of which he
swallows gets into his stomach, the rest runs out of the wound.
Skin natural. Wound looks much better. I have more bones of hi s
recovery to day than I’ve had yet. July 31st Granulating at the bottom. [Speaks]
much better. Skin natural, pulse rather weak, regular, and about 80, soft.
Talking about adding alcoholic stimulus to his diet this morning. Sustained chiefly 
by injections, about one third of water be drunk getting into his stomach. Augst 4th Thinner than when
I last saw him. Pulse weaker, articulates much better, can understand him. Wound looks
well, and Dr Elliot thinks is granulating from the bottom. Does not swallow
any better. Still injecting. Augst 6th Thinner. Opening still in the pharynx, I suppose
it is the pharynx subsultus when asleep. Aug 7th Pulse stronger. talks better, wound
about the same. healing very slowly. Augst 13th Pulse strong and natural. Thinner, has been sitting
‘up occasionally in his arm chair supported by pillows since the 9th Talks better, wound about
the same in appearance, swallows about ½ of his food still unable to take solid food.


Mania-a Potu  combined with Erysipelas.
Aug 3rd
Came in the wards about a wk ago
with symptoms of mania-a potu, which soon
afterwards developed themselves. AT the same
time erysipelas attacked the right cheek
The mania-a-potu was treated in the usual
way and the cheek painted with nitrate
of silver (solid stick)
Aug 8th 
Found him this morning very rational
and the erysipelas not spreading
Aug 9th
Found him sitting up in bed this morning.
Pulse rather feeble. His face looks to me about
the same speaks rationally.
Aug 10th 
Erysipelas checked. And altogether much 
better can now hold out his hand, with out
evincing the least tremor. Pulse though 
weak, is soft, and regular, wants to get
up and go to work.
Aug 12th 
Erysipelas and maina-a potu both almost
gone.
Aug 14th
Sitting up. No trace of either erysipelas,
except in the eye of the affected
side which is very red, but not accompanied
with any inconvenience
or pain, or mania-a potu. Reduce his 
stimulus.


Aug 22
Entirely well.
Enlarged liver.
Case March 9th
Dr Wm Hooper dispensary physician, was
kind enough to show me this case. The patient
was an Irishman, 46 yrs old. According to 
the doctor, this swelling became as 
extensive as when I saw it, in a weeks
time. The hypochondriac region of the left
side and as low down as half
the distance between the umbilicus and
symphysis pubis and almost to the
crest of the illium of the right side,
was dull, the patient evincing when 
pressed over the epigastric region.
(more than when pressed over the liver.
The tongue was thickly coated in 
the middle and back part with a 
white fur very white like chalk,
and was red at the edges. Stools
according to his wife were yellow.
Urine filled with [illegible] of ammonia.
Bilious temperament.


A very distressing case of boils covering the whole bod
Michl Sexton age 30 came in with his 
whole body covered with large boils
Aug 16th 
Covering the boils with flaxseed poultice
and giving
Decoction of Sarsaparilla.
Iodide of Potassa zi
Aqua zvi
Tablespoonful 4 times a day.
Aug 20
To day he is better.
Aug 28
Much better.
Sept 9th 
well
Continuation of Elliott’s Case
Augst 16th Nature doctoring slowly, surely, and effectually. Nature curate
Doctor curat.” Speaks very distinctly. walks now around his room.
Expression good. Cicatrix on each side ½ inch in length. Augst 24th Expression almost
natural. sitting up in his chair. Articulates much better, no difficulty in understanding
him. Swallow all his fluid food, by depressing the chin. Still a large gap



Case of Tinia capitis.
Sept 1st
Using ung. sulphuretum iodidi
Sept 11th
child well
Purulent Opthalmia
Sept 1st
child aged 4 yrs. Eyes entirely closed
and very much inflamed outside, when
forced open large quantities pure pus
flowed from them. Began the case with 
dropping a 4 gr solution of nitrate of silver
into the eyes every night and morning
also zfs of magnesia 4 times a day
Sept 3rd
Ordered two small blisters behind
the ears with the above treatment.
Sept 4th 
Substituted xx gr solution for 4 gr
Sept 11th
Can open his eyes, and looks about
him little inflammation left in the eyes 
yet


Typhus Fever
Came into the ward 4 days ago with headache
and pains in the back
Aug 24
Tongue dry and hot and rough resembling
a piece of rare beef baked in the sun
Pulse quick and of ordinary sise. Skin hot
and frequent. Constantly raving insomuch
that he is strapt to the bed.
Aug 25
Less delirium ordered him brandy punch.
Sept 1st
Much better, and wants to sit up.
Sept 2nd
Found him weaker, ordered wine whey 
Sept 9th 
Still doing well
Sept 11th
Not so well pulse weak, complains
of pain in the pubic region.
Case resembling Erysipelas Mrs Roe or Rose’s case
1859
Feby 21st Indianapolis. Mr Stewart visits for the benevolent Ro: sent word to me to 
call on Mrs Roe or Rose [illegible] 35 yr
widow with three children, oldest 12 yrs old. Found her lying in 
bed, at 2 P.M. with her arms swelled, skin tight over them, squamous
patches. Burning itching, and tingling like nettle rash. tells me her legs are like her
arms, also her neck, and head, it seems to affect her whole body. I found her
keeping constantly upon her arms by means of wet cloths, a solution of Alum
do not know the preparations. Could not make up my mind what it was. Prescribed cream tartar
Rhei griv
Ipecac grii
D.P. grs iv
m ft: pulv: No iv. S one every 3 hrs 
I did not weigh these preparations. Substituted the [aloe] wash for slippery elm



Feb 22nd 10 o’clk A.M. Found her sitting by the fire. Says she is no better or no worse, likes the
slippery elm wash better than the other. Took all the powders,
had two, or three, passages. Hardly know yet what it is, still inclines to the belief of
erysipelas in a mild form She has had this 10 days, says it commenced with 
burning and itching and swelling, Says she has an acid taste in her mouth
in answer to my question. Tongue clear. Pulse small and harder than [illegible]
she says she has a small pulse always. 80. Says she could go to work at [illegible]
if her skin did not burn and itch so. Prescribed half a teaspoonful of magnesia
for the acidity and Liq: pot: [illegible] zfs
Acacia pulv grs iii
Aqua menth: zfs
Aqua Destilled ziii
as a feeler. There are not enough constitutional 
symptoms for erysipelas, as
she has had it 12 days now.
4 ½ P.M. better, swelling legs, no change in treatment, except to intermit during the night
Feby 23rd 4 ½ P.M. Arms legs swollen and tender to the touch. Has taken about gtts xxx of [Fowler;s]
solution. No pain in the stomach. Still complains of burning, and itching in the
arms & legs. Prescribed the arsenical mixture 2ce daily. Still using the elm wash.
Feby 24th 4 ½ P.M. Up attending to her work. Arms less swollen, the disease still 
lingers about the upper third of the arm, in the form of an erythematous
swelling, tender to the touch. Complains still of the burning, and tingling, 
I think the Fowlers solution has done good service in this case treat: tablespoonful
twice a day after eating. March 3rd Arms well except a squamous 
eruption on the middle of the A.M. Looks well. Was scrubbing her floor. Is not
now and has not been taking any medicine since my last visit


September.
Case 1st Hepatitis.
Sept 12th
Pulse quick. Surface of the skin has
begun to assume a yellow tinge. Extreme tenderness
over the liver. ordered 12 cups over the
region of the liver and wild cherry bark & soda
Sept 13 Jaundice increasing
Sept 18th 
Tied down to the bed. very yellow. Face
has a very wild expression. very tinder over the 
hepat: region
Sept 20th
L Not so unruly. Tenderness over the liver
diminished. ordered a blue pil every 8 hours in 
addition to the above treatment.
Sept 27th
Much better. for the last 4 or 5 days has
had a diarrhoea for which he has taken
Dovers powder.


Sept 28
Came in with oedema of the legs. ordered
cider mixture.
Sept 19th
Was seised last night very suddenly 
with great dyspnea which threatened to 
suffocate him and an acute pain over the heart
ordered a blister over the heart and 12 dry cups
for the dyspnoea
Sept 20th
found him much relieved in every 
way excepting a pin, which he complain
of in the right shoulder.
This month; the chief diseases were
intermittents and dysenterys. in the [mens]
medical.


October. Surgical.



venereal. (mens)
Oct. 15th
Came into the wards with
his testicle of the left side enormously 
enlarged to the sise of a half a foot and
also a borrowing ulcer extending 2 or 3 inches
up from its opening into the cellular tissue
of the groin. Opening about the sise of a quarter
of a dollar. ordered the ulcer to be injected
with diluted nitric acid 10 gtts to zi
Oct 22nd
Stopt the nitric acid wash in 17th
and substituted for it, black wash, and
the wash to be injected twice a day, into
the ulcer. Has been under this treatment
for a week, and the sore begins to assume  	
a very healthy appearance, granulations
rapidly spunging up.
Nov 7th 
Was tapped yesterday and today his
scrotum is much smaller. The ulcer 
after having appeared to begin heal has
remain somewhat stationary
Nov 8th 
ordered the scrotum to bound with 
sticking plaster. to promote absorption of
the fluid.


[?as]: Surgical
Oct 16 Emma Hamilton age 27 came with 
erysipelas of the neck on the right-side. On
account of which her swallowing was much 
interfered with. along with this there was a very
fetid breath. Painted the whole of the swelled
surface with Lugols solution of iodine
which caused the whole of the painted
surface to be covered with blisters. the
next day. Exceedingly painful to the touch
Oct 20
Swelling not so large but gave for
the fetidness of breath
Aqua chlorine at ae ziv
Tr myrrhae zi
Ol: creasotii gtt viii
Oct: 22
Stops the creosote because of its making
her sick and prescribed
Aqua chlorinata ziv
Tr: myrrhae zi
m ft: garg
Oct 24
Fetid smell of the breath gone, ordered 
her to take a tablespoonful three times a day of the
following
Oct 2
November 1st
The opposite side, beginning to swell
ordered a flaxseed poultice and hydriod potassae


Nov 5th
The opposite side was lanced this
morning by Dr Graham and the poultice applied
N.B. This was at first supposed to be a case
of erysipelas.
Nov 10th
Complained of a cough for which she took
Rx
Syr: seneka
“ scillae
Liq: sol: morphia a a zi
Nov 11
Complained this morning of the medicine causing
a pain in her head and vertigo.
Nov 15th 
Still complains of giddiness, and vertigo in ‘
the head after taking the cough medicine.
There is still a running from the abscess of the neck.
Dec 3rd neck healed.



Case 3rd Margaret Russells Case.
Oct 15th came into the surgical wards
([illegible]) with her fore finger presented
the appearance of being lacerated, which 
upon examination proved to be the result
of neglected whitlow or felon. Upon inquiry
our suspicions were verified her whole
finger was one mass of lacerated surface
having sponged it, ordered a carrot, poultice
Nov 4th
The continual application of the carrot
poultice has made the finger almost
well
Nov 7th 
The finger has all healed except in 
two little spots about the sise of a pea
continuing the carrot poultice.
Nov 14th
The dressing reduced to simple cerate.
Nov 16th
Looked this morning as if it was getting 
worse as if an ulcer was beginning to be formed 
on the end of the finger owing no doubt to some
indulgence in diet.
Dec 3rd Fungous like appearance on the end of the finger
Dec 5th Finger looks red and the ulcer becoming
larger. ordered bread and milk poultice.



Dec 10th
The finger still looks obstinate and
undisposed to heal the loosened and
decayed nail was extracted was 
caused much pain.
Jan 15th
Up to this date the sore has not yielded
to any remedy the last thing used was 
a solution of chloride of zinc gri to zi Two days
ago I commenced, at the suggestion of Dr Page
to touch the sore around the edges with 
lunar caustic. Today I think it looks better.
Jan 17th 
The finger has improved under the caustic
touched it again to day.
Jan 20th 
Did not see her to day. Touched it yesterday.
Getting better.
Jan 24
Found her this morning with her face
swelled and very much salivated. She has
been using besides the pills, calomel in 
an ointment.
Jan 25
Face still swelled very much.
ordered lead water and pulv. tannin.
Jan 27th
Face better. Did not examine the finger
Jan 28 Face better ordered a poultice for 
the finger. Sore beginning to heal from the
circumference in the middle there is a slough
the sise of a twelve-pence.



Nov1st James Cox came into the venereal ward
with two large buboes in each groin, one
having broken before his admission. The
other I lanced ordered both to be injected
with aromatic wine.
Nov 5th
Yesterday the opening in the bubo on the
right side was enlarged by Dr Graham
This morning they both looked red, and
inflamed, with a healthy appearance.
Nov 7th
Bubo of the right-side filled with 
pus ordered it to be kept filled with lint 
soaked in aromatic wine. The buboes also
to be injected with the same.
Nov 8th
The buboes look very red and angry this morning 
Nov 15
No change in the appearance of the sore.
Dec 5th
The buboes look about the same except
on the right side which has been for
the last three or four days been touched
with nitrate of silver (solid) on which 
granulations are spunging.
Dec 10th
The buboes are showing a disposition 
burrow under the skin which was only noticed
to day.



Dec 18
Still in the wards. for the last four or five
days the buboes have been burrowing into
the skin until sinuses two inches in depth
have been made. These have been 
injected with 10 grs sol of nitrate of silver 
and then filled with lint soaked in 
vin: aromat. They are now improving
the sinuses are filling up and the sores 
assuming an healthy appearance.
They have been touched daily around
the edges with lunar caustic.
Jan 13th
Since the last date quinine in powder
has been sprinkled over the surface o f
the left bubo. It now presents a healthy 
character the specific appearance of the sore
having vanished. The right bubo which 
was accompanied with a sinus extending
down the thigh about an inch, has entirely 
closed up with the exception of an opening
the sise of a six pence. Treating them
now as simple sores with simple cerate.
Jan 17
Ordered a poultice for the left bubo as it run
a good deal of matter last night.
Jan 18
The sore on the right side healing around the
edges continuing the simple cerate. the other to be
stuft up with lint as there is still a hole large enough
to insert the end of little finger


Case of ulcer at the elbow joint.
Nov 3rd 
The ulcer was about the sise of a six pence
and had been according
to the patients account has been very 
troublesome by breaking out often it has
been healed over and after falls
upon the elbow.
When I first saw him, it was a little hole
through which you could see the periosteum
of the olecranon process. Ordered
his arms to be straightened and kept so
with a splint.
Nov 8th
Ulcer entirely healed over. Left off the
splint this morning.
Nov 9th
Still in the wards the cicatrix not having
yet become strong enough for the man to use
his arm much in work
Nov 12
Perfectly well, and left the wards to 
go to work.
Dec 1st
Found to day a little hole which extend
through to the bone. ordered nit: arg injected
into it (10 grs to zi).


Bubo and Oedema of the Prepuce.
Nov 7th Jas: Smith’s Case.
came in the wards with a bubo
and oedema of the prepuce. The prepuce
covering the glans penis and creating a 
kind of phymosis. I lanced the 
bubo and ordered it to be injected with 
aromatic wide. The prepuce to be injected
with black wash and a laudanum 
poultice to 
cal [illegible] i
Aq: calais zvi
be applied.
Nov
8th
Ordered cold applications
applied in addition to the black wash.
Nov 9th
The prepuce can now be drawn over
the head further than it could before 
the wash was used.
Nov 16th
Still continuing to improve.
December 2nd
The prepuce can now be drawn
over the glans. A large phagedena was
discovered on the inside of the 
prepuce and partly on the glans touched
it around the edges with lunar caustic.
Dec 3rd
The ulcer was touched this morning with
lunar caustic
continued on.


Erysipelas of the face and body.
November 30th
Catherine Dunphy came
into the wards with her eyes and ears
and whole face swelled and her
whole countenance much disfigured
with erysipelas. Painted the border of 
sound skin pretty freely with nitrate
of silver. (solid). and ordered her a purge
of
December 1st
found the disease extending over
the caustic mark and extending down
the back. No movement of the bowels
ordered her croton oil in pils combined
with other purgatives.
December 2nd
This morning we found the redness
extending still further down the back. and
under the arms. The pills which were given
yesterday have operated. To day the whole surface
extending from the back of the head down
to the 1st and 2nd dorsal vertebra was painted
with Tr: iodine. The pills were
Rx Ol: Tiglii gtts ii
Mass: Hydrarg: grs x
M. ft: pil iii
One pil every hour until a passage
P.S. The first, and second pills were given without
any effet.


