DEP/DUA/1/21/20 (Normalised version)

Mary Cook

(1779-1780)

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Mary Cook

Symptoms in case of this patient leave us I think in some measure in state of doubt as to nature.

May venture however at least to say that all her symptoms either Catarrh or Phthisis.

And from many reasons which if time would admit of it might here be urged am inclined to latter opinion.

Am disposed to consider vomica in lungs as giving rise to purulent expectoration & in [commencement] of absorption to all the hectic symptoms which here take place.

In this case will evidently conclude that prognosis can by no means be favourable.

And notwithstanding relief which patient seems to have received yet look upon recovery as being extremely precarious.

Would even consider chance as being much against her.

Yet no doubt that more prospect of recovery when free discharge by expectoration than if vomica shut.

And from appearance of expectorated matter does not seem to be that sanies which gives worst hectic fever.

Hence then by no means entirely [without] hopes of recovery.

This I imagine would best be aided by promoting as far as we could a free discharge of matter in way of expectoration.

And was with this intention that had here recourse to frequent repeated emetics.

These consider as operating in promoting expectoration on principles entirely mechanical.

That is from actions which [produce] & from [general] [commotion] thus excited.

Whether on these principles or not to [me] appears in instance before us to have been product of best affects.

And indeed nature of expectorated matter so far changed that now reason to presume vomica completely discharged.

Have therefore put her on use of [mucilage] mixture that may have opportunity of observing how she continues.

And if no farther return may dismiss her cured at least for present.