DEP/DUA/1/40/62 (Normalised version)

John Hossack

(1786-1787)

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John Hossack. January 20^th.

Hardly subject of practice.

For never returned after first prescription.

Hence known nothing of effect of medicine.

And may be thought almost unnecessary to add anything to former observations.

Then remarked that considered chief part of affection as catarrh.

For with cough & dyspnoea copious expectoration

And little doubt that all these the effect of augmented separation of mucus.

Here indeed may perhaps be thought some suspicion of Phthisis.

And must allow that diagnosis often difficult.

And that where no symptoms of Phthisis for long time observed coughs degenerate into that affection

And that this may have [occurred] in present instance cannot be considered as even improbable supposition.

Especially as evidenced some degree of fever.

Hot & cold fits with sweating.

But these not infrequent in catarrh.

And here several circumstances against Phthisis.

Particularly age of patient as past consumptive [period].

Copious expectoration almost from beginning.

And that too with every appearance of ordinary mucus.

While at same time such separation sufficient cause both for cough & dyspnoea.

But while from these consider disposition to considerable pulmonary symptoms as chiefly catarrhal, to be remarked that this not only complaint.

Affected also with symptoms of incipient anasarca.

Evident oedematic swellings in different parts of body.

Particularly on those where Anasarca first appeared feet & legs.

And these also accompanied with scarcity of urine.

This scarcity not indeed with common appearance of anasarca urine.

For in that affection in general observed of light or whitish colour.

But here as in greater number of instances where scanty of high colour.

But though other appearances more common this cannot be considered as even rare in anasarca.

And from anasarca not improbable that cough & dyspnoea in part proceed.

For both very frequent attendants.

And [must] indeed be necessary consequence of [effusion] & deposit of water in cellular membrane of lungs.

Here then consider [us] as having complication of affections.

And neither could be considered as slight or unimportant.

But notwithstanding this hoped that patient in no long time might recover.

For neither with any symptoms indicating obstinacy.

Naturally of sound constitution, having enjoyed good health before attack.

And neither of long standing.

Here with view to removal of different parts of affection different objectives to be aimed at.

But what seemed of first [importance] was to produce evacuation of water.

And to give determination to some other part than lungs.

Particularly to kidney as means of restoring discharge of urine

Was with this intention that thought of having recourse to Cream of Tartar.

An article well known to combine both purgative & diuretic power.

Here however wished that in former way should produce some immediate evacuation.

And on this account conjoined with Cream a small proportion of Jalap.

An article by which purgative power much [improved].

To this also added small proportion of Cinnamon one of best of vegetable aromatics from which hoped would sit more easily on stomach.

In future practices should have been determined by effective result [from] this.

But had thoughts of conjoining with it occasional employment of emetic.

Both as means of promoting expectoration & of promoting absorption.

What however effect even of first prescription have never been able to learn.

And as now little probability that shall see anything more of patient farther conjecture unnecessary.