December 3rd
The erysipelas is leaving the face
and extending down the body continuing
the iodine and giving internaly quinine & 
beef tea. She is now able to see.
December 5th
To day it is as low as the sacrum
Pulse 118. [illegible] with a hot, dry skin. Tongue
not so much furred. Touched part way
around with lunar caustic.
Dec 6th 
This morning says she is better
Pulse 100 tongue not so much furred, but
cannot yet protrude it with case. 
The redness has not descended any farther
down the body. Night before last was delivered
of a child.
Dec 7th
Dec 9th
Pulse 100 and cuick. Tongue moist and whitish
skin dry.
Dec 10th
The erysipelas spreading down.
The legs, painted it around with iodine Tr:
Dec 11th
Two little abscesses upon the upper eyelids
were lanced this morning seems very
languid and is constantly moaning
Pulse soft and of ordinary frequency. Tongue
moist
Dec 12th
Much better this morning. Pulse almost 



natural.
Dec 13th Complained last night of a painful
little abscess which made its appearance
on the back part of the scalp. ordered
a poultice. This morning still complaining.
The other symptoms however are
gradually leaving her. her eye looks brighter 
and her pulse feels more natural
Dec 18th
Another abscess forming just below
the scapula.
Dec 18th
The abscess on the back is all that
now demands attention. This has been
poulticed and shows an appearance
of suppurating.
Dec. 20th 
The appearances of the 
swelling this morning are I think
against my diagnosis of its being an
abscess. As the poultices which have been
applied, have not the least effect.
ordered one to be put on again to day.
Jan 13th
Up to this date my patient has been daily 
complaining of a pain in the left thigh. The 
The large hole which
was left from the abscess back of the head is filling up fast 


Bubo and oedema of the prepuce. (continued) 
December 4th
The phagedena is still extending
Touched it again with nitrate of silver.
Dec 6th 
The prepuce this morning could not be
drawn back over the glans so that the ulcer
could not be seen.
Dec 7th 
Nothing unusual.
Dec 9th
The ulcer was again touched with lunar caustic
Dec 10th 
The ulcer was touched this morning
pretty freely with lunar caustic.
Dec 11th
No longer extending. Touched it this
morning with lunar caustic.
Dec 12th 
Touched again to day with caustic.
Dec 13th
Complain of erections at night gave
him [camp] and opium. ulcers not burrowing
Dec 17th 
Had an erection last night notwithstanding having
taken grs ix of supuline and the same of
camphor with a third of a grain of opium.
The ulcers healing up under the caustic.



Dec 18th
Had another erection last night
in spite of the pills. The ulcer upon the
left side of the gland is better. Cold
cloths were also applied without any effect
ordered a slippery elm poultice.
Dec 18th
Has had no erection last night
The ulcer on the right side still looking
red and inflamed. the other healed over
entirely.
Dec 19th
Had another erection last night.
Dec 20th
Had a goo look at the termination 
of the largest ulcer, which as far as
I could see extended little below the 
coronal glandis. Touched it again with 
the lunar caustic.
Dec 21st
Oedema of the prepuce. touched the 
ulcer to day again
Jan 13th
Up to this date he has been fast improving
his penis with the exception of a scar the
sise of a five cent piece looks perfectly natural.
He has been using the simple cerate
only for the last week or two.
Jan 15th
discharged from the hospital, well.


James Cox’s Case continued (Buboes)
Jan 20th 
Keeping nothing on the rt bubo, but simple
cerate. And filling the left side with lint
and injecting it with aromatic wine.
Jan 21st
Bubo on the left side beginning to heal
around the edges and filling up with 
granulations. The other is healing very fast.
Jan 22nd
Found something like a sinus in the
right bubo The whole surface was painted
pretty freely with lunar caustic. so also was
the left.
Jan 24
Buboes look about the same as yesterday
Jan 25
No change perceptable from yesterday.
Jan 27th Still look about the same.
Jan 28 no change.
Jan 29
A narrow border of healthy skin was
seen this morning around the wide bubo
ordered the buboes to be washed once or twice
during the day with a one or two grs sol of 
silver.
Jan 30
The border observed yesterday becoming
larger cont. treatment


Secondary Syphillis.
Susan Wilhelm came in covered with
chancrous looking sores. Her throat also
ulcerated and a chancre in the left corner
of her mouth, The scalp was covered
with sores and abrasions. The bridge
of nose also had an ulcer upon it
The vagina was examined, and was
found covered with chancre, as was
also the labiae.
Dec 10th
The sores upon the scalp healing
under the application of lunar caustic
Seems much better in spirits.
Dec 13th
Complains this morning of her eye
The sores upon the scalp have all healed 
except one or two under the use of the
nitrate of silver (solid). Her throat
which was troublesome yesterday
to her has been relieved by the 5 grs sol of sil
applied by means of a camel’s hair brush.
Complains also of a hot fever at midnight.
Dec 17th
Scalp healed over. Eye feels very painful.
Dec 18th 
Scalp still continuing to improve. The eye
according to her own expression is neither better
or worse. The mucous membrane
much inflamed painful



it with a camels hair brush soaked
in a v grs sol of nitrate of silver.
Dec 19th
Eye the only thing that required attention
this morning, which was touched with
the solution.
Dec 20th
The eye better this morning. applied
the brush again.
Dec 21st
Applied the brush again this morning
Jan 13th 
All inflammation has left the eye, but
is very weak and can not bear the light
Jan 14th
Weakness in the eye yet.
Jan 15th
Eye still kept shut on account of the weakness
but says she can see better out of it today 
Jan 16th
Found her this morning sitting reading the
newspaper
Jan 17
The eye getting stronger.
Jan 18
Eye begins to look quite well.
Jan 21st Eye quite bright to day.
Jan 24
Eye almost well
Jan 25th Eye well but on her left leg discovered
an ulcer of a circular form 



about 3 or 4 inches [illegible] and another upon 
the calf of the leg somewhat larger than 
a dollar.
Jan 27
Did not examine this patient to day.
Jan 28th 
Did not see this patient to day. No worse.
Jan 29
Examine the ulcers on her leg to day.
found larger and getting worse under
the blk wash. ordered the surface of the 
sores to be sprinkled with calomel. And 
poultices to the scalp to remove the thick
scabs which were forming.
Jan 30
Ollis Ameys Case Mania-a-Potu
This patient came into the wards Jan 11th
with a slight tremor scarcely perceptable
in the tongue.
Jan 12th 
about the same.
Jan 14th
Tremor in the hands when requested
to hold them out. Tongue also more
tremulous, pupils somewhat contracted
ordered Spts: vin gal ziv
Tr: valerianae
“ assafetida a a zfs 
tablespoonful every 
2 hours.



and gtts of Acet: opii every hour.
Jan 15th 
More tremor over the whole body. Pupils
very much contracted very restless passed
a sleepless night. pulse small and
quick countenance a wild look
continued the above treatment.
Jan 16th
No sleep last night continually
talking about his affairs imagines
there is a woman who he dislikes in 
the cell with him, very weak and
shaking all over like an aspen leaf.
skin feels moist pulse small and quick 
increased the blk drop to every half hour
cont the other mixture as before.
Jan 17th
Found him this morning very 
restless and cowardly. imagines there is a 
company of soldiers outside trying to shoot
him. very weak. no sleep yet continually [illegible]
his trousers and imagining the blanket
on his bed is his new over oat which 
causes him to bery careful of it rolling
it up carefully and pacing it aside
his pillow. Pulse very weak but stringer
than yesterday Has taken from 200 drops
of Acet: opii. cont: heat:
Jan 18th
slept from 12 oclk yesterday untill
3 without waking with the exception frequent
starting and opening his eyes and looking wildly 


Erysipelas, [Cathn] Dunphey case continued on.
Jan 14th
Great deal of discharge from the sore back
of the head this morning. Complained of the
swelling in the back this morning for the
first time for two weeks. On examining it
found a diffused pinkness resembling
erysipelas.
Jan 15th
Opened the abscess on the back beneath
the scapula from which a pint or more of
bloody pus was discharged. The pus had
collected beneath the fascia of latissimus
dorsi muscle.
Jan 16th
Still complaining of the pain in her hip 
and thigh of the left side. The sore on the 
occiput healing up fast no more pain
in the abscess of the back.
Jan 21st
Hip and thigh still pains her. Sore on the
back of the head nearly healed over.
Jan 22nd
Examined the painful leg to day but
could not see any thing to account for 
the pain.
Jan 24th 
Still complains of pain in her left leg
and tenderness upon pressure.


Jan 25
Found her to day sitting up. Did not 
examiner her leg to day.
Jan 28th
Says she has no pain now, and can
walk better continued the liniment.
Jan 29th
Saw the sore back of the head which is
almost healed does not complain of her leg
found her sitting up.
Jan 30
Says she is great deal better.
Ameys Case. Mania-a-potu continued
Around the room. Skin in a warm sweat
pulse softer and fuller. drowsy. ordered
the brandy mixture every three hours with 
7 drops of acet: opii every 2 hours
Jan 19th 
has slept pretty well. much better
lays quiet pulse full and soft wild
expression fast leaving his face. [illegible]
a little yet in his sleep. stopt the opium
Jan 25th
great deal better. had him moved
to the light. slept well last night
Jan 26th
Treating him now for [dysentery]
of which he had when he came in.
Jan 29 Convalecent pretty well.


Cancer of the Mouth, Benson’s Case., 
Solomon Benson entered the wards Decr 2 1850
having been in twice before
& up to May 1st 1849 he has enjoyed perfect health
and worked hard at this time he had an
attack of pleurisy and gonorrhoea. he was
 discharged cured March 1st 1850 he felt a
 slight soreness in the roof of his mouth
soon two small ulcers were perceptable
The attending physical thinking it owing to decayed
teeth, had five pulled, but obtained no relief
he was again discharged, and again 
admitted August 1850. At this time having
become discouraged with medicine, would
not have anything done for him and left
the house in September 1850, and staid
out until his present entrance Decr 2 1850 
At this time
there was a fissure large enough in some
places to lay the points of your little finger
in, extending irregularly from one side of 
the mouth of the other. Dr Graham who had 
the wards at this time put him immediately 
upon the protiodide of merc and ptyalised
him, the fissure was touched every 
other day with lunar caustic. The sore
seemed to get worse under such treatment and
it was stopt by me I now having charge
of the ward. He was now given a gargle
creosote gtts iv
Aqua zviii and continued for two weeks 



scarcely any improvement being perceptable
I changed the gargle to acidum nitrici gtts viii
[Aqua] zviii
use as
Jan 16th
The outside of his face much swelled 
using nitric acid gargle. suffers a good
deal of pain and has no appetite.
Jan 17
Gave him the following to be taken internally
Rx
Zincae Chloridae gri
[Aana] zviii
Tablespoonful twice a day.
Jan 21st
Made an examination with the 
probe, and found the back part
of the mouth very much diseased.
applied grs sol solver by means of 
a camels hair brush.
Jan 22nd
Did not examine the throat to day.
complained of the gargle to making his
mouth sore. substituted gtt ½ to zi
Jan 24th
No so much pain in the side of the
face to day swelling gone down. Cont. treat
Jan 25
Did not perceive any difference in 
the appearance of the sore touched it with 


10 grs sol of silver applied by means of a
camels hair brush.
Jan 27 Did not examine him to day but says
it feels easier.
Jan 28
Examined the back part of the mouth
to day and think it looks better. The fissure
is not so large as it was
Jan 29
Did not examine his mouth to day but he 
is however no worse.
Jan 30
Found him this morning with the
left side of his face much swelled
up to his eye.


Acute Bronchitis
Nov: 29th 1860 Was sent for toe see Joseph [Ridley] residing
2 miles south of Napoleon. About 30 yrs of age. [illegible] sanguineous. 
Skin hot and feverish. Pulse 100 to 112. Was attacked
two or three days ago with a chill, thought he was 
going to have the ague. Cough dry and tight.
Costive. Took this morning a dose of salts and had a
operation. Pain in the breast physical signs between the 
clavicles loud bronchial respiration puerile [respiration]
when the ear was applied upon the front part of the 
chest. Resonance upon percussion, little more over the
left. Treatment Tart Em: gri
Pot: Not: grs x
Ipecac grs vi
to be dissolved in a [illegible] vi of water
of which 2 teaspoonsful to be given every 
three hours. Mustard plaster over the upper part of
the breast, to kept on 20’ Flaxseed mucilage with 
teaspoonful of pot. bitart to zviii of the mucilage.
Nov: 30th Frequent serous passages. Pulse [full] and gaseous.
Pain in the abdomen. Cough and pain in the breast
better. Physical signs about as yesterday. Stop the antimonial
mixture, and gave D.P. grs ii every three hours
and a 4 gr powder at ped time. Ext: hyos: grs xv m ft [illegible]
one at 12 M. another at 6 P.M. and the other at
10 P.M. Mustard plaster over the abdomen.
Dec 1st Tongue white cleaning at the tip. Pulse an irregular and 
soft [80] NO passage since the antim: was stopped. Slept
well last night. Skin more natural. Pain when sitting 
up over the hepatic region. Weak. Physical signs
[illegible] on percussion Treat. horehound tea and a 
teaspoonful of the antim mixture three times daily
Dec 2nd Found him sitting up in bed propt up with pillows. Did not rest so 
well last night on account of his cough, which appears painful and tight. Cannot locate
his pain this morning, says it is all over but chiefly in his back. Bowels again [the]


Cathn McHale’s Case. Femoral Abscess.
Cathn McHale aged entered Feby [26]th 1850, a year ago,
having had a fall upon her hip. about 
three years ago. she was not deterred from 
work however now then she felt pain 
in the hip especialy in changeable
weather. about October 16th 1850
a swelling about the sise of a goose
egg appeared about the upper third
of the thigh. This after an examination
was found to contain pus
which appeared to be underneath
the fascia of the thigh. It was opened
and has up to this time been discharged
pus and a [sa?ious] fetid matter.
Jan 20th
There are now four openings in the 
which at times discharged very freely 
Treatment is altogether constitutional.
poultices truly, as a local remedy.
Jan 21st
Complained of pain in the thigh
treatment same.
Jan 22nd’
Found over the old abscess a red space
from an half an inch long to a quarter of an
inch wide in which were 3 small holes from 
which a great quantity of matter was discharged
another opening on the lateral portion of thigh
which also discharges a thin looking pus.s


Great tenderness and pain over the [trocha??]
of the affected limb. also a constant pain 
there.
Jan 24
The abscess did not discharge as much 
last night. Troubled very much with night
sweats which have heretofore resisted both the
muriated tinct: of iron and sulphuric acid dil
put her on pl: [illegible]: aselli to day.
Jan 25th
Owing to a disposition to vomit, and
irritability of the stomach did not give her
the oil yesterday.
Jan 27th
Found her complaining of being
weak and a diarrhoea.
Jan 28thg
Found her better. pulse good still 
however weak.
Jan 29th
She is taking now and has been for
the last three or four days pills. every four hours
[balett] mass
Quinia sulphas a a grs x
m ft: pil viii
Jan 30
Complains very much of night sweats
still taking above pills 



Caldwells Case. (Cold)
Jan 18th
Jan 18th
Observed a depression just beneath the distal
extremity of the clavicle; large enough to 
insert a silver dollar. immediately suspecting 
a cavity. put my ear to the 
spot and detected amphoric respiration
and resonance when the patient spoke.
examining lower down 
amphoric respiration was again detected
accompanied by a metallic tinkling
Pat him to day upon ¼ gr calomel every 2 hours
made into pills.
Jan 19th
Could not hear the tinkling to day
But in the place of it there was amphoric
respiration. perfectly flat on both sides.
Jan 20
heard tinkling again to day in the same
place. still flat over the left lung.
Jan 21st 
Resonance on the right and normal respiration.
on the left side at the summit of the lung.



just beneath the distal extremity of the 
clavicle I though I could detect amphoric
respiration.
Jan 22
Dr Haines thought there existed a dry 
cavity at the summit of the left lung
still taking pills first prescribed.
Jan 24
Could not hear the cavity this 
morning stopt the pills as his mouth
was getting sore and his gums tender and
soft and swelled.
Jan 25
Did not examine this patient to day
Jan 27
Did not examine this patient to day
did not think it necessary found his setting
up and looking worse and 
complaining of nothing.
28th
Did not examine him to day saw sitting
by the side of his bed.
Jan 29th
Sudden death in a case after
taking 15 grs of Ipecac
Indianapolis Jan 22nd [1850]
Simon [Rath] at 7 or 8 years. Supposed by his father to have
swallowed something, and was lodged in his nose
Found him lying upon his bed, breathing naturaly
face flushed. skin natural, pulse somewhat quick


and frequent and small. No appetite. Bowels [illegible]
[illegible] costive. Pain general especially in the back
Diagnosed either the case to be continued fever or [verminous]
irritation. Prescribed cal gri 
I did not weigh them Cal gri
Rhei gri
Morphia grs v [illegible] cal [illegible]
Rhei [illegible]
about these proportions
[illegible] ½ tablespoonful of castor opii to give every 3 hours
[illegible] [illegible] next day
Jan 23d
Slight operations. Face more flushed. Skin 
[???ngent] heat. Cough dyspnea. Pulse small frequent
and quick. Tongue heavily furred as yesterday.
Has been up. Gagging and making ineffectual
efforts at vomiting. Poured out about 75 grii ipecac
and attempted to give it to him but he resisted
His mother not being able to manage him
call’d his father who rather roughly pulled
him up, and placed him upon his lap.
while doing this fell into a profuse sweat 
head fell about as of one dead. I suspected 
nothing however, and left telling them to give
him two or three cups of warm water, until he
vomited. I had not gone 4 squares when
I stopt by a hasty, and allmost breathless 
[illegible] to return I did so, and found
my patient a lifeless one. what did he
die of is a query. was it the ipecac or the [illegible]
[illegible] or was he dying when I saw him and 
did not know it I can hardly think the [illegible]



