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            <text>&lt;h4&gt;Page 1&lt;/h4&gt;
&lt;p&gt;Cases of Rheumatism terminating in suppuration -&lt;/p&gt;
&lt;br /&gt;&lt;p&gt;1&lt;sup&gt;st&lt;/sup&gt;. of a negro woman Louisa, belong-&lt;br /&gt;ing, to my father - after exposure to&lt;br /&gt;cold suffered pain in the extremities ;&lt;br /&gt;The fingers were much swollen and&lt;br /&gt;both ancles &amp;amp; knees. after some months&lt;br /&gt;the pain &amp;amp; swelling left every part ex-&lt;br /&gt;cept the right knee.&lt;/p&gt;
&lt;br /&gt;&lt;p&gt;I first saw her in this disease on the&lt;br /&gt;30th April 1819. Knee much swelled,&lt;br /&gt;and incapable of motion. By resort-&lt;br /&gt;ing to the ordinary means of leeching&lt;br /&gt;cupping, blistering, and vss. &amp;amp; long con&lt;br /&gt;tinued purging the pain in seven weeks&lt;br /&gt;was entirely relieved, and the knee reduced&lt;br /&gt;almost to the size of its fellow - about&lt;br /&gt;this time I removed to Richmond.&lt;/p&gt;
&lt;br /&gt;&lt;p&gt;In two months I returned &amp;amp; found by too early&lt;br /&gt;exercise &amp;amp;&lt;/p&gt;
&lt;h4&gt;Page 2&lt;/h4&gt;
&lt;p&gt;&lt;br /&gt;discontinuance of the treatmt. the in-&lt;br /&gt;flammation had return with great violence&lt;br /&gt;and now suppuration had taken place.&lt;br /&gt;Near two quarts were discharged by an&lt;br /&gt;incision I made just above the knee&lt;br /&gt;Extensive sinuses existed, one leading to&lt;br /&gt;the groin. She now had hectic fever.&lt;/p&gt;
&lt;p&gt; &lt;/p&gt;
&lt;p&gt;In consultation on the case D&lt;sup&gt;rs&lt;/sup&gt;. Kleit &amp;amp;&lt;br /&gt;I in favor of amputation - D&lt;sup&gt;r&lt;/sup&gt;. Hos-&lt;br /&gt;kins &amp;amp;amp Dew, proposed to try alterative dose,&lt;br /&gt;of calomel. I yielded to D&lt;sup&gt;r&lt;/sup&gt; H&lt;sup&gt;s&lt;/sup&gt;. experience,&lt;br /&gt;and after six weeks returned when the&lt;br /&gt;infl. had reached the body, thigh enormous-&lt;br /&gt;ly swollen and I never again had the&lt;br /&gt;opportunity of operating, - she died after&lt;br /&gt;severe suffering, of colliquative diar-&lt;br /&gt;rhea - June 1821.&lt;/p&gt;
&lt;p&gt; &lt;/p&gt;
&lt;h4&gt;Page 3&lt;/h4&gt;
&lt;p&gt; &lt;/p&gt;
&lt;p&gt;Frederick [1 word illegible] 43 - a servant of M&lt;sup&gt;rs&lt;/sup&gt;. Camp&lt;br /&gt;bell's suffered for months with marked&lt;br /&gt;Rheumatism, which terminates&lt;br /&gt;in suppuration and entire destruction of&lt;br /&gt;of the structure of the knee - joint, ca&lt;br /&gt;ries, great emaciation &amp;amp; hectic fever.&lt;/p&gt;
&lt;p&gt;&lt;br /&gt;&lt;br /&gt;&lt;/p&gt;
&lt;p&gt;I visited this man at the request of my friend&lt;br /&gt;D&lt;sup&gt;r&lt;/sup&gt; Hoskins in May 1820 &amp;amp; concurring with&lt;br /&gt;him in the propriety, necessity of the&lt;br /&gt;operation, I amputated the limb. He re-&lt;br /&gt;covered most perfectly and now enjoys&lt;br /&gt;good health - Dec&lt;sup&gt;r&lt;/sup&gt;. 1821 - suppuration of&lt;br /&gt;the joint head existed more than 18 mo&lt;sup&gt;s&lt;/sup&gt;.&lt;br /&gt;previous to the operation. I used animal&lt;br /&gt;ligatures around all the arteries except two -&lt;br /&gt;the femoral profunda - one of the silk&lt;br /&gt;ligatures came away on the 16&lt;sup&gt;th&lt;/sup&gt; day, the&lt;br /&gt;other remained near six weeks, at the end&lt;br /&gt;of wh. time the stump had almost entirely&lt;br /&gt;healed. I had directed that the ligature sh&lt;sup&gt;d&lt;/sup&gt;&lt;br /&gt;be slightly drawn every day, but they not&lt;/p&gt;
&lt;h4&gt;Page 4&lt;/h4&gt;
&lt;p&gt;&lt;br /&gt;being attended to and adhesive plaister not an-&lt;br /&gt;swering the purpose of keeping it tense I tied&lt;br /&gt;a leaden bullit to it, and this bro&lt;sup&gt;t&lt;/sup&gt; the&lt;br /&gt;ligature off in 24 hours - no accident I&lt;br /&gt;tho&lt;sup&gt;t&lt;/sup&gt;. c&lt;sup&gt;d&lt;/sup&gt;. result &amp;amp; no danger of hemorrhage&lt;br /&gt;be apprehended as the cavity of the vessel&lt;br /&gt;up to the last branch must long since have&lt;br /&gt;been obliterated, from the stop put to&lt;br /&gt;the circulation of the blood.&lt;/p&gt;</text>
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              <text>Text.</text>
            </elementText>
          </elementTextContainer>
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        <element elementId="43">
          <name>Identifier</name>
          <description>An unambiguous reference to the resource within a given context</description>
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              <text>MS 2001.22</text>
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