DEP/DUA/1/44/35 (Normalised version)

Mary Thorborn

(1788)

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N^o8. Mary Thorborn at 26.

When formerly spoke of case of this patient represented it as in some degree doubtful.

But very apprehensive that should find it dangerous & even fatal

For although then had not marks of decided Phthisis, at least strong presumption of this.

And that occurring as sequela of influenza.

Then remarked that influenza of 1782, had been product of many Phthisis.

But that present instance first which had occurred in my practice from that cause.

Cannot however now add that is only one.

For since occurrence of cold weather have met with several others.

And some of these have even [already] fallen victim to the disease

Still however inclined to think last epidemic, more slight both during continuation & in consequences than former.

But among other cases may now I think justly enumerate present as example of Phthisis originating from it.

For during course of patients attendance almost every doubt of [nature] of disease removed.

And when last heard of this patient could have no hesitation in representing Phthisis as having made even an alarming progression.

Have not indeed seen anything of this patient for some length of time.

And should not I own be surprised to learn, that has already fallen victim to her disease.

Not many days ago lost Patient of Phthisis consequential on Influenza, where of Ulcerous kind.

For after symptoms indicating Phthisis in [illegible] of Vomica very large purulent discharge.

Soon after which patient fell victim to Hectic fever

Must however remark, that although consider every modification of Phthisis as highly dangerous, yet at least best chance of recovery where of catarrhal kind.

And from quantity of expectoration as well as from origin of complaint conclude this to be case in present instance.

For of different cases of Phthisis which I have seen arising from Influenza most if not all of catarrhal kind.

That is where reason to conclude purulent separation merely from scurf of lungs.

Would be very far however from venturing to assert that this universally the case.

On contrary little doubt I think, that Influenza, as well as either Smallpox or Measles, may give rise to Scrofula affection.

And thus usher in even most rapidly fatal species of Phthisis, the tuberculous

But whatever has been or may be fate of patient cannot represent her as benefitting by any practice which we here employed.

Although when first came under care did not look upon case as decided example of Phthisis yet on presence of that affection had recourse to a remedy which have I think in some instances employed with benefit.

Particularly in instances of Catarrhal Phthisis viz the Gym Myrrh.

This as a remedy even in tuberculous Phthisis, of late highly extolled by different practitioners.

Particularly by Dr Saunders, Dr Griffith.

But for most full account of it yet published may refer you to treatise lately published on subject of Phthisis by Dr Simmons¹.

Will [there] find that notwithstanding evils said to arise from healing balsams in general by Dr Fothergill & others, yet on concurrent tests of different practices this sometimes product of good effects.

To testimony of other practitioners can I think also add my own.

At least, much deceived if in some cases which strongly suspected to be Phthisis, have not seen good effects from it.

And where patient in end recovers.

Must however add that recoveries I have seen from Phthisis comparatively speaking very few.

And neither by Gum Myrrh, nor any other article, could rapid progression to fatal termination be prevented.

Still however am acquainted with no practice, from which have upon whole seen greater benefit.

And what have seen sufficient I think to encourage to future trials.

At least till more effective remedy [discovered] Gum Myrrh in Phthisis, sometimes given alone.

More frequently however in combination with some other article.

Dr Griffith one of Gentleman mentioned recommended its combination with salt of steel.

Dr Simmons again advises [illegible] with nitre.

But as far as my own experience goes have seen more benefit from combination with Cream of Tartar than any other article.

And accordingly union of equal parts of Gum Myrrh & Cream Tartar, form composite powder used at the Dispensary.

To this taken to extent of tea spoonful twice a day had recourse in present instance.

And this at commencement at least consider as medium dose.

For in some instances disagrees with patient exciting looseness.

And when this the case in place of Cream of Tartar sometimes advantage given in combining with Succus Japonica.

Sometimes obliged entirely to [omit] use.

Here however when first given at least product of no bad affect.

For cough & dyspepsia rather easier.

But complained of bad rest during night.

From this led to conjoining with the Myrrh an anodyne at bed time which hoped might both mitigate cough & procure sleep.

But notwithstanding use of Opium looseness supervened.

This was not I own inclined to suppose on effect of Myrrh.

For should rather in that case have expected it during first week.

And when now happened patient using an opiate.

When came on symptoms in every other respect worse.

Looked upon it rather therefore as dearth of colliquative kind.

But in any view occurred as objection to farther employment of Myrrh.

With continuation therefore of opiate directed merely Infusion Japonica to obviate diarrhoea.

And Saturn ointment for excoriation occasioned by urine.

Under these medicines, some symptoms, [particularly] looseness a little alleviated.

But in every other respect patient rather worse.

Particularly colliquative sweatings & quickness of pulse

In this situation did not think I could do better than to continue.

But have now seen nothing of this patient for more than a month past.

And as formerly observed not improbable that has already fallen victim to the disease.

But if on contrary disease has taken turn for better, is to be ascribed much more to operation of nature than to any remedy here employed.

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Explanatory notes:

1) Samuel Foart Simmons, Practical observations on the treatment of consumptions (1780).