Harry Hamilton Vaccination
March 21st Vaccinated. Mch 22nd
“
[illegible] day 6th Red spot as large as a buck shot. No vesicles yet
Napoleon
Mr Thackeray’s child Marasmus
Augst 5th Boy. 3 yrs, had been sick about a month
was first attacked with ordinary summer complaint.
Phenemonae. Pulse frequent feeble small and quick.
Much emaciated. expression of his countenance and
the character of his cry and voice like that of an old man.
Mouth covered with dark whitish looking
patches. Abdomen tender and sometimes tympanitic
Passages consist of small dark brown and whitish
lumps about the sise of peas. (large) very pale.
sleeps with his eye half open. Prescribed Arg: Nit: gri
to be rubbed all over three times daily. Pulv: Dov: grs xvi
with cod’s liver oil. teaspoonful three. m ft: pulv: xvi
Times daily. Half teaspoonful of mutton [illegible] every [illegible]
tea every 15 minutes alternately with the hours same quantity of
whiskey punch (one tablespoonful of the best, to two of milk)
Abdomen to be kept red with turpentine. Chlorate of potash as mouth wash.
Augst 6th morning Phenemonae external about as [illegible] day. Abdomen
more tympanitic, passages more frequent and feculent
no lumps. pass’d about a two quarts of urine, and half pint
of feculent matter. Afternoon. Passages more feculent of gross
green colour, a little at a time. Treatment as above except dropping
the turpentine as it ceased to have any effect on his skin or only slight 
and painted the abdomen with comp: tr: of iodine. Tongue half clear 
rom the tip. Evening suspended the powders became too much, stupor.
Augst 7th Mouth cleaner. operations less frequent and less green.
[coathed] the whiskey punch & mutton tea, and takes now coffee with cream & sugar


Thackeray case
and treat as before except as to the powders
which were substituted for quinine grs iv. 
D.P. grs iv
Arg: nit: grs ii
The quinine was
given upon learning that every other day
he was worse
5 P.M. voice stronger operations less frequent. Mouth and tongue almost
clean. Abdomen as before, only less tympanitic. Rejected rice water and
took beef tea and whisky punch. Last night ordered a warm salt and
mustard bath 5 minutes kept him four min in the bath
Augst 8th 4 or 5 operations in the night, about a teacup full of [solid] [illegible]
[illegible] matter with a yellow tinge through it, in a gallon of wine
Ridgely care (coloured)
Jan 18th 
Both sides flat has a short cough.
no respiratory murmur. heard over the lungs.
put him on zfs cod’s liver oil 3 times day
Jan 20th 
Still has cough no difference percentable
either
by percussion of auscultation. still [illegible]
cod’s liver oil. zf 3 times a day
Jan 21st
Distinguished a faint respiratory murmur
on the left side still flat on both sides.
Jan 22nd
Did not examine this morning.
Jan 24
No difference in percussion and auscultation 
lays he as well as ever he was and
looks strong and hearty.
Jan 25
Percussion still flat. Discharged as well.
Jan 28th Walking about the war apparently well. 


Suspected Schirrhous of the stomach.
June 3rd
came in with a circumscribed
rough and hardened space over the
region of the stomach. complains of lancinating
pains. very tender cannot bear the slightest 
pressure. over the epigastrium. Face haggard 
cheek bones prominent. Does not vomit. stools
natural except in collour being rather too white
indicating the want of bile. ordered iodide of potassa 
internally and the hardened space to be painted
over with tinct of iodine. The roughened space 
is from 3 to 4 inches in length and 3 inches wide the
long diameter extending around his body the
other parallel with linea alba it now
resembles the cicatrix of a burn.
June 5th
Complains of having no appetite. the swelling 
was thought by Dr Shively to be a little increased and running
over to the left side. he says he can not lie on the left 
side. the other appearances the same. ordered the part
to be blistered. the other treatment continued.
Thackeray case
the urine turbid. Pulse about the same Treatment. No change. 1 P.M.
Pulse 120 to 130 quite frequent & feeble. Operations about the same as to quantity & colour, thinner,
and not so lumpy, as last night. Cold sweat on the forehead, skin feverish. Takes about
a teaspoonful of nourishment an hour, because of sleep etc. etc. interrupting the regular times
of giving it. Augst 9th voice stronger. Pulse very feeble, scarcely perceptable. 5 green (grass])
concrete mucoid passages, a gt: of fluid and half tea cup of solid matter. Mouth as
yesterday Arg: nit: grsii
D.P. grs iii  Quinine
m ft: pulv: xii
Tr: iod: comp: to the abdomen
did not suit, there was an aggravation of all 
the symptoms. Did not bother him last night.


Inds
(Distinct) Small Pox Indianapolis Jan 13rh 1854
Jan 14th
Bennet Brookes aged 45. Full habit. Complains of not
pain. Bowels regular. Face covered with pustules
Pimples on the rest of the body. Breathing
free, throat not sore
Treatment. Room well ventilated. Solution 
of chloride of soda to be thrown about the room.
Lod diet [Thal] grs vi
Rhei grs x
Ipecac grs v
m ft pulv: no vi
one to be given every three
hours
Jan 15th Slept well last night. Nostrils stops up.
still breathes easy. Has taken
three powders, had a passage which his
nurse said smelt very bad.
Jan 17th 
Slept well last night. Pustules on the 
face scabbing off. no sore throat, says he is as
fine as a [trout]. Treat: stopt the powders as
they moved his bowels too freely. Still on low
diet. Ordered a roasted apple for him yesterday
which he relished very much.
Jan 19th Sleeps well. complains of nothing.
Bowels regular. No medicine.
Jan 15th
Has been rapidly convalescing
and now is well, except the scabbing of 
the pustules.
Remarks
This was one of the mildest cases; no
pulmonary, alimentary or cerebral derangement
occurred, and very slight cutaneous irritation



had him wash and scrubbed and washed in Liqr: sod: [chlor??]
discharged on 26th of Jan.
Indianapolis
Mrs Hamilton’s Case March 7th 1854.
I saw this lady for the first time, medicaly,
about a month ago the sympto0ms which 
then presented themselves were, an anxious
expression. very nervous.
Hysteria
from the least fatigue. Exceedingly 
troubled about her inability to attend to her
household duties. Large quantities of [illegible]
of ammonia passed from the kidneys.
Pain in the left shoulder, and also between
the scapulae; no appetite. Cough which was
slight, night sweats. Numbness of the legs, which 
she describes by saying that when she
attempts to draw down her legs in bed
she feels as if unable to do it.
continualy thinking of her children in 
Baltimore.
March 6th
Yesterday my patient had spitted 
of blood while at church. Today I examined
her lungs and found not much difference
between the two sides by percussion
But upon putting my ear at the 
subclavicular region of the right side
I detected cavernous respiration and
pectoriliquy, I immediately concluded 
that a small cavity existed at the
summit of the right lung upon inquiry
as to the character of the sputa my 


suspicions were confirmed. I immediately
ordered a small blister and cod’s liver
oil zi three times daily, and gentian and
columbo tea.
March 9th
Thinks the treatment doing her
good. Can take zfs of the oil.
March 16th
Had another nervous spell
and refused to take any medicine
two or three days ago. Has now
however resumed her medicine and
for the last two days has been
much more cheerful. The oil was beginning
to nauseate her and consequently 
she laid it aside, for awhile.
March 18th
Much better can walk farther. looks
more cheerful convenes and laughs with the
family, this change has been attributed
to exclusion from the kitchen and heat
of the stove. her cough is still harsh and
resonant sounding as if coming through
a brass tube. has an enormous
appetite
May 31st My patient has taken a travelling tour
and come home looking fat and hearty, but
had yesterday spitting of blood, is taking nothing.


Mr Gray’s child Aug 2nd 1854
Dysentery Indianapolis
August 2nd
Child 2 yrs. has had the dysentary stopt several times, but
not permanently. I gave it on my first visit the following
Rx Cal grs iii
Ipecac grs i
Morp: grs 1/20 m ft pulv: No iv [illegible] one every two hours. 
Warm mustard bath night and
morning
mist: creta zfs
Tr: [:rame??]
“ kino a a [illegible]
Tr: opii camp zfs
Aqua menth zfs
Sacch: [illegible] : zi
Mucilage Acacia zi
M f S. teaspoonful every 2 hrs
until the [illegible] [illegible]
Gave her 4 more powder at evening to be taken through
the night. ordered a [musk] poultice or red flannel
to be placed over the abdomen.
August 3rd Head one passage at day break which was more natural
had three in the night. Skin natural
Gave her Rx Quinine grs iv
Rhei grs i
Sod: Bicarb. grs i
Cal: grs ii
M ft. pulv: iv S. one every two hours.
Saw the child in the evening and found it had only 3 passages
through the day and only slightly streaked with blood
ordered in zi of castor oil and zfs of paragoric.
Augst 4th Slept better than it has for sometime, more blood,
and pain in passing . Ordered Rx cal grs iii
Rhei grs ii
Ipecac gr i
Sod: Bicarb: grs ii
Mass: sulp: gr 1/20 
M ft: pulv: No 4 S. one every 2 hrs
Rx
Plumbi acetas gri
Morp: sulp: gr 1/20
m ft: pulvi No 4
S. on every 2 hrs.
Ordered also a warm bath and [musk]
poultice and injections every hour
of cold water. and an injection 
composed Rx Plumbi acetas grs x
Aqua frigidum oi
every 3 hrs.
I think the child is
worse. The father says it has been sick 4 weeks. Did not give [illegible]
Augst 5th Saw the father on the street this morning
who told to me his child was better no passage
in the night and the last two more natural
one being yellow and the other green/
Augst 7th Less blood. Skin natural gave Cal. grs iii
Ipecad grs i
Sod: bicarb grs i
Quinine grs i
M ft: pulv vi S. one every 2 hours
These seem
to do more good than anything else.
at bed time I gave him Dov: powd grs v
Morp: sulp: grs 1/20
Aug: 8th Found him better the last stool more natural. Slept well.
Did not order any medicine today until I see him at 12 M.
Aug 11th No bloody stools is getting well. The father told me today he was pretty
well except a diarrhoea.



Stuheller’s Case syphyllis.
Herman Stuheller aged 22 Born in Germany
Single. Temperate. A skin dresser by trade
previous to this disease was a strong and
healthy man. he is of a light complexion and
has light h air. On the 1st of January he had
connection with an unclean woman and 
7 days after a bubo and chancre appeared 
simultaneously with the former being
at this time on the corona glandis about
this sise of a pins head. This healed
over. But the bubo after being poulticed
for 4 weeks at last suppurated at
this time he was admitted into the
Penna Hospital, The opening being
enlarged. Lime water black wash
and powdered calomel were successively
applied. In a week after the 
appearance of this bubo another on the
opposite side made its appearance
this was lanced but according to his 
account discharged no pus but blood
this bubo burrowed very much pills
of calomel were given and he was ptyalised.
No improvement in the sores.
Sys: sarsce comp were then given internally 
and the bubo dressed with S
He continued on this treatment for 7 weeks
He now left the Hospital unrelieved
and uncured. And was placed under
Dr Senderling, afterwards under 


under Dr Hartagin whose care he was
under for 9-10 weeks.
Herman entered the Almshouse Sept 3rd 1850
immediately after being under the case
of the last mentioned gentlemen. when
he entered the house his groins were much 
ulcerated and a sinus extended from 
the right side about an inch
and a half which gradually sloughed
away and left a large sore. On the
opposite side there was another sinus
running upwards which was large enough
to insert the thumb of common sised hand
into.
He ahs not improved at all since he has
been here. since he has been here Arg: nit
xx grs to zi and xx grs cup: sulp: zi have been 
alternately sued iodide of potassa et ext:
conii with sarsae decoct. Iodide of iron
iodide potassae et bichloridi hydrargi
Besides these he has used externally
Sabaraques sol: sulp: quinae solution,
creosote water
Jan 18
has been taking calomel pils and
his mouth is slightly touched
The groins are very tender and cannot bear the pressure
of the lightest poultices. The left side
is now nearly healed over except a an ulcerated
surface alongside of the scrotum which
extends around the perineum and is about 


an inch in extent. There is now on the right
side a large phagetanic ulcer about
two inches long and one inch wide
quarter of inch in depth encircling the
crest of the illium. This ulcer has grown
very rapidly since its first appearance.
The diseased surface of the right side now
occupies the whole of the illiac region of that
side. the ulcers vary from a sixpence
to two inches in length. separated by 
cicatrises of cold ulcers.
Jan 19
Found a sinus running from the right
side across towards the left side above 
the pubis, about the three inches in length.
ordered a light bread and water poultice
and the sinus injected with aromatic wide
His mouth is slightly affected by the calomel 
Jan 20
No change. The large ulcer over the crest of illium
seems large. cont the prescriptions of yesterday
Jan 21st
The large ulcer on the crest of illium seems
increasing. Could not bear the poultice on yesterday
so great was the pain.
Jan 22
Discovered that the sinus communicated
with the penis. running therefore in this
direction The ulcer looking worse especialy
the large one on the crest of the illium


Jan 26
The largest ulcer seem to be increasing.
cont: the last treatment
Jan 25th 
The ulcer is running down along the
crest of the pubis.
Jan 27th
Did not see his groin to day, he
being asleep.
Jan 28th
No change from the 25th ult, except
in the sinus which is filling up.
Jan 29
No change perceptable from yesterday
Jan 30
Seems to be some disposition I the sores
of the right side to heal. the largest ulcer on the
opposite side is no larger that it was yesterday
ordered as a drink marks ext of sarsaparilla
an zi during the day in a pint of water
Jan 31st
Hardly any change perceptable in 
the sores
The treatment in this case is very 
unsatisfactory.
Left the ward February 1st 1851 to take the 
womens medical.


[Wht] [illegible]: Med: 2-8th
Case 1st
came into the ward Feby 7th
complaining of pain in her legs and back
puse 80 tongue of a cream white and
moist
Feby 8th (morn)
Pulse soft and about 90, skin natural 
tongue moist and of a creamy white. Face slightly
flushed.
Feby 9th Morning
Pulse about 90 tongue cleaner than it was
yesterday. it is now red at the edges and tips, and down
the middle creamy white and slightly furred
did not complain of pain to day in her legs.
Bowels open.
Afternoon visit 5 ½ P.M.
Pulse 100. complains pain in the 
stomach. The pulse was soft and only little more
than of ordinary fulness.
Feby 10th morning visit.
Pulse 85 no headache no pain in back tongue
only slightly furred cheeks flushed, complained last night
by pain in her stomach ordered a dose of oil and mustard plaster
found her this morning with no pain.
Feby 11th
Complains cramps in her legs which I discovered was
something like rheumatism as she says it shifts
about from place to place
This was a case of rheumatism which resembled
a case of continued fever. 



June 6th
came in to day after a long
walk in a hot sun, with pains in his bones and headach
and general langour.
June 7th 
pulse rather quick face rather flushed skin feverish
still has the pain in his bones no tenderness over stomach
ordered brandy punch zxvi a day
June 8th 9 A.M. Pulse very slow and weak not more than 48 
per minute. No red spots. Tongue moist, and of pinkish
white collour. ordered punch zxvi again to day
[Mens] Medical
June 26
has been sick for two or three
days with looseness in his bowels. No pain or 
on pressure over the abdomen. pulse full and
regular. skin natural. Tongue slightly furred.
ordered 10 grs of cal: at once. and the following however
to be given through the day 
cal: grs xx
pulv: Doverii zi
m ft: pulv: xx [illegible] tris hourae.



