DEP/DUA/1/31/18 (Normalised version)

Stuart Ailison

(1782-1783)

---

Stuart Ailison.

In this case as well as former disease principally appears under form of affection of breast.

And cannot pretend to say that certainly or distinctive characteristics.

But while no hesitation in pronouncing former to be a catarrhal affection, here again very strong suspicion of Phthisis.

This may in some degree be inferred from nature of cough which here takes place as well as from state of expectoration.

Especially when consider that these occur with a patient at the consumptive age.

But still stronger grounds for apprehension from quickness of pulse & haemoptysis.

And suspicion not a little corroborated by what are told respecting fate of his brother.

He we are informed fell victim to Phthisis nearly about time when disease of present [patient] began

And to this cause some would be inclined to attribute origin of present affection.

For with many practitioners Phthisis held to be a contagious disease.

For this however as far as my own observation goes have never been able to discover any evidence.

Admit indeed that when anyone sleeps with a consumptive patient from exposure to increased heat, & still more to colliquative sweats bad effects may arise.

And that may even produce catarrhal affection at length terminating in phthisis.

But in present case patient not exposed to any such cause.

For informed that never slept with his brother.

Here then would have connection in very different manner.

And inclined to consider Phthisis both with one & other as being a hereditary affection

When of this nature is usually of the tuberculous kind.

And such take to be its nature in the present case.

To this indeed may at first [seem] some objection that has begun with Haemoptysis

For from Haemoptysis a large vomicae or ulcer in general formed.

Here however to be observed that spitting of blood never very profuse or considerable.

And seemed rather to proceed from accidental rupture of tender vessels than from haemorrhagic [affection]

Such however not unfrequently the consequence of that state of vessels [surrounding] tubercle.

And upon whole consider it as presumptive evidence that Phthisis of this kind.

With this idea of nature of affection opinion as to termination must be very unfavourable

Every instance of Phthisis dangerous.

But tuberculous Phthisis particularly so.

In so much that after once distinctly marked, very rare to meet with recovery.

Or at least of apparent recovery at one time, yet still fall victim to it at another.

But while of all Phthisis the most dangerous so in general also the most slow in its progress.

In so much that in many instances patients will linger under it even for space of several years.

Probably consequence of successive inflammation & suppuration of different tubercles in same manner as happens of Scrofula tumours in other parts.

Must however be admitted that this slow progress by no means unwarranted.

And even in same family where affection hereditary course often observed very different.

While one cut off in few months another will remain subjected to it for several years.

In case before us am inclined to think that even without interposition of art has appearance of being of slow kind.

For although has already subsisted for near space of year, yet still retains considerable strength.

And although constant quickness of pulse indicating certain degree of fever, yet no manifest exhaustion of habit.

From this then better opportunity may at least be afforded for trial of medical assistance

But must at same time own that from any remedies I can think of employing hopes of recovery far from being great

If this can be effected, is I think to be looked for from means of resolving Scrofula tumours.

And is with this view that with present patient have had recourse to the Cicuta.

An article the use of which in Scrofula have already oftener than once had occasion to mention

This medicine hitherto principally employed as diffused in a Mucilaginous mixture.

From which hoped that might at same time obtain some effect as mitigating frequency of cough

Now however as cough [somewhat] easier am employing it under form of powder.

And in this way is intention to give it full & fair trial.

Rather however by due continuation of course than by large doses at once.

Since Cicuta begun have occasionally had recourse to other measures.

Such for example as application of blister with a view to pain of side which consider as depending on active inflammation on some tubercle.

On similar occurrences may again have recourse to same practice or to other measures such for example as blood letting.

And for obviating particular symptoms different remedies may be employed.

But with view to radical cure of [affection] is my intention to employ Cicuta alone

If that accomplished shall I own be disposed to consider present case as affording strong presumptive fact in favour of this remedy in such cases

At same time recovery not be expected but from long continuation of medicine

And hence cannot be certain that if even should take place may not be [entirely] work of nature