DEP/DUA/1/34/42 (Normalised version)

Donald Thomson

(1783-1784)

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Donald Thomson. April 24^th.

In case of this patient disease distinctly marked by state of expectoration.

In consequence of coughing has of late discharged from lungs blood to considerable extent sometimes in fluid sometimes in grumulous state.

And though other symptoms numerous yet little doubt that to this cause all of them to be attributed.

This affection need hardly observe is one of very dangerous nature.

And indeed perhaps even majority of cases terminate in Phthisis & thus prove fatal.

Of such an event cannot be without dread in present instance.

With view however both to prognosis & practice of consequence to determine whether haemorrhage of active or passive kind.

And here from circumstances of case presumption at least in favour of latter.

Patient indeed not passed that period of life at which active Haemorrhage may be supposed to arise.

At same time much more frequently before than after 30^th year a period which our patient has already passed.

But besides this commencement of bloody expectoration here traced to an obvious accident.

The effect viz of an emetic operating with great violence.

Since that discharge supported by severe cough

And to this indeed, probable that irritation afforded by blood itself.

Here however even supposing haemorrhage of passive kind still of consequence that impetus of circulation should be diminished.

For thus at least less force propelling blood through ruptured vessels.

Was with this view then that had recourse to powder of Cream of Tartar both as gentle laxative & refrigerant.

But besides this seemed necessary to do something with view of giving constriction of ruptured vessels.

And as an astringent here had recourse to infusion Rosarum.

An article which although [derives] name from the Roses, yet has efficacy almost entirely from Vitriolic Acid

And this need hardly observe one of most powerful astringents we possess.

Both however with view to dilution & likewise to obtaining effect as a demulcent conjoined it with proportion of mucilage of Gum Arabic & water.

By this hoped that tendency to frequent cough might in part be diminished.

But at same time still more affective to obtain that end added a proportion of the Tincture Thebacai.

What has been affect of this mixture have not yet learned.

Am however hopeful that may at least have had effect of mitigating affection for the present.

At same time but too much reason to dread, that will in the end prove fatal to him from supervening Phthisis