Indianapolis
Neuralgia Facialis
veratria gr ifs
Morp: sulp: grs vi
Ceratum [illegible]: zi
m for Mrs Neff.
Indianapolis
May 16th 1853 Mr D. Yandis. Eyes red, and throat sore.
had a chil on day before yesterday. bowels not
opened for two or three days. ordered
Tart: em grifs
Pulv: ipecac: zi + grs v
m ft: [illegible].
Pulv. alum ziifs
aqua zvi
m ft: garg
Pulse 120
4 oclk P.M. Skin soft, and his pulse not so 
quick and hard. but frequent. Face flushed 
and eyes still red, throat still sore. has
vomited freely, and bowels opened. Says he is 
better, but contrary to orders has been up.
ordered Rx 
pot: bicarb zvi
Ant: et pot: tart gri
Spts: etheris nit zi
Syr: simp: g.s.
Aqua zvi
zfs every hour in afternoon 
to season his food 
with 
Sod. [phosph??]
Acidum citrici
Aqua aa g.s.
17th Pulse 80 soft and larger. Skin soft, and moist. No [decided]
measley spots. Tongue slightly [illegible]. Throat still
sore. Eyes still inflamed. had a slight fever yesterday
afternoon. bowels open. small pimples on 




his arms, but I cannot tell what they are as yet.
wants to get up. Ordered him zfs of the fever
mixture every hour when he has fever,
and at other times every 3 hours. Nose bled
this morning. 12 M. sitting up. Pulse feeble. Eyes still
red. No eruption. except the aforesaid pimples.
18th Throat still sore, found him sitting up. Pulse very
feeble. Told me I must not call him a sick man.
4 oclk P.M. found him out. 19th In bed. Tongue yellowish
eyes not so red. had a passage (natural) from pills. Pulse
small and feeble. bad taste. ordered Dov: powder
tonight. and one bottle of citrate of magnesia.
3 P.M. Sitting down stairs by the stove the day being
cold. Pulse still weak, and feeble. Tongue cleaner.
Eyes quite bright. bowels open. No eruption.
20 well without any eruption.
Remarks
I think the [eusetic] checkd the approaching
disease. It was just the minute of time to give it
Ind
Mr Hopper Age 26 spare.
symptoms. Frequent desire to pass urine. Pain in 
renal region. Costive. ordered Uva: Ursi zi and the following
pills Aq: Font oi
Calomel grs iii
Rhei 
Aloes a a grs xviii
Ext: colocynth grs vi
m ft: pil xii
one an hour before each meal.
Remarks. Met him a week after and said he was well, except
about the renal region. One pil operated.


Inds
George Owens June 28th
Received a blow from a brick, which caused
his eyes to become much ecchymosed and 
also cut his eye brow, about an inch in length
ordered cold water, at my first
visit, but changed it to slippery elm in the
afternoon. The parts were too tender for [illegible].
His pulse was in the evening full, and 
strong. ordered at my first visit jalap grs xii
Cal grs v
as a purge. In the evening there was no operation.
gave him every three hours
a powder containg 1/3 gr of cal and 2 grs Dov powder
July 1st
Swelling and blueness much less told me I 
need not come any more. His bowels
were not opened after he had taken in 
addition to the above jalap grs xii
Cal: grs v
Rhei grs v
The remarkable feature in this case was
the difficulty of getting his bowels opened
notwithstanding [illegible] care was taken that
there should be nothing on his stomach
at the time. This case strengthens me in the 
idea that simple measure are the
best. Finding the powders had no effect
he took a dose of castor oil. which 
operated.


Typhus Fever ([Farrels] Case)
May 1st Has been in since the 28th Irishman, when 
entered had the ordinary premonitory symptoms
of typhus fever or ship fever. ordered an
emetic. today petechiae have appeared on his 
aldermen. Tongue dry. skin hot and pulse frequent
and gaseous. ordered punch (brandy) zxvi beef tea zviii
Turpentine mixture xzi every two hours.
May 3rd
Tongue moist. Petechiae increasing in numbers.
5th Tongue moist. other symptoms no worse. Cont: Treat:
6th No marked change.
Indianapolis Feby 2nd /59
Catarrhus Infantorum
was called last evening at 8 oclk to see a little
girl 9 mos: old. Fat and healthy looking child, symptoms
dyspnoea, skin hot, feverish, cough with expectoration.
Face flushed. Uniform heat over the body, one of the neighbours 
remarked that she had alternate flushings of heat
and natural temperature. Had two free operations from
some medicine, and had taken an emetic
of hive syrup. I ordered a warm bath, and a mustard
plaster to the chest, with directions if the feet became
cold, and head hot to soak the feet, in a hot
mustard bath. I also prescribed 2 [illegible] of hive syrup
every two hours and the following powders every three hrs
Rx D.P. f gri
Rhei pulv grs ii
m ft: pulv: v
in [illegible]
Feby [illegible] 10 o’clk A.M.
Breathing easier. Skin natural.
Discovered that two biscuspides were fording
their way through. Face not so flushed.
Had a natural passage last night. Has taken
three powders. Slept from 11 o’clk P.M. til 1 A.M. 2 hrs. Cough about 



the same. Saw the tongue imperfectly, whitish fur. Treatment To take the remaining
two powders, with about ¼ teaspoonful of cream of tartar dissolved in ½ pt of
water as a drink as she was thirsty. Reddened the skin with mustard.
over the breast. ordered it to be applied again this afternoon, and another
warm bath to day. 5 ½ “.M. feverish, sleep, bowels unmoved since morning;
had a warm bath, and a mustard plaster on her breast.
Prescribed nothing but the bath, and mustard on the breast. I was
tempted to give small doses of cal: rhei & magnesia.
as she has had only one passage to day, but did not.
Tomorrow will decide whether I was right. The mother and father
think she is better. Drinking the cream of tartar solution, which she
likes. Feby 4th Skin more natural. Cough looser, had two passages one, free and
the other more scanty, I saw the scanty one, and thought it tolerably 
good, rather darker than it ought to be. Slept well last night.
Picking at its nose. Tongue, whitish with a tint of yellow lues
on titty. Treatment continue the sinapisms over the breast as heretofore.
To take one of these powders every two hours cal: grfs
Rhei gri
Magnesiae calc: grs iv
m ft: pulv: no iv
S one every two hours in molasses.
To take one of these powders every two hours
These quantities were not weighed and 
therefore may be more or less than is [illegible] down. 6 P.M. Heard the mother singing
as I came in, and concluded rightly, that the child was better. Has
taken 3 powders no operation Cpoughs still, Has been much better to day 
the mother says, requested a teaspoonful of castor oil to be given at 10 ro 11
oclk to night, if no operation hope that time. Feby 5th Slept well last night.
Had an operation soon after I left last evening they did not therefore give
the oil. No fever tongue cleaner. Disposition to play. Treatment Hive syr: gtts iii
every three hours
with a hip [bath] (warm) and the breast kept red with sinapisms of mustard
Discovered an apthous condition below the lower incisors & biscupidati
prescribed Sod: [illegible] grs xx
Aq: distillat ziv to be used as a mouth wash.
m ft: sol
Feby 6th coughed a good deal last night, disturbed its rest. Skin natural, bowels rather too 
costive. Hive syrup caused it to vomit, stopt it and gr ½ of rhei every three hours.
Teething may be the cause of the trouble. Feby 11th Haven’t see her for 5 days
cough still hangs on, think it is the teeth. Prescribed Linimentum [illegible] zii
Spts: terebinth zi
Aqua: [Comp}: zi
S. M use as a liniment, [illegible] the breast red.s
Feby 18th Met her on the street with her baby, [illegible] well. 



Acute Inflammatory Rheumatisms, (Emma Dixon Case)
Feby 3rd
When I first saw this patient which was
the 2nd of Feby about a week ago I saw that
her rists and hands were
much swollen oedematous and very
tender, the least pressure causing intense
pain the patient is a young mother
about 25 yrs of age. ordered
the following.
grs 5 of [am??] phosphas in solution. with 
5 grs of Dovers powder 3 times daily. and a
liniment composed of ol: olivae. Tr. Canth.
ol: [cajeputi] etc. for her rists and hands.
4th
Rists very painful and
swollen ordered her to rub them with 
camphorated solution of [morphia]
about a gri of the sulphate to and zi of aq: camp
and to take a teaspoonful at night.
Feby 6
stil much pain, in the rists, and
now for the first I noticed that her feet
and ankles were much swollen
ordered a ½ doz leeches to be applied to each
rist and ankle. Cont the above treat
Feby 7th
Much better can now raise her hand
up. cont the above treat
Feby 8th
Complained of loss of appetite. ordered quinine.
complaining of much pain in her ankles ordered hop poultice


Feby 9th
Found much better. expressed great relief from 
the poultice to her feet. Bore a good deal of pressure
upon her hands this morning.
Feby 10
swelling the rists most all gone can use her rists 
and hands pretty well. bore a good deal of pressure this morning redness
all gone.
Feb 18th
Sitts up now and [nurses] her (blk) baby, got
much better on the 11th and has continued
so ever since not needing any attention.
Continuation of Mr Gray’s child’s case of 
dysentery.
Aug 12th 1854 Mr Gray called on me this morning to tell me his child
had several passages of a green collour, but no blood, in the
night. I ordered the warm mustard bath and the diarrhoea
mixture. So that the dysentery has been checked by the 
above treatment
Augst 12th Is now passing green watery stools every hour
which the diarrhoea mixture did not check I gave him 
1/6 of a grain of acetate of lead and 1/16 of grain of morp: every half an
hour and ¼ of a grain of quinine and 1/20 of a grain of morp: every
hour. These powders were given at 8 A.M. and after taking
3 or 4 of the lead powd and 2 of the others the child fell asleep 
and slept from ½ hour to an hour. At 12 ½ M. it was
better not having had but one passage in the course of the
morning. Skin natural and tongue clean. No pain but 
very feeble and anemic. Gave him Cal grsiii
Ipecac gri
Morp: sulp: gr 1/10
Quinine gri
M ft: pulv: No 12 S. on every 2 hrs
also
plumbi acet gri
M ft: pulv iv
S. one after a passage
and at [illegible] time
[illegible] [illegible]
Aug 13th Had 3 stools, in the night 
no blood, thicker and yellow. Skin rather hot pulse quick, and frequent. [illegible] the 
powders with [illegible] gri and in we used quiinine grsii making 2 grs in the whole.
Aug 14th Skin natural. stool less frequent more natural still streaked with blood. did not [illegible]
the powders until I should call in the afternoon I gave 5 grs of Dov: powd: last night at bed time.


March 6th Maria Johnsons family.
This family consisted of a mother and three
daughters ages mother 40 oldest daughter
25 second 15 yrs third 9 yrs and youngest 3 yrs
They all came directly from the ship which 
brought them from Ireland.
Mother Maria Johnson
March 6th
Skin in the morning not hot pulse
about 100. Diarrhoea. Tongue moist with a white
fur upon it. no petechia. not much head
ache. ordered chalk mixture
March 7th 9 A.M
Skin about same. Tongue still moist and
furred. Pulse 100. no petechia diarrhoea still
complains of sickness at stomach. According 
to nurse’s account was delirious all night
ordered effervescing draughts to be given through
the day.
6. P.M
Pulse 120. skin not very hot. Tongue as in morning
March 8 9. A.M.
All the symptoms about eh same no petechia
was up very often during the night. ordered
chalk mixture and starch injection. has been taking
to carb ammoniae. ordered [neut] mixture with vin ipecac
through the night and vin: [illegible]. for stimulus and diarrhoea
9th 9. A.M. Pulse 120. skin rather warm but not hot. Tongue
exceedingly dry and hard. Complains of headache and
drought. No petechia. Diarrhoea better. ordered vin [illegible]



to be continued. Carb. Amiae stopt and terebint: mixt to be given
instead. also a wine glassfull of infusion. made of
Rx Serpentaria rad
Coptis trifoliata a a zfs
Magnesia sulphes zi
to be given three times a day.
6. P.M. Tongue completely moist quite different from what it
was in the morning. skin almost natural. Ordered neut
mixture to be given during the night.
March 13th 9 A.M.
Tongue moist and almost natural collour
skin natural. Pulse about 80. Bowels only opened
once during the night still complains of 
headache. 1 P.M. tongue still very [illegible] bad diarrhoea
14th 9. A.M.
Tongue moist. The skin natural pulse
not more than at 100. little [deaf]. Bowels to day 
are better than yesterday The above tonic was
stopt 6. P.M. not much febrile manifestion
15-16-17th
On the 15th and 16th No diarrhoea but to day 
has it again. skin natural. Tongue moist
18-19th
Tongue very dry. Her husband is also in the
building and she frets a good deal about him. ordered 
turpentine mixture.
March 22
Yesterday the right and as far back as 
behind the right ear was attacked with 
erysipelas. ordered the parts kept wet with
lead water and wine of opium and quinine and [illegible] int
Today found the tongue very dry. ordered mist terebinth.


Fanny Johnson Age 9 yrs
March 6th
Pulse 120 skin soft and natural in the 
morning but very hot with a pulse 160 in 
the evening no petechia. A diarrhoea. Not much
head ache, a tolerable amount of strength
Tongue furred whit and moist.
March 7th morning
Tongue moist on the edges but dry and hot
down the middle. No petechia. the other symptoms
of yesterday not perceptably increased ordered cal et D. powd
6 P.M.
Pulse 160 no petechia skin not over heated
diarrhea less. stopt calomel et Dover’s powders
March 8 9. A.M.
Tongue moister. skin not so hot, as I expected
pulse 120. Puts her tongue out readily and promptly when told
6. P.M. not much aggravation of fever. ordered neut mixt
with vin ipecac through the night every hour
March 9th 9. A.M. Pulse 120. skin natural tongue moist
and not so much furred cleaning from the tip which 
looks red. No petechia. No diarrhoea. No headache.
6 P.M. Skin a slight degree hotter than natural. ordered
neut mixture in the night
March 13th 9. A.M.
Tongue moist and slightly reddened
Pulse about 100 skin feverish. face slightly 
flushed 1 P.M. Face flushed. Pulse 145
14th 9. A.M.
Tongue moist and natural (little redder). Pulse 120
skin natural no stupor 6 P.M. no increase in symptoms


15-16-17th
No symptoms have occurred since the 14th 
that would indicate a augmentation of disease
she is now fast
recovering. Giving reasons to suppose the crisis
was 12th
22nd
rapidly convalescing.
Indianapolis Continuation of Mr Grays child’s case
Dysentery. Aug 14th Change the treatment to the following
strychnia gr 1/12 m ft: pulv: No 12 S. one every 4 hours and syrupus
ferri iodidi gtts iv in 4 tablespoonsful of water teaspoonful
every three hours with port wine. Dovers powd grs v
 at bed time.
Augst 6th Call in, and learnt from the mother that the child
had been getting better until some of the neighbours gave
it some improper food, and the bloody stools returned
I ordered a dose of oil (zi) Have not given the Dovers
powder since the 14th
Aug 17th Had one passage since the taking the oil
with a little blood. Continued the treatment.
Aug 20th Better.
died some two weeks after this with convulsions, according
to Dr: Kitchen who attended.


Elisabeth Johnson Age 15
March 6th
Pulse 120 in the morning but 160 in the afternoon
with a hot arid skin. Tongue moist and
furred white no petechia
March 7th
skin very arid and hot. Pulse 120
very drowsy complains of headache. Tongue white
and furred
6 P.M. skin not so hot. Pulse 160 Tongue as in 
the morning still drowsy
march 8th 9. A.M
Tongue moist, and furred. skin almost natural
Pulse 120. No petechia
6 P.M.
Skin very hot. and pungent. Pulse 140. still drowsy
9th 9. A.M.
Pulse 12. skin natural (little hotter). Tongue moist 
and cleaning off from the tip. No petechia. No diarrhoea
and only little headache. ordered neut mixture
continued.
13th 9. A.M.
Pulse 90. skin natural. Tongue moist
complains of headache. ordered mustard plaster
back of her head.
1 P.M. Face flushed. Pulse 140
13th-15-16-17th
has been gradually improving. yesterday 
had a bad cough ordered 12 dry cupps and cough mixture
Syr: scilla
“ [revena]
Liq; morphii sulp a a zi



18-19th
Says she is better the morning. skin feels natural.
Tongue moist and natural.
March 22
rapidly convalescing
Thomas Mc Lennan case Indianapolis
Sept 23d Aged 49. Pale. Shortness of health. pain extending
from the lower and anterior part of the
right side of the chest, around the back towards
the left scapula. tight hacking cough. Flat
on the right side all over. while the left was
hyper resonant. the pain and [dysnoea]
was relieved by six cups took ziifs
of blood. Blister to the superior anterior portion 
of the right side, of the chest. Gave Syr [scillae] cinch
[illegible]
Tr: opii camp a a sfs
Mass: sulp gr fs
S. zzi every 3 hours
Sept: 27th Pain shifted to the lower part of the right 
side of the chest much [better] otherwise for 
the last two days. This morning came to me complaining
very much of pain, and dyspnoea, the
pain being chiefly in the lower part of the right
lung, applied 4 cups (dry) too pale to lose blood. which 
instantly relieved him. Cough much easier. Dressed
the blister with basilicon. continued the cough mixture
and gave him rx Cal grs vi
Rhei grs x
Aloes grs vi
Ext: gentian 
“ [hyoscianni] a a
“ colocynth grs vi
M ft: pil No 9 one every 3 hours
Tongue covered with a thick
dirty white coating [illegible]
fetid.


