DEP/DUA/1/21/35 (Normalised version)

James Scott

(1779-1780)

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James Scott

Disease probably of complicated nature

When came under our care had been for considerable time subjected to a disease very distressing to infants in particular.

And which of late has prevailed much more as epidemic than have ever seen since began practice in Edinburgh.

That is Pertussis.

Is comparatively speaking at least but short time since was last epidemic in Edinburgh

In Spring & Summer 1776, was also epidemic in Edinburgh.

Then indeed numbers affected by no means so great as at present.

But as far at least as my experience went in proportion to number much more fatal.

At that time succeeded Scarlatina anginosa which had [prevailed] very generally among children the year before viz 1774-5.

Many of those children who had [nearly] escaped from that disease were attacked with Pertussis & fell victim to it.

Whether in these cases the preceding affection had any influence may perhaps be a question.

Yet whatever cause have for my own part no doubt, that epidemic which then prevailed much more severe than present.

Was particularly severe in way of inflammatory affection of breast.

And child cut off by it for most part died from pneumonic inflammation.

In some of them this terminated in state of suppuration with very copious purulent expectoration.

In present epidemic again, have for my own part seen very few cases where any evidence of inflammation.

And except in one or two instances have never thought it necessary to have recourse to bleeding or blisters

Almost only symptom requiring mitigation some degree of dyspnoea from accumulated mucus in breast.

And this most readily relieved from promoting expectoration by means of emetics.

In 1776 however as have already observed most active measures for combating inflammation often necessary & often ineffective.

Perhaps this difference with greater probability to be ascribed to season of year than to any other particular.

And to be observed that then the affection most prevalent & most fatal during spring months, particularly February. March. April.

In present epidemic greatest part attacked with it were affected with the disease in autumn months when tendency to inflammation much less considerable.

But whatever cause can have no doubt that epidemic then though less prevalent more severe than on previous occasions.

Was with view to this affection that directed Cicuta.

And here in place of mixture directed in form of powder.

And therefore for week at least resolved to do nothing

And with this patient the Chin cough which had subsisted for some time was manifestly on decline.

Had it not therefore been for other symptoms would not probably have applied to us.

But besides remaining pertussis some appearances still more alarming.

With symptoms manifestly of febrile kind was affected with pain of head & frequent startings in sleep.

These appearances it is true may have proceeded from different causes.

But not unfrequently attendants of an affection of most dangerous nature Hydrocephalus.

Yet reckoned it more probable that all his symptoms the consequence of teething

But as have had no opportunity of learning progress of affection do not know how far any foundation for either