2nd year in Blockley.
Childrens Asylum April 7th
Case 1st
Elisabeth [?innock] 6 yrs old has been sick for three weeks
I first saw she was much emaciated and eat
nothing. never changed position all day but
lay all day with its hands by its side and on 
its back with its head thrown back on the pillow
has been taking the following as a standing
prescription Syr. sarsaparilla z
Pot. iodidum
Prunus virginiana
wine whey was also
given every now an then in small doses
This treatment I changed to the following
understanding that its bowels had not
been moved for two days I ordered the followin
powder
Rx Hyd: chl: mite gri
Pulv jalapa grs iii
which was to be repeated every third day.
also as a standing prescription to keep its
bowels regular
Rx Magnesia calc zfs
Tinct senna zi
Ol: carui gtts ii
Saach alba zfs
Liq: calcis zifs
Take a teaspoonful 3 times a day
The magnesia and lime water acting as a purge
and also as absorbents of any gases which owing
to the very deranged state of the alimentary canal
might accumulate. Besides as a tonic I prescribed
& retained the wine whey of the old treatment.


Rx Quiniae sulphas gri
Sacch alba gr
M ft: pil viii one every three or four hours.
April 8th
Found the child still laying in the usual
posture. on its back. the powder operated once a
still pale and emaciated pulse very quick and
feeble. continued the treatment. Has eaten more to 
day than before. Bowels opened twice.
April 9th
Pulse 120 very weak. still laying on its back with the
the same dull and listless expression of countenance. I touched
its abdomen this morning and it appeared to cause pain
the matter in the eyes collects and forms membranes
over the eye. Continued the same treatment. She has been
taking besides I forgot to mention a teaspoonfull of cods liver oil
three times a day. Cannot bear any part 
of her body to be touched
Ol: qec: aselli zi
ziii quotidie
10th 
Found her this morning lying on her side. with 
her head on her arm which I considered an evidence
of returning strength. Her bowels not having been opened 
yesterday I ordered again cal et jalap as before
this being the third day. Pulse very quick and the skin 
rather hot continued the treatment unaltered.
Afternoon visit. The powder not sufficiently purgative ordered
an injection of zfs ol: ricini which caused a thin watery stool.
11th
The oil injection did not operate more than once cont
treatment.
14th Bowels opened every day the matter does not collect above her eyes 
now. very tender can see every bone almost in her body she is [setting]


April 17th Appeared to be not so well has vomited every thing
she eat this morning according to the nurse account.
No perceptable difference in the general appearance
of the child. thinking this might be caused
by the ol: qec: ordered it stop if the sickness cont.
19th
Film collecting around the eyes. Becoming thinner
every day.
20th Died this morning
Cancer of Os Uteri
When I just saw this patient she was
in a most deplorable condition not
able to retain her water, and looking
very thin and pale. The stench arising
from the cancer rendered her an object 
of disgust to all around her. Her urine
dribled from her by drops, almost incessantly 
made an
Phthisis Pulmonalis
Nov 17th Elizabeth Whitehead Age 25.
Saw this patient to day for the first time
Eyes presented the peculiar appearance of phthisis
Blue line around the gums. said that she used 
to have sweat at night. Legs very oedematous
cavernous respiration on the left side. very 
anemic.
Nov 18th Day clear and cool. still anemic. ordered zfs of cod’s
liver oil 3 times a day in porter.


Nov 19th No new symptom. change the ol: Qec: [illegible] for [calas]
phosphas a remedy now coming into popular use in 
phthisis.
Nov 20th
Declare’s herself better. appearance of the patient the 
same
Indianapolis Diabetes May 2nd 1853
Mr a farmer phlegmatic, 46 yrs
of age has been to Dr Patterson who says
he has a diabetes, does not pass much
urine now. urine high colloured;
uneasy feeling across the abdomen
temporary paralysis in the left arm
becomes giddy when [illegible] slim
habit says is urine smells like
new hay
zi of Rad: quassia
Aq: [illegible] oi
zi an hour before each
meal into which dissolve ferri cit zi
walked to my office to day being fine
and appeared well. I am indebted to my
friend Neff for this case.



French 1854
Pertussis
August 8th child 3 yrs old, has had whooping cough
for sometime. I gave it Cal: grs iii
Sod: bicarb grs i
Ipecac gri
Tart: em: gr 1/12
M ft pulv: No vi S. one every 3 hours
Tr: valerian
“ castor
“ [illegible]
[illegible] nitratis [illegible]
Sacch: [alb] [illegible]
[illegible] [illegible] [illegible]
Aug 9
The powders operated six times on the bowels. Cough
better. besides the above I ordered a warm mustard
bath three times a day. Stopt the powders until  
the operating diminished.
Aug 10th Only coughed twice to day. They say the child is
much better. Had to stop the mixture because the
child would not take it on account of the
disagreable taste. I substituted Tr: valerian zi
“ opii camp zfs
Spts: etheris pulp: zi
Aqua ammonia gtts ii
Aqua camp: zi
“ menthae [illegible]
Sacch: alb: [illegible]
Aqua distilled zi
M S. teaspoonful 3 times a day.
Aug 11th Cough’s less. Its parents seem perfectly satisfied
with the treatment. The powders
have done all the good. I think, as the mixture
could not be taken on account of the taste. Took
the second mixture without any trouble, even smacked his
eyes. Is not taking any powder to day.
Augst 12th Continued the 2nd mixture. Cough much better.
NB The treatment in this case has been satisfactory to all.


James Caslin Ireland Age 17 yrs Came in 4-9
April 10th morning 9 oclk
Tongue dry and red gashed in the middle.
very dull and stupid complaining a numbness
all over. no headache abdomen tender on pressure
skin rather hot. ordered brandy punch zviii beef tea
zviii afternoon 5 P.M. No perceptable change skin perhaps
a little hotter.
April 11th 12-13-14 9. A.M.
Has been getting weaker. tongue not [illegible] dry 
this morning except in the middle tympanitic
skin rather hot no headache
April 15th 
Tongue becoming moist at the edges. Found
him this morning with one side of his face swelled
ordered 3 doz leeches to be abstracted from the part.
April 17
His face is now enormously swelled. the [illegible]
muscles are deprived of use. can not shut his mouth
ordered the border of the swelling to be painted with 
tinct: of iodine. the swelling seems to be confined
now to the two parotid glands. and the contiguous parts.
ordered half the quantity of punch and vin [illegible]
 zviii the face to be kept constantly wet with [illegible]
soaked in lead water, and opium.
19th
The abscess has broke inside the ear and matter
is continually running from left ear. he can
now open his eyes pretty well espeacaly the right
taking zviii punch. zviii beef tea and 4 z vin [illegible] [???ssings] as
above.


20th
Discharging a great deal from his left ear. his face
on the left is very much swelled. cont. treatment
22nd
The left side still much swelled. matter [illegible]
of his ear Tongue very dry and hot has
very high fever in the afternoon towards dark
ordered flaxseed poultice to the face and
the following to be given through the day
Rx Mass hydrarg grs xii
Pulv: ipecac et opii grs [illegible]i
M ft: pulv in iv one every 4 hours
Rx Vin antim zfs
Vin: ipecac zi
Sod: bicarb [illegible] ii
Aqua menth ziifs
Syr: simp zfs
Aqua Fort zi
Teaspoonfull every [illegible] hours
along with 4 z punch and zviii vin [illegible] [illegible] beef tea zviii
to support his strength.
22nd
Much better this morning can open the left eye found
him yesterday afternoon sitting up in his bed eating
with a spoon [head] soaked in 
tea. The left ear discharged a great deal last
night. Tongue still dry hot and red at the edges.
very red at the edges
23rd
Much better to day although his face is much
swelled on the left side. The matter is gushing incessantly 
out of his ear and also from an opening
which showed itself for the first time this morning
behind the lower portion of the ear. made the opening
larger and ordered the poultice again. no change in 
the treatment.
24th A large [illegible] came from the opening behind the ear


looks quite bright this morning. tongue red as before
but much more moist.
25th great deal discharged the external opening not much 
from the ear. Much better. cont treatment.
26th
Stopt the antimonial wine mixture and ordered
the quinine sulphas grs xii and protocarb ferri grs xii every 
three hours. Face still much swelled on the left
side. left eye entirely closed, smells very bad.
Discovered yesterday the matter running from the 
other ear.
28th much better. swelling gone down very much.
May 1st great deal discharged from the right ear.
is anxious to sit up and was allowed to do so being
tolerably strong.
June 8th Has been well and assisting in the ward
sometimes for one or two weeks.
Napoleon Continuation of [illegible] Riddle’s case. Acute bronchitis
Dec 2nd and frequent pulse not so strong as yesterday about 80-85
skin rather more feverish. Tongue not so white and furred
Grunts with every breath as if he suffered pain. Treatment Stopt
the antim: mixture again with the determination. not
to use it again in this case if I can help it. Substituted
D.P. grs ii every three hours, with ext: hyos: grs vi 
mustard over the breast and abdomen. He spat 
up two bright red clots of blood before I left. 3 P.M.
Found him much easier, diarrhea stopt, no cough or pain
D.P. and [hyoscya???] have changed him. No more expectoration
Dec 3rd Rather restless last night. until morning the opium appeared
to have affected him. Skin feverish, pulse 80full soft and
easily compressible. Smells better. Headach, cough less frequent
Treat Ipecac & quinine grf iecac gr ½ every three hours.


Typhus Fever.
April 20th Morning 9. A. M. (Harrington’s Case
Pulse 100. Tongue moist but disposed to be
dry. Face the peculiar typhus expression. Eyes very
dull and stupid looking. abdomen arms and
chest thickly covered with petechiae. Abdomen
slightly tympanitic. stools according to the
captain account very offensive (this he told without
my asking) ordered brandy punch zxvi beef tea xviii
Difficulty of breathing and cough ordered 12 dry cups
5 P.M. Skin very hot and pungent. all the other
symptoms as in the morning
April 22nd 9. A.M.
Tongue dryer than yesterday. Pulse 115 (not having
a watch I had to guess at this.) Face still has the peculiar
expression incident to typhus fever laying with his
eyes, half open. skin not very hot. covered from head 
to foot petechia. ordered zfs mist terebinth every
hour with 12 z of punch and beef tea zviii
22nd
Petechia not diminished. Pulse 120. Skin hotter
than yesterday at this time. says he feels little better
tympanitic, tongue moist. ordered as yesterday mist terebinth
Rx Ol: Terebinth
Spts Lavendul a a zfs
Mucilage acacia zi
M
Teaspoonfull 3 times a day
23rd Much worse. Tongue dry. Petechia still covering his
body. Sordes collecting around the teeth. some subsultus
this morning in the hands. ordered the turpentine to be given every
2 hours. Brandy punch zxvi beef tea zviii head to be shaved
and ½ dox cut and ½ dry cups back of his head. and afterwards 


a blister.
24th Tongue moist. Sordes still upon the teeth. skin very 
hot. Stupor less. petechiae becoming rather duller
Pulse 100 or 90. continued yesterdays treatment.
25th Tongue still moist but dryer than yesterday. very
thick sordes on the upper front teeth. Eyes little blood shot
and half closed. pupil very much contracted. very deaf.
The petechiae are disappearing. those that remain have
a bluish look. Cont. treatment head was
shaved yesterday.
26th Found him very sleep and stupid. eyes half open
when he looks at you. does not answer your
questions. cannot protrude his dry and hot
tongue. A thickness of sordes covers his teeth
petechiae almost gone cont: treatment.
27th Great change for the better. Tongue moist and
easily protruded. skin quite cool. Sordes still
about the teeth. not so stupid. Pulse regular 
and rather full. ordered turpentine mixture
every three hours. instead of every 2 hours.
28th Not so well this morning. Tongue dry and protruded
with difficulty. skin hotter. and more stupid
ordered the turpentine mixture every 2 hours again
29th Does not talk any. Tongue this morning was protruded
comparatively easy which moist and coated thickly 
with a white coat. skin cool. sordes nearly all gone.
cont treat:
30th Tongue moist, and cleaning from the tip. skin moist
and cool, pulse regular and full. spoken to me the first
time this morning for a week or more. asked to 
get up. cont treat:



May 1st Tongue clean, nearly half way up from 
the tip. skin and pulse natural is anxious to get
up. teeth white and mouth clean. cont: treatment
May 2nd becoming convalescent.
Thackeray Case
Augst 9th 3 P.M. Pulse about the same. 5 operations since morning, amounting
to a zvi not as much fluid. mouth still cleaning. Augst 11th
Pulse and voice better. Mouth cleaning. Abdomen status quo.
only one passage. much more consistent greenish
and slightly tinged with yellow. sleep much better last
night. 12 M. only one small passage this morning [illegible] [illegible]
[illegible] with Camp: tr: iodini. Augst 11th Slept until 4 A.M. when
[illegible] four operations in succession in all amounting to one healthy
[illegible] [illegible] quantity, better as to odour and appearance and [illegible]
[illegible] a dark green. Pulse very feeble. Abdomen little more swelled.
[illegible] and mouth better. No change in treatment. 2 P.M. Pulse very
feeble Mouth almost clean. 4 operations [illegible] and
[illegible] yellow. Abdomen not so [tumid]. Loathing his food, advised [illegible]
not to offer it until he expressed a desire for it. 7 P.M. No operations since
2 P.M. another [illegible] [illegible] Augst 12th [illegible] operations (as before.) Pulse
little stronger. Mouth nearly clean No change in treatment. Augst [13th]
[illegible] becoming white again. Other symptoms the same. No change
in treatment. 7 P.M. vomited a quantity of acid matter according to his
[illegible] account upon awakening out of a good sleep. 5 or 6 operations, similar to 
[illegible] [above] to day. Mouth threatening again. Augst 15h About as
yesterday and the day before, except had a more natural operation. No change in 
treatment 2 P.M. one operation since morning 5 or 6 small masses like [illegible] meat.
Urine natural. Painted with iodine. Vomited again yesterday after taking the powder
has taken now in all will when though [illegible] [illegible] 13 [illegible] [illegible]
8 P.M. he had 4 operations to day . 3 [illegible] dark [illegible] morning as before [illegible] 2 P.M. 2 stools today greenish yellow


Acute Rheumatism very satisfactory case in 
which 16 z of blood cured. (bloodletting the remedy.)
April 20
Jos Osback came in yesterday age 23 says he has 
been sick one week and never had rheuatism before
complains of pain in his knee joints and in his arm
had to be carried up stairs into the ward and lifted
into his bed. Found him this morning with a full strong 
and regular pulse, which did not correspond
with his face which was pale and also his body.
this pulse was therefore inflammatory. I took immediately 
from his arm 16 z of blood and ordered
pulv ipecac et opii grs v every three hours (each to 
be given at an hour’s interval)
Afternoon visit 5. P.M. Declares himself much better
can move his legs up and down the bed.
22nd Left yesterday for home much better could move
his legs as he pleased before he left.
Thackeray Case
Pulse much stronger. Mouth clearing off again. No change in treatment 7 P.M. had
two stools  today. Augst 18th 3 stools in the night thin and yellowed. Pulse [illegible] the [abdomen]
[apthous] [illegible] still [illegible] Renewed the [illegible]
making [illegible] [proof] [illegible] [illegible] Augst 19th Mouth still apthous. 5 stools greenish
and [semi solid] Petechia upon the back. 4 P.M. 3 or 4 stools one almost
natural. [illegible] Apthae still seen. 7 P.M. appears to [illegible] had a
[illegible] something gelatinous substance in small masses [illegible]
very restless and sleepless, appears to be suffering. changed the [illegible]
to day to chl: potassa et D.P. try abstaining from the arg: Nit. Augst 21st
Was called at 4 ½ A.M. had tossed and [illegible] nearly all night sleeping only 2 hrs.
Pulse very feeble and weak. No other change. Mouth appears better 9 A.M.
almost constant pain in bowels, [illegible] [illegible] grs [illegible] to be [illegible] every two hours. Had [illegible]
[illegible]


Wm H. Darrach’s Case (Teething probably)
June 26th
Wm is 6 months old. The hottest day of the season therm: 84 [degrees] at 3 P.M.
His bowels for two or three days have been irregular as to 
their action sometimes not moving for two days. This morning
they were moved 3 times and in the afternoon and evening
and during the night 12 times. They gradually became
thinner, until towards the last almost ran from 
him as thin as water, and almost colourless accompanied
with much pain, causing the little fellow to twist
and cry piteously. High fever set in about 4 P.M.
I had to walk the floor with him during the night
His stools for two or three days have been light coloured
indicating I though deficiency of bile. About 2 P.M
I gave him about gr ½ of calomel on the end of my finger
and about 10 o’clk P.M. gave him about 15 gtts of paregoric
He fell asleep at 1.15 A.M.
and slept until 4 o’clk A.M. His skin at 4 A.M. was hot
June 27th 
Awoke at 4 A.M. with a hot and dry skin, but
appears much brighter laughs and plays. Operations 
much less painful and towards evening became much 
better. Fed him to day on gum arabic water and boiled 
milk with cinnamon and cloves boiled in it, all of 
which he took with relish. The gum arabic water he liked
better when the fever was on him. Have heretofore been
mixing baker’s bread dried and rolled into powder (coarse)
Thinking there might be some ingredient in this bread which caused
his diarrhea. I stopt mixing it in his milk. Slept sweetly all day nearly
June 28th
Slept sweetly. during the night. No operation during the 
night. Skin natural. Had a good operation about 8 oclk A.M.
going to mix dried boiled flour in the milk instead of baker’s bread
(continued)



A very interesting case
Description of a case that occurred at Blockley
hospital June 24 1851. Caused by eating cherries
as was supposed by the patient rather an 
intelligent man.
June 23
Mich Hurley aged [?9] very diminutive in 
stature. eat some cherries this morning
which caused his bowels to become very loose
sent for me about 6 ½ oclk found him on 
the stool but did not see the discharge.
Pulse very small which I supposed
was his natural pulse as he walk from 
his room down a flight of stairs pretty 
steadily to me and stood pretty [illegible] on 
his feet. I sent him immediately to the 
medical ward where he was not seen
by a physician until an 8 ½ oclk 
at which time he was passing “unpercetably”
to use his own words. the characteristic rice
water discharge of cholera. also vomiting
the same. Pulse very small and attenuated and
feeble. beating about 60 according to Doctor Shively a
minute he was ordered a half a grain of 
morphia in a teaspoonful of aq: camp: and 
half an hour afterwards x grains of calomel. after 
taking this he vomited very freely this rice water
discharge. so that they supposed he had vomited
it up. consequently gave him 20 gtts of the following
mixture. Chloroform zi 
Tr: opii camp zvii
and ordered hot bottles to his
legs and face & mustard
to his stomach
I saw the second time about 10 o’clk
at which time he was laying in a reckless kind 



with his head leaning over the side of the bed
seemingly unconscious of any thing around
and caring less. he was very restless tossing about
from one side of the bed to the other. and
crying out with cramp in his legs. Tongue very
cold. constant thirst, asking incessantly for
water. skin on the back of the hand
and over his body clammy and cold
when [??inched] up into [pleets] remains so
for some time without relapsing int its natural
condition. complains of being very hot inside.
I gave him a teaspoonfull
of the chloroform mixture. before mentioned
10 ½ oclk. still very restless tongue and all 
the other symptoms about the same except the
cramps in the legs which are not so severe.
Passed about a tablespoonful of rice water discharge 
from his rectum. I now ordered a strong mustard 
sinapism to be applied directly to the whole
length of his spine, (the mustard in direct contact
with the skin) the same to the calves of his
legs and his rists. ordered a grain of calomel to 
be given every fifteen minutes and an injection 
of starch and laudanum every hour the
first injection to contain zi of Tr: opii to zviii
of starch mucilage.  the second 60 gtts to zviii
and the third without laudanum.
11 ¼ seems disposed to sleep. still restless and
thirsty has had but one inclination
to stool since 10 ½ o clk. The cramps appear
to have ceased. Tongue still cold. skin warmer 



Rheumatism. Phosphate of Amie
Case 1st (Cold)
Nov 12th Ann Master. aged 50 has had rheumatism
3 years. was at the time of her admission
not able to walk without crutches, and
cried out with pain on being touched
Dec 12th
Can bear pressure upon her limbs
and can walk about with the aid
little stick. In this case the Dovers
powder was given along with the
ammonia.
Jan 20th
still in the wards. much relieved
but not well.
Cold sweat on his forehead. Rept the mustard 
on an hour. We now left him with orders for him 
to have a gri of calomel every 15 minutes and
starch injections every hour untill he went to 
sleep. his pulse has come up. the tibial artery
artery on the maleolus can be felt beating
very distinctly.
June 24th
Found him very much refreshed from 
a good sleep. having fell asleep soon after
we left. which continued untill morning, and thanking
us for having saved his life. skin natural
tongue however still cold. and still thirsty [illegible]
warm tea for him to drink. and the calomel powders
through the day every fifteen minutes.
2 oclk P.M. Tongue still cold. but he is evidently better ordered cal gri
every hour


Case 2nd
aged 18 came in 
with rheumatism of the shoulder and
lower extremities.
Dec 12th 
Has completely recovered
and walks about the ward without
any trouble.
Case 3rd
Aged 76. Coloured came in Dec 11th
Dec 21st 
Has been gradually improving
since he came in.
Jan 13th 
Discharged about a week a go greatly 
relieved 
Case 4th 
Elizabeth Miller, cold, age 12 was
admitted Decr 21
Says he has had rheumatism for 9 yrs. was in 
bed one y ear.
Jan 17th
Complained of pains. this morning in the 
leg
Jan 19th 
walks much better than he did 
took yesterday 10 grs of Dov. powd 3 times repeated
which caused to sweat a great deal.
Jan 20th 


Did not see him to day, but heard no complaints
Jan 21st
Complains only of pain in the elbow and
knee. gave him lin. ammoniae.
Jan 22nd 
Pain in the elbow and left
leg nearly gone.
Jan 24
Still has pain in the left leg.
Jan 27
Did not see him to day.
Jan 28
Great deal better although the day
is damp and rainy
Continuation of Hurley’s Case.
June 25th
Found his pulse full regular and soft
skin and tongue natural. complains of not having
any appetite has not had a stool since yesterday
morning ordered mass hydrarg: grs v to slightly relax
his bowels.
July
This patient entirely recovered and was
operated for hernia by Dr: Page. some six mos
afterwards.


Major Frisby’s Case. Blk.
Jan 21st
Came in complaining of pains all over his
body put him on Rx Ammonia phosphatis zi
aana zvi
M tablespoonful 3 times daily
Jan 24
Says he is better. this is a fine day
however, and it may be on account of the
weather and not the medicine.
Jan 27th
Complains of a little pain to day
Jan 28
No pain. complains to day of a cough.
The day is wet and cold.
[illegible] [illegible] Med:
Case 1st Emma Dixon’s case, acut articular rheum
phosp amia et pulv. ipecac et opii. Case among
the [illegible] medical cases, in another part of this book
Case George Ross age 50 blk
April 23rd Has had rheumatism for 7 yrs. An extraordinarily
large man. weighs about 250. has been often relieved
by the ordinary remedies. complains this morning
pains in his legs can not get out of bed.  ordered 10 grs
of phosphate of amiae with 5 grs Dov. powd: three times a day.,
April 24th Better
“ 25 Still getting better
“ 26th better, but tender over the hips.


28th sitting up and looking pretty well.
May 1st Complains of pain this morning in the old place
in the hip: 
Inds 1854
Sprained Ankle
May 26th Mr [Boon] fell down into a
cellar 15 ft. Contused and cut the back part 
of his scalp, making a cut about ½ an inch
in length and also twisting his [illegible] [ankle]
He did not complain of his ankle when
I saw him Saturday night, but sent for 
me on Sabbath morning. I found the ankle
much swollen and exceedingly tender
Suffered much during the night. [illegible]
[illegible] leeches (American) and [afterwards] [illegible]
[illegible] poultice with hot vinegar poured 
on it. The leeches only applied 12 leeches
May 28th Less swollen and tender ordered
[illegible] blister over it to day and Rx Cal gr 1/11
Mass grs [illegible]
[illegible] [illegible]
M ft: pil [illegible]
S. one every [illegible] hours
Was cured
Thackray Case
9 AM Aug 21st
Another good operation. 2. P.M. was sent for to see the child. No stool since
9 A.M. Abdomen tympanitic. Hiccoughs. eyes roll under the lids. [illegible]
and throat breathing Pulse almost gone. Augst 22nd Pulse stronger more
lively and easier. Was given up last night for dead. Gave him [illegible] anodyne [illegible]
[illegible] motion of bowels seen through the cuticle. Not so tympanitic. Opii gri
Camp [grvii]
M ft: pulv: to iv
Easy and without pain. Tongue coated with a dirty [illegible]
[illegible] coat. Mouth still apthous. had 3 stools in his [illegible]. 7 P.M. [illegible] with his
eyes half closed. Stools [illegible] [illegible] [from] this afternoon. Augst 23d 3 stools more consistent
with yellowish streak through the [illegible] green. Sleeps with his eyes half open.  [No pain]
Pulse very feeble, skin hot. mouth cleaning. 7 ½ P.M. high fever. pulse [160] [illegible] [10 small]


John Sharpless 9 yrs standing. (wht) age 49
April 23rd
Has been taking phosphate of amiae 2 wks his
pain is in the muscles of his limbs. when he first cam in 
2 wks ago had to be carried up stairs. now runs about
ward when he chooses.
April 24th still continuing better.
Inds 1853
Mr Allen’s Case Age 64 (about) anxious face. hard to understand.
Came to my office about 6 wks ago complains of 
a diarrhoea which he says he has had for a 
year. ordered him injections for which according
to his description I though piles, of
cold water. and 15 gtts of Syr: ferri iodidi 3 
times daily an hour before each meal. saw
him 3 wks after this, better complained 
of acidity ordered chalk. Saw again
to day a month after the last visit
found him costive. no acidity. chalk
having removed it. according to his own request prescribed argenti nitras gri
Pulv: opii grs ii
Acacia grs iv
M ft: pil: No viii
one pil an hour
after meals. also to use 
the following as an injection 
as the cold water injections before ordered did
relieve his piles or ulcers as he calls them
having as he says a yellow discharge 
from them. 
Acet: plumbi grs ii
Aqua zviii
M ft: injectio




John Kenneday. Art. Rheumatism April 18th Phosp: amiae
A case of marasmus Augst 9th 1853 Indianapolis
Aged 1 year was first attack with cholera infantum
which was in all probability 
brought on by premature weaning, and feeding
upon arrow root, and mutton broth,
The cholera was apparently checked, but
owing probably to some irregularity in 
the diet, a diarrhoea set in, which 
could only be checked temporarily, and
continued up to the above date. when I 
first saw the child. The most striking
and characteristic symptom was the 
senile appearance of the face, when 
the child cried; together with extreme
immaciation. Two lower incisors were
through.
This case has undergone mercurialism, and
Dr Woodburne is now stimulating with
port wine, and nourishing with mutton
broth.
Query. Was the marasmus caused by the cholera
infantum or improper food.
Thackerey Case
semi solid greenish (spinage) not so much yellow as in the morning. Mouth [illegible]
again. Tympanitic (little) again. Appears to be easy. Stopt the brandy punch on account
of the febrile condition, to be sponged with tepid water. Aug 24th Renewed the punch
[illegible] poultice to the abdomen when pain is present there. Pulse very small and feeble
Augst 25th Eyes wide open when asleep; death upon his face. Augst [26]
Pulse very feeble 120 or 130. Gagging every now and then, [illegible] sinking.
[Stools] not so frequent. dark colour. During the past two or three days the 


[Ahead’s] case (child) Inds
October 18th 1853 Case of contusion in a child 5 yrs old.
This child was found by me, with its heel much 
contused, and lacerated by a heavy bench which
had fallen upon it. There was a cut extending
around the lower portion of the heel, and
a small round mass of muscle had been forced
through the skin. Thinking this had better
slough off I applied flax seed poultices.
Oct: 28th Stopt poulticing and using Turners cerate.
There is now a healthy ulcer with area
of a half inch. all the slough gone.
Nov: 1st Continuing Turners cerate and the ulcer
is bathed in laudable pus and 
cicatrising around the edges rapidly. Quickened 
granulation by lunar caustic.
Nov: 3rd Granulation had to be cauterised, continue the
Turners cerate & opium. General health from the beginning
very good. Throughout this case great attention has
be paid to keeping the foot elevated at an angle of 20’
N.B. This case was satisfactory. The wound healed nicely
and I got paid $10 as soon as I dismissed the case
Thackrey Case
feet swelled, [illegible] subsided. The stools improved also in appearance.
Mouth worse. Refused its nourishment and other little things
it was in the habit of taking Augst 25th ied sometime in the afternoon
The symptoms [illegible] [illegible] which rendered prognosis unfavourable were. continued
emaciation in spite of the rich food taken. Recurrence
of the apthous deposits in the mouth. Continued if not increasing debility.
Swelling of the feet. [illegible] stagnation manifested the petechia on the back
and shoulder.



Cholera Morbus. Inds
Nov: 4th I was called to this case this morning Found
the child lying in the cradle pale and
with dark areolae around its eyes. Its 
mother said it had been vomiting and 
purging for the last 2 days, which had a 
sour smell. The vomited matter looked
like curdled milk and that passed from 
the bowels very yellow and tinged with 
greenish hue. [illegible] mustard to its
stomach 5’ as the child was only 8 mos
old and one drop of laudanum
to be repeated in three hours if the vomiting
did not cease, also a warm
bath. Left cal gri
Dov: powd; gri
Sod: bicarb grs iii
made into 
12 powders one every three hours 
Nov: 5th Vomiting and purging ceased, its mother said it
had fever in the night. sucks well. Eyes bright, and
plays with the children. has a bad cough. Areola
faded. has taken 5 powders. ordered the remaining
powders and another bath. Has had one stool.


[illegible] case
A very obstinate case of incontinence of urine.
April 20th 1849 Blockley Hospital.
This patient came under my care about the
latter part of last month he was then dribling
his urine incessantly and very irritable.
His trousers being continually wet and sometimes
marking his way along the floor when he
walked. He says he has had this constant
dribling for two years without and hours intermission.
he is very weak in consequence.
Before he came under my care he had been
taking the Tr: ferri muriatis 15 drops three times daily 
being very anaemic. and tinct catharides
this treatment was persisted in for a long
time (2 mos) without affording him the least relief.
according to this account. I changed his tonic for
Rx Quinia sulphas grs xii and also [illegible] an hours 
interval Ferri protocarb zfs the gr 1/24 of strychnia 
M ft pil xii unus quatuor horae
April 21st 
last night did not pass any scarcely
There is now no wet patch in his trousers
over his privates
April 22nd
Complains this morning as he [illegible] since he took
strychnia of numbness and inability to stand
on his legs. says he passed a good deal from his 
bladder last night by dribling. It seems to relapse 
backwards as he gets better and show a disposition
to be periodical. The urine the other day
did affect litmus very slightly 
reddened very slightly not near so much as my own did


or that of the apothecary (Mr Marks) both of us being
that day in good health.
23rd
Says he passed scarcely any last night. his trousers about
his privates no keep dry.
24th Did not pass any wine last night scarcely. cont
treat.
25th Did not pass any urine last night. can walk better.
26th Says he pass a little last night. but not enough
for the nurse to notice when he change his
bed clothes in the morning. keeps his trousers dry
and seems to be in better spirits. continued treatment.
27th Pass a good deal last night
28th Says he passed a good deal last night. compared
to what he has done within the last two weeks.
29th Pass a good deal last night. The patient very stupid
irritable will not answer questions put to him.
Cant seem care whether he gets well or not.
20th Pass scarcely any last night says “it comes by 
spells” to use his own words
May 1st
Discovered to day, that he has not taken strychnia
for a week or eight days. nor any medicine for
a tow or three days. ordered all medicine to be stopt
May 2nd Did not pass any last night scarcely.



Syphillitic [?upia]
Saml Williams came July 7th 1857 with
his face body arms and legs covered
over with sores and scabs some of which
were the sise of an American quarter
of a peculiar dark collour. and when 
pressed upon with the finger there
appeared to be from the elasticity
of the scab filled underneath with 
fluid some of them stand out from 
the surface of the skin, the 1/6 of an inch
some of the sores where the scab has
been removed presents a raw chancre
surface.to these are applied the red precipitate
oint.
and the patient is taking the following.
Rx Pot: iodidum zi
Hydrarg: bicholridi gri
Aqua zviii
Tablespoonfull 3 times a day
Rx
Decoct Sarsa
zvi per diem
July 15th
The scabs upon his face after having
filled up (as it were) are beginning to fall off
and leave sores covered with a thick yellow
pus. to which I apply the red percipitate oint.
he complains of [illegible] pain any where
has a good appetite.
July 17th Nearly all the scabs have fallen of and
he says he is a good deal better


July 21st
Not a single scab remaining still continuing
the above treatment.
July 31
has been well for a week past
Inds Infantile Convulsions [sequelae] of dysentery.
March 20th 1855
Mrs Brewer at Little’s Hotel called on me to see her child 2 yrs
of age labouring under convulsions. Found the child [illegible]
breathing natural. Face flushed with an unnatural
dusky hue. Had convulsions every hour, insomuch the 
mother became alarmed and sent for me. The bowels
had not been regular natural since last summer
which the mother attributed to an attack of dysentery
the child then had. I ordered an emetic of
ipecac and tart: emetic and grs v of Dov: powd:
jalap ordered mustard bath and sinapisms to the ankles
and rists. The child since the dysentery attack has been [illegible] [illegible]
greenish
March 21st Much better. Left the following for the chronic 
diarrhea
cal brs iv
Quinine grs iii
[illegible] grs iii
Plumbi acet: grs iii
Mass: sulp: grs 1/8
m ft: pulv: No viii



Phthisis
Cases in which phosphate of lime have been used 
Nov 17th 
E. Whitehead age 26. Anemia large frame,
oyster shell eye. Adunque fingers. Blue line around
the gums legs very oedematous. has had night
sweats. Cavernous respiration in the upper part
of both lungs.
Nov 19th
Symptoms and feelings of the patient the [illegible]
put her upon phosphate of lime. a remedy now
coming into use 10 grs 3 times a day.
Nov 20th 
Says she is better still on the lime.
Nov 24
Much weaker. continued the lime.
Nov 26
Hectic flush more intense. pulse fuller and
stronger. did not examine her chest to day.
Nov 28th
Countenance more healthy, skin natural perhaps
a little colder than natural. Pulse soft and feeble
Same sounds heard in the chest as at first
says she is better. Continued the powder. is much 
stronger. Raised her self to a sitting posture with less effort
than yesterday.
Nov Dec 5th
Countenance the same. not much stronger
feet very much oedematous. yesterday there was
distinct cavernous respiration on the left side 




she also complained yesterday of difficulty in
passing her water. her bladder on perception
was found not to indicate a fulness
it was therefore inferred the kidneys
did not secrete or there was an obstruction 
in the ureters. This morning
much more dropsical, she is rather inclined 
to constipation.
Dec 8th
Did not sleep much last night but declare
herself much better to day. looks rather
more cheerful. her urine is very dark of a 
musty brown collour and very opake, and
thick.
Dec 11
No change in the patient to day
Jo: Riddle’s case
Dec 4th Pulse full and gaseous 100 Breathing rather short
and labored. Skin feverish. Tongue [illegible]
very weak. 3 operations since yesterday. The quinine
appears to have made him feverish. Treat. Gent:
and quassia tea. tablespoonful 3 times daily.
Dec 5th Pulse 80 regular and little hard. Operations less frequent. skin less
feverish. Stools yellow. complains of pain in the region of the 
diaphragm when he raises up. Treat: D.P. gr ½ every 6 hrs
tablespoonful 2ce per diem of the tonic tea.
Dec 6th Pulse 60. Sweat very much last night. One thin operation
Respiration better. Says he feels better, stronger and has a little appetite.
Stopt the D.P. and is taking a tablespoonful of tonic tea
3 times per diem Dec 7th Pulse to be regular and soft. skin little feverish 
No operation since day before yesterday. ordered [illegible] and molasses Respiration
good. No pain Slept pretty well last night. No sweat. Treat


Case 2nd Ellen Groves Age 45
Nov 20th symptoms in this patient indicating
phthisis are the eye night sweats swelled
feet (oedema) and a cavernous respiration at
the upper part of the left lung
Dec 5th
Has been using the phosphate of lime for
two weeks, without much benefit complains
this [illegible] of sick stomach and diarrhoea
with griping. (this diarrhoea I have cause to 
think is caused by the phosphate of lime, it 
being insoluble in water) may also be in 
the juices of the stomach. and therefore act
as an irritant to the stomach, causing
sickness, or to the bowels, causing diarrhoea)
Dec 6th
Signs indicating a cavity on the left side. loud crepitation 
over the left axillae. Diarrhoea less; renewed the
powders.
Diabetes Mellitus. Henry Lynch.
Has had the disease two years entered the
wards Feby 19th when the following
appearances were noticed. Temperament
a mixture of the bilious and phlegmatic
large frame. Broad face and features large
face pale, muscles flabby. The first complaint
was that of excessive thirst and incessant
voiding of urine, I desired him to pass some
into a bottle which he did without the
least effort about zvi of clear white urine
which upon being shaken up a thick white 



foam collected upon the top, which remained
some time, the odour resembled 
apples or new mown hay or limes. Sugar
in great quantity was detected by three
different tests. Before he came in said he vomited blood
Feby 21st
Complains of pain in his breast and 
small of the back. said every thing tasted
sweet, gave him some very sour vinegar
which he said tasted sweetish, which seem
to like, said he “could take any thing like
drink no matter how bitter it was,” these are
his very words, ordered his drink to be made 
one third vinegar. plenty of met which he craved
a wine glassfull of an infusion of 
gentian in which 15 gtts of Tinct: ferri
muriatis was mixed and given 3 times
a day. 10 grs of Dovers powders at night.
passed about 2 gallons last night.
Feby 23rd
No sleep. vomited blood, complains of
nausea after eating passed usual quantity
of water last night. The Dovers powder was not
given last night. Same treatment as above to be
continued.
23rd
Took Dov. powd grs x but did not sleep much
better passed usual quantity last night which
the nurse said had spotts on it as
thick as beer. took some salt and water
to check haematemesis. wants his meat half
cooked cont. the above treatment.


Feby 24th
No change still complains of burning
heat in the left side. cont: treatment.
25th
Better. Did not pass so much water. did 
not complain of the burning in his side
slept better last night
26
Slept well last night complains a severe
burning at the cardiac region could not
detect any thing abnormal there ordered
a blister for the pain. as he said it always
did him good. cont treatment.
March 13th
Up to this time the patient has been alternately
better and worse. often complaining of vertigo
and burning at the cardiac region. about the first of 
march the quassia was substituted for gentian. rest 
of treatment same. The treatment is now entirely changed
Liq: arsenicalis zii
Ammoniae hydrosulphas gtts xx
Tinct hyoscamus
Spts lavendulae a a zi
Infus diosmae zviii
except the Dov powder at 
night
Tablespoonful 3 times a day
March 13th 
Complains of weakness in small of back
[illegible] region his stomach which he says takes 
away his sleep. Quantity of urine still lessening 
passes [illegible] almost half the quantity he did at 



first. the patient is still kept upon 
old treatment. Quassia & Dovers powder gr v
the new medicine not obtainable
besides the medicine he is kept as strictly
as possible on meat diet, still poured
down him immense quantity of water
drinking sometimes seven quarts in 24 hrs
March 14
Complains this morning of pain in region
of the kidneys, which would not allow me to 
press upon this part ordered 6 cut cups
continued the treatment
March 20
Does pass as much urine, spat up blood zifs
last night
March 30th
Cannot keep bread from him but
notwithstanding much better.
Gonorrhoea Inds
Jan 12th 1854
Penis very much swelled, especialy the
gland meatus urinarius extra ordinarily large
A large prominence below the corona gland
on the posterior portion of the penis.
Treatment
Cold water injections. 2ce daily succeeded
by an injection of nitrate of silver 5 grs to the zi
Jan 12th 
Had chordee last night, which would awaken
him out of a sound sleep


Jan 13th Penis much less swollen no running.
less ardor urinae. Took 3 pills of the following.
last night on retiring and had no chordee but was kept awake, through mental anxiety
being a poor man and out of work. His right eye is much 
inflamed, this mornings an old complaint.
[illegible]
Camp: a a grs x
Opii grs ii
M ft: pulv. viii
Treat: applied the solution to the eye and ordered zi of salt
in the morning and powders of cal: grs ii an hour before
each meal. Low diet. (strictly) Dov: powd grs viii
m ft: pulv: viii
Inds 1853
Mrs Manus Case (coloured woman)
I found this woman through Dr Gaston’s
information in a miserable hovel
over the canal. They were too poor to buy
candles. I found her lying upon the
bed in a dark corner groaning as if
in labor. Dr Gaston having told me she 
was about to have an abortion, I was
led astray, and when I heard her
groans. I told her, she need not try
to deceive me for I knew she was in 
labor. she assented to this. 
The next
day I discovered my mistake. and
altered my course. I found that instead
of having an abortion she
had dropsy. This fact was discovered
first by an old Indian Doctor (coloured)
and he out doctored me because I 
relied upon anothers judgement
and not my own. I then, having found
her bowels not opened ordered her a
purge of cal: Rhei: and jalap: large doses 



her pulse was 120. skin feverish.
Tongue whitish and furred. slightly pain 
in the left side, and right thigh.
March 10th
Took besides what I gave her a
dose of castor oil, and when I saw her
found her passing thin watery stools.
Pulse 120. Tongue whitish and furred. I left her
yesterday some cal: and Dovers powder
and this morning found she had taken
all except one. Did not order any 
medicine to day.
4 P.M.
Finding she had griping pains at stool I 
ordered her cal: 
grs ii
Dov: powd grs xii
Morphia gri
M ft: pulv: xii
one to be taken every
three hours
March 11th
Pulse quick and frequent Tongue as yesterday;
has had no passage since bed time
last night Complained of ringing in the head
and crazy feelings last night which I attribute
to the morphia and Dov: powd: together, sweat
last night. The only symptom I dislike, is the pulse
which is too frequent, and quick. Stopt the powder
is taking no medicine now.
1 ½ o’clk Pulse softer says she is better.
March 13th 
Pulse hard and quick, 100. Tongue as yesterday
white and furred. Complains shortness of breath. slept tolerable.
stopt the powders for fear of salivation.
March 14th
Pulse softer and more regular had shortness of breath in 


the night bowels inclined to be costive. Fearing
the dyspnoea indicated water in the chest I 
ordered her cal: and morphia. Cal: grii
Morp: grs ¼
M ft: pil: No 8
one every three hours.
March 15th 
Pulse 110 hard full and quick.
slept well less dyspnoea. Bowels free took zfs of
oil.
March 16th 
Pulse softer and less frequent about 80
or 90 per minute. Bowels regular. Tongue cleaner
ordered for her juniper berry tea and cream of 
tartar and nothing else.
March 17th
Pulse 80. skin natural. Face brighter. Bowels
regular complained of a gristle rising in her
throat when she has these weak spells.
continued the tea.
Pulse more regular, and softer. Tongue whitish.
Skin natural. Slept well. Bowels regular. Urine
opake and deposit a whitish
precipitate, which was dissipated by a slight
heat. ordered the tea continued and added
a tonic tea. Gent: & Columbo
March 21st 
Pulse 100. soft and full Skin moist bowels regular 
Tongue much cleaner. Good appetite
strong enough to sit up a little while by 
the fire in a chair. cont: the treatment
March 23rd 
Pulse quick and strong. Tongue clean 


Bowels regular tells me the tonic tea prevents her fainting 
spells. only taking the tonic tea at present.
April 7th
Has been since the last date getting alternately
better and worse, being attacked with dyspnoea
at times so bad as to prevent her lying down
Has not been taking medicine regularly,
Found her this morning not able
to lie down and her breathing very short.
gave her elatri gri
Cal: grs viii
Jalap: grs xx
Rhei grs xx 
M ft: pil: viii
This patient died last night
Secondary Syphillis
Aug 13th 1854
Age 24 contracted a chancre and bubo some
months ago. Has swelling of the submaxillary 
glands, and excoriation of the side of the tongue
(stomatitis) prescribed Pot: iodidum zii
Aqua zii
Teaspoonful 3 times a day
Low diet.
Ung: [illegible]
also
“ hydrarg
z z zi
also Hyd: bicholor
grs xii
Aqua ziv
M ft: mouth wash.
Jos: Riddle’s case
Dec 7th Cough less frequent and purulent expectoration in 
small masses. Treatment. Tonic tea, tablespoonful three times
daily. Dec 8th Pulse. 72 skin little feverish. [cough] better
All say my patient is better. slept better. Feels stronger
No uneasy symptoms. No operation [illegible] day [before] [illegible]


Ulcer of the thumb resulting from exposure after 
being lanced for 
Oct 12th Barry (Irishman) Age 45 Full habit sanguineous,
Sandy complexion. Had his thumb lanced for felon, and
used [illegible] the same day, when I first saw him, his
thumb was much swelled at the ball, and a
large ulcer (new) with its middle filled with 
slough, ordered a head and milk poultice
Oct: 14
has been poulticing, and this morning I took
away a part of the nail in removing the slough
ordered the poultice again to day.
Oct: 17th Slough, all away, and the ulcer presents
a healthy appearance, ordered him to keep a
piece of lint spread with carbonate of lead cerate
zii to the zi Brought the edges together with sticking plaster.
Oct 20th Has been using the above cerate, which has caused
the ulcer to exude a great deal of pus, without appearing
to hasten the granulating process I sprinkled
powdered rhubarb over one side and, calomel over
to other and did not use the lead oint: did not remove the
strips.
Oct: 31st Strips still on, no union appears to be taking place
between the opposite sides, reapplied the powdered rhubarb.
stopt using the calomel, as the side upon which it was applied, indicated
no improvement the next day. The ulcer does not exude near
as much pus as when the lead oint: was applied.
Oct: 22nd Took the strips off to day, and found much improvement, 
reapplied them and the powdered rhubarb
Oct 23rd Did not come to day I suppose he thinks he is well
[pour] his thumb was doing finely though not well yet.
Thinks the flaxseed meal poultice done him most good.


Oct: 30th Still hanging to the Doctor, though much [better]	
touch it occasionally with nitrate of silver, and still
apply strips of adhesive plaster, much smaller,
and a great less painful
Continuation of Mrs Hamilton’s lease Inds
Jan 14th 1854.
Mrs Hamilton’s cough commence troubling her
about a month ago. Had a conversation with Mr Hamilton
last night, who told me he thought I was correct last winter
but now. thought it was not so; but thought it was her 
liver and not her lungs. When I look back upon my 
course, in this case. I [illegible] myself with a rashness
in venturing a opinion. I paid too much attention to a 
haemoptesis she had one Sunday at church, and her
own description of symptoms without seeing them myself. 
I am a good deal staggered this morning. Another
thing that enabled me to express an opinion was
the apparent good effects from cod’s liver oil. She
has asked me to get her some more to day.
Jan 23rd Has been taking cod’s liver oil in porter teaspoonful
3 times daily felt relieved immediately. Still has cough
Is easily depressed. Was [shaved] a small red line extends
along the outer edge of the fore finger as far as the 
rist, described the pain in it, as stinging and burning 
I told her the nerve was inflamed at least the neurolema. 
Coughed several times in my presence rather 
severely. I can see a great difference in her cough
She is much pleased with the oil
Feb 17th Is still taking the oil, finding it very beneficial to her cough.
The cough increases every time, she neglects taking the oil and is
immediately relieved upon resuming it again. There are several 
circumstances in this case which puzzles me, and at times, make me 



wish I had not ventured an opinion, and then again I
discover symptoms  which fortify me in my former [and]
first impression. The symptoms [illegible] other circumstances
which stagger me is the fact if her not loosing flesh
and as she coughs most when excited, I am inclined to
think her cough sometimes purely nervous, although the
excitement would produce the same effects in some cases
of phthisis. Mistaken or not in my diagnosis there is great
relief from cod liver oil. I still retain her assent, to my 
[first] opinion her husbands argument to the contrary
notwithstanding. She maintains and defends my opinion
on all occasions. It has now been a year since
my attention was first called to her and she looks now as
fleshy as then. Whether the cods liver has been 
the presence of her flesh I cannot say, very
likely it has. Jo: Riddle’s case
Dec: 8th Disposition to sleep all the time. Treat
tonic tea and beer, about half pint per diem.


Inds
Hemoptesis, Mr Jocelyn (Phthisis)
May 6th Found him sitting by the side of the bed
with a chamber in his hand [illegible] which he every
now and spat a mouthful of blood after coughing
told he had been walking and was attacked
when about a mile from his house. Thinks
he spat up 3 pints. Upon inquiring into 
this case I conclude he was labouring with 
phthisis. He said he had lost much flush
has had the cough for sometime, night sweats
dyspnea, and oedema of the lower limbs. I found
that the haemoptisis had stop in a great measure
but ordered him to keep on his back and
quiet, and to take every half hour Acet plumbi gri
Morph: gr 1/32
and a teaspoonful of the following every two hours.
called at 7 o clock 5 hours after and found Spts: Terebinth zfs
Tinct: kino zii
Sacch: alb: ziii
Aqua menth zfs
Aqua zfs
him with out any symptom. left grs x if Dov:
however for him to take at bed time.
May 9th Pulse full, and slow and easily compressible.
spat up about 3 ounces last night. Ordered him to 
take every hour Acet: plumbi grs ii
Morp: sulp: gr 1/24 Took about 3 ounces
by cupping and ordered a blister over the part. Thought 
several times of bleeding from the arm, but thought his pulse
too compressible and gaseous. Found dulness over the sub
clavicular region of the right side, and also over the middle 
lobe of the same lung. vocal resonance very distinct 
on the right side, immediately under the
clavicle, and also over the left lung at the upper and
middle portions. Pass the day without spitting any blood
[illegible] some small coagulated clots. At 9 o clock P.M. [illegible]
been labouring under great oppression and spitting up every
now and then clots of the sise of 25 cts piece. Pulse was full and 


and little hard, I proposed to bleed him but he objected 
His skin was hot and cough frequent. Ordered him a seidlitz
powder every two hours and a teaspoonful of
the following mixture every two hours until the
fever should slacken. Tart: Em grs ii
Pulv: ipecac grs iii
[Pot]: Nitratis zi
Aqua zviii
He also took zfs of castor oil combined with 
xx gtts of turpentine to open his bowels. For his cough
he took vin antim a teaspoonful every two hours.
syr scillae
“ tolu cam
Tinct opii camp a a zi
May 10th
Found him at 8 ½ A.M. Another with no fever, pulse soft and regular. 
Rested well after my last visit 9 o clock last night.
had several coughs and one rather severe and choking [illegible] [illegible] but
threw up at no time blood, except only enough to give the 
expectorated matter a rusty pneumonic tinge. The [illegible]
mixture nauseated him so that he refrained 
from it. The oil operated. Ordered him to day teaspoonful
of turpentine mixture every three hours and
acet: plumbi grs i
[illegible] gr 1/35
mixture, every two hours, and teaspoonful of the cough
not every three hours, if the cough is frequent and if
though rather gaseous. 4 P.M. pulse 80 soft and regular
[???tural] expectorated very little to day no blood scarcely
cough up frequent. He is much better and feels quite
comfortable. Ordered nothing for the night.
[illegible] To day feeling much better, very imprudently, get up
and walk over to my office (about half a square) and [illegible]
sat and walked about the house the rest of the day. 
May 12th In consequence of yesterdays exertion was attacked with haemoptesis 
about 3 oclock this morning which was checked by the usual
[illegible] (as above used) applied a bladder of ice to the neck, which threw
him into a chill and [???nding] to his wife had no effect upon the bleeding


Cod’s Liver oil. (Ol: Rubrum) in Phthisis Rheum etc.
Case 1st Mary Mooney Case.
Feby 6th 1851.
Had been in the ward some time, very thin
pulse small and hand and about 100. Spittle come up 
in small flakes with a mixture of frothy expectoration.
Flat on both sides when percussed. sound
at this summit of the right lung as if there was a 
cavity as large as a dollar or large. ordered
cod’s liver oil zfs three times daily.
Feby 7th
No change in the above symptoms. Cod’s liver oil
made her sick. stopt it.
Feby 8th 9th
On examining her spit cup did not see the little flakes
that I have seen heretofore but a mass of frothy white expectoration 
like that of beer. ordered her a zi of cods liver
oil in a wineglassfull of porter 3times daily. other signs the [same]
Feby 10th morning
Found this morning again complaining of cramps other
symptoms the same as yesterday. The oil nauseates her
afternoon. Did not throw up the oil to day ordered zfs in wineglass of porter
Feby 11th
Made very sick (I believe by the oil.)


Continuation of Wm H Darrach’s Case
June 29th Is now sleeping sweetly in his cradle having fallen asleep without
any coaxing. Drowsy all day and fretfull. 4 stools two last
greenish and greenish white lumps.
June 30th
4 operations first greenish mucous, las three
more natural being yellowish. No fever. Cry’s more
than usual. Drowsy. No medicine to day. Has had
more exercise in the fresh air, riding in his little wagon
July 1st
4 operations about the same as yesterday
with the exception of greenish mucous stools
Appears well except being too thin and too frequent 
stools. No sign of teeth yet.
July 2nd 4 operations, still thin and mixed with mucous
yellowish. very thin as to his body. Not as fretful to day
good appetite. Slept better than usual last night.
No teeth yet
July 3rd 5 operations mucous, and thinnish. In good spirits
all day. Sleeps as well as usual. No teeth as yet.
July 4th 5 operations. Have been feeding him a watery solution 
of arrow-root as we could not get milk. Took him riding morning
and evening. In good spirits has not pulled and bit at things so 
eagerly. No teeth.
July 5th 3 operations. Feeding him now on boiled flour and
milk, still thin otherwise well Had two good rides
morning and evening in his little wagon which
seems to do him a great deal of good. No teeth nor
perceptable prominence of the gum.
July 6th 4 operations. Rode in his wagon in the afternoon. Good appetite 
sleeps well, and appears in good spirits. No teeth nor
swelling of the gums passes water more than usual.
July 7th 4 operations thicker than yesterday. Thin and pale.



Case end Mary [Burns]
Feby 6th 
very thin. Pulse small quick and hard about 65 yrs of age
ordered zfs of cods liver oil 3 times daily. Flat upon percussion 
heard a sound resembling air rushing into a cavity at the
summit of the left lung.
Feby 7-8-9th 
No change stopt the oil as she became very sick
Feby 9th 
She says she is getting better. ordered zi ol: Sec: arell: in 
zii of porter 3 times daily
Feby 10th
Oil sickened her, and caused her to vomit the last dose 
(3rd) up. ordered zifs three times daily in porter. Say she is better not so much
cough
Feby 18th
Examined her chest to-day, found the same symptoms 
of cavity, that were first noticed. continuing the cods
liver oil as heretofore.
July 23rd Baby 5 days old. Inds
Was spending the day at Mr Hamilton’s in the country
when Mr Keely requested me to see his babe. 5 days
which he said was dying. Found a [illegible] baby, which 
would weigh I suppose 5 lbs lying with closed eyes
perfectly motionless. Bowels very loose running almost
incessantly. The father had given it a dose of cordial
which I suppose was the cause of the stupor
Had no feet bathed or rather soaked in rather warm
water, and had its spine and lower extremities rubbed
with flannel. This appeared to revive it, for a short time. Ordered
15 drops a solution of borax, a piece as large as a beech nut
dissolved in zifs of water. I ought to have said mother’s milk zifs
called next day and found the child better without my [illegible]



Matthews Case
April 14th 1851
Flat on both sides on the left cavernous respiration
a man of very large frame has been taking a zf of cod’s liver oil
three times daily for 6 wks.
19th
Not so flat; when he speaks the chest
resounds. Expectoration bloody and watery. Dulness
of sound over the heart. Can hear respiration very
distinctly over the cardiac region. caused him 
to walk up and down the ward about 5 minutes
as fast as he could, which was not very fast however
as he was very feeble, and then listened to his heart.
it seemed to beat faster and the sound was
very dull. could not be seen beating. outside
unless the finger was pressed upon it which it
raised up feebly. This seemed to me to be caused
by debility. it also beat very quick.
23rd Found him to day in bed complaining of hjs [illegible]
at night having had a very profuse one last night
he to weak to get up
25.
Sitting up to day Inds
John Hamilton’s case (a victim of homeopathy)
hard to say which. Active mind. About the first of April
(1856) on a rather warm day, (according to his mother’s account)
he was splitting wood in the open air, and becoming heated
took off his coat. Sometime the next day complained of
pain in his right thigh. They tampered with him 
for about a week, with home made remedies, and
still becoming worse, and sleeplessness coming on 



along with delirium they sent for a homeopathic
who fiddled and fooled with him about
a mouth and came to the wise conclusion that 
was beyond the reach of homeopathy and
requested his discharge. This case after passing
through all the stages of inflammation
suppurated and an abscess of the thigh
succeeded. Dr Bobbs and myself opened
the abscess in two places and both are
now discharging matter. The pus 
was very thin and watery. Chloroform was
given with the happiest result. Dr: Bobbs ordered
rich and nourishing diet, and poultices
to the thigh.
May 9th
has changed his physician. [illegible] Homburg
who has lowered his diet. I am afraid to
his sorrow.
May 29th
Has been kept close to his room which
is badly ventilated incessant discharge from
his thigh from both the upper and lower
opening
John died sometime in June or July 
of shere exhaustion from the purulent discharge.


Inds
Case of Mr Warner
August 10th
A young man 20 yrs or thereabouts. [Neuro], bilious. When first
seen had fever suffering with diarrhoea two or three
days. When I saw him, I found his pulse full and
very compressible. Tongue furred and of a dirty
white colour. 6 or 7 stools a day of a watery nature.
Prescribed Cal grs ½
Pulv: Ipecac gri
Mass: sulp: gr 1/8
M ft: pulv: 
every two hours
Plumbi acet: grs ii
Morp: sulp: gr 1/8
after every 
passage.
Augst 20th tongue still very much furred and keeps his
[illegible] Diarrhoea stopt, in a great measure though his 
stools are still thin, but their colour is now yellow.
Two or three days ago I gave him cal gr ½
Pulv: Doveri grs I every 3 
hours I have given him no medicine since.
His appetite is very scant and he is I think all
the better for it.
August 25th
Has been gradually improving since the
ninth day of the fever. To day his pulse was soft
and regular about 80 per minute. Skin soft
and natural. No operation of the bowels for two days.
Has been taking for the last two or three days a
teaspoonful of the following mixture every three hours
except to day. he now takes it every 4 hours.
Liq: amiae acet z
Tinct: cinchonae [illegible] ii
Etheris sulp: comp: zi
Tinct: opii camp: zi
The paregoric was added
to check a diarrhoea which
he had.
August 26th sitting up, eating his breakfast. Pulse soft and
rather quicker than yesterday at the same time.
Tongue clearing off Skin moist and natural temperature.
August 27th Was up yesterday walking his room. Tongue cleaning rapidly. nearly clean.
pulse at 9 o’clock 90. Bowels opened once daily. Skin natural. Expression natural.


April 28
Age. Much emaciated says he has
only been confined to the house 3 months. very 
flat on both sides of chest. night sweats
oedema of lower extremities. Phthisis eye 
can scarcely walk but manages to 
walk easily and slowly about the ward.
ordered a tablespoonfull of cods liver oil in porter
3 times a day.
25th
Found with his clothes on but very weak. detected
either an enlarged bronchi filled with mucous on 
a cavity at the summitt of the right lung. Feet
very oedematous. no change
Continuation of Wm H. Darrach’s Case.
July 8th 2 operations. Health good except too thin and pale.
July 9th 1 operation Do Do Do Do Do Do 
“ 10th 4 operations Do Do Do Do Do Do 
July 20th Had a high fever was very restless. Head
and superior part of his body hot and acrid while
the feet cold vomited up his milk several times
done well up to this time. Allayed the vomiting by 
a little pepermint and paregoric. Bathed his legs in 
a hot mustard water which appeared to believe
his head and break the fever. Repeated it
before bed time and he slept the second night
naturally and awoke well.


June 1st 1857 Vaccination.
Wm H Darrach age 5 months, in good health. Nervous temp:
was vaccinated at 10 A.M.
June 2nd The punctures a little redder. No areola perceptable 
No fever no perceptable deviation from health
June 4th The former vaccine did not take and had
to revaccinate him.
June 5th No perceptable change
June 6th Ditto these failures I attribute
to kay not drawing enough blood. having only 
produced a slight redness
1st day
June 5th Revaccinated for the third time. Took a little more blood
2nd day 
June 8th Faint blushing areola.
3rd day
June 9th Areola extending. Vesicular elevation perceptable.
Ring of small vesicles surrounded by a faint
and narrow areola. No constitutional disturbance.
4th Day
June 10th vesicles have united and become one large one.
more elevated. Areola not much altered either 
as to sise or colour.
5th Day
June 11th vesicle wider and more elevated. Areola
not much different. No constitutional symp.
6th Day
June 12th vesicle becoming more silvery and elevated
areola about the same. No constitutional symptoms.
7 Day
June 13th vesicle more developed having a small particle of
encrusted lymph in the centre. Commencing to pit
areola 6 times longer and redder.
8 day
June 14th No change except the vesicle more elevated and 
duller white not so silvery. The pit more marked.
9 Day
June 15th Areola no wider, commencing to fade, vesicle changing gradually


very fretful, may be on account of the heat
from the centre into garnet coloured scab
10th Day
June 16th Areola still fading. The garnet coloured scab has
encroached so upon the vesicle as to leave a 
vesicular ring around it, has also become
more deeply coloured and dryer
11th Day
June 17th Areola almost disappeared. Scab taking th e
place of the vesicle. Assuming daily a more
decided garnet colour.
12th Day
June 18th Areola entirely gone, also the vesicle nothing
now remains but the scab, which has 
not yet began to loosen.
13th Day
June 19th Areola and constitutional symptoms all gone I mean
restlessness which makes him pit and
cry through the day Scab still tight but 
show a disposition to separate from the 
surrounding tissue in which it is
imbedded.
14th Day
June 20th Scab still tight and drying fast.
15th Day
June 21st Scab still tight. Appears perfectly dry, except a little
oozing from the centre.
16th Day
June 22nd Scab still loosening around one edge. A little oozing
from the centre.
17th Day 
June 23rd Scab drying, and shrinking.
18th Day
June 24th Scab much smaller
19th Day
June 25th Scab still shrinking, and tight
20th Day
June 26th Scab still tight and smaller.
21st Day
June 27th Scab still tight, beginning to raise up. [illegible] compact.
22nd Day
June 28th Scab loose.
23rd Day
June 29th Scab lost, was lost some time in the night. Not pit
visible in the scar as yet.
N.B. On the [illegible] the day the local and constitutional symptoms
were at their acme.


Diarrhea
Jany 21st 1858. I was attacked with ordinary diarrhea
and made myself. some pills containing Acet; plumb grfs
[illegible]: sulp: gr 1/8
which I took every two hours. not regularly
however. No good ensuing I changed them for the following
misture Tinct: catechu zi
Creta preparat: zfs
Tinct: opii camp: zi
Tinct; cinnamon zi
M: teaspoonful every hour
Jany 23rd
Worse. Stools like serum and mucous. 3 or 4 
a day. Dieting strictly. Toast and tea & rice
Jany 25th Finding these remedies useless, I abandoned
them, and thought I would try tinct: mur:
ferri. not having a very good reason. for so 
doing, as my mind was very imbecile at the time
Jany 27thg In addition to the above. & grs viii of D.P.
twice before retiring. After taking the iron 
a [illegible] a zi alltogether in 3 doses. (more or less)
I took upon retiring grs viii or x of D.P. I did not
weigh it. Almost immediately upon taking the
D.P. I felt sick and had difficulty retaining
it. As soon as I laid down up it came
with the, I think, iron from the acid taste.
Jany 28th
I concluded I was not treating myself
right and that cal: & rhei was indicated
I accordingly took the following.
Almost immediate relief
and change in the colour
of stool.
Cal grs iii
Rhei grs vi
D.P. grs vi
M ft: pil: No xii S. one every hour 



Jany 29th 
Much better. took now cal: grs vi
D.P. grs vi
M ft: pil xii S. one
every hour.
Jany 30th 
Convalescent. took now Quinine grs vi
D. P. grs vi
M ft: pil: No xii
S. one every hour
Jany 31st Well. Not peration since day before
yesterday 2 days and a half. Had one
this evening making 2 days and a half.
I thought I would not taking any aperient
but let nature do the work. I was right
May I always do so.
“Natura sanat
Medicina curat” I hope 
will be my motto.
P.S. Astringents were the stumbling blocks
of nature in this case. cal: Rhei quinine
and the small doses of D.P. the adjuvants.
I consider it very important to notice, that there
was no symptom on the tongue, eyes, skin, or pulse
indicating hepatic torpidity.
Return of diarrhea after almost a year
Monday Decr 13th Was attacked similar to the attack of last Jany. Griping
pains at night, with operations sometimes almost natural as to 
colour & consistency but small as to size, and at others colour good but
consistency too much. I was troubled most a night. 2 operations 
at night. I attributed it to cranberries but may 
be mistaken. Painful [borboryni], with smarting of the sphincter



Have taken no medicine or altered my diet. A
month or thereabouts was attacked suddenly with sick
head, during which I vomited bile all night. No symptoms
of hepatic torpidity as before. I suppose I have 5 or 6 motions
in the 24 hrs. Decr 17th Diarrhea not getting any better, I took cal:
Rhei:
D.P. a a gfs
M ft: pil:
one every two hours beginning 2 hours after meals. No change in diet. Decr 18th operations 
much thinner & more bilious attribute it to the medicine, took 7 pills
= 3 grs of each. Griping about the same. No difference except
as to colour & consistency of stools. Intend taking Quinine gri
Pulv D.P. grs
Ext: Gent:
Ol: [illegible]: Nig: 
4 or 5 operations in 24 hrs. Attending to my business, No
alteration in diet. Decr 20th Took 3 pills of the last sett, but had to 
stop because of the griping and frequency of operations being no less
than before; did not take any medicine yesterday and to day am
much better. I think the first pills unloosed my bound up 
liver. If I had taken astringents as I did last year at 
this time, I think I should have had the same difficulty.
Il est tres necessaire, pour le medecin, d’etudies
beacoup, beau coup. La nature, en querissant
les malades. Il lui faut, l’etudies aved l’oiel
medicale, et ne [illegible] [illegible] point de detourner 
en routes [illegible] Observation et
la patience pourront nous guides [illegible]
les straites de son Labyrynthe.
Il est tres necessaire [illegible] [illegible] [illegible]
de [illegible]
G. M. Darrach