DEP/DUA/1/44/51 (Normalised version)

Isabel Dewar

(1788)

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N^o16. Isabel Dewar at 36.

When formerly spoke of case of this patient, observed that considered it as in some degree both of doubtful & complicated nature.

While however evidently subjected both to stomach & pectoral ailments consider latter as by much most important part of affection

And with regard to pectoral complaint was very apprehensive that should find it terminating in Phthisis.

Patient however did not remain so long under care, as to enable us to judge more accurately of nature of affection.

And with regard to this case as well as former very little to add with respect to practice.

For whether from aggravation of affection or any other cause in short time deserted attendance

Began by prescribing for this patient a gentle mucilaginous mixture with a proportion of vitriol acid.

To this chiefly led with view to cough & sweating.

By mucilage expected that irritation at fauces might be diminished.

And vitriol acid, probably in consequence of astringent power, one of most powerful means of checking sweats, of colliquative kind.

Besides this, expected also, that might be of some use, as bracing stomach

For in this way no doubt that powers very considerable.

And accordingly, while vegetable acids, or even articles affording these, give great unease to dyspeptic patients often very great benefit from minerals, particularly vitriol.

Would appear that this article, so far at least, answers expectations.

For after use sweating observed to be less considerable than before.

In other respects however cannot say that any alleviation of affection.

For while cough continues severe, much affected with loss of strength.

Which combined with small & quick pulse, gave additional apprehension of Phthisis.

In this situation with continuation of former medicine, directed mixture of Peruvian Bark & Cicuta.

A combination from which have been inclined to think, that in some instances of Phthisis, have seen benefits.

And imagine that might tend still farther, both to restrain sweating & restore tone of stomach.

But although medicine borne without inconvenience yet product of no benefit.

For under use, as found at succeeding report, sweatings became even more profuse than before.

Still however expected that by proper continuation more effect might be obtained.

And in hopes of alleviating cough by unloading breast directed an Emetic.

Since these medicines prescribed however, have seen nothing more of patient.

And although cannot speak with certainty, yet I own am inclined to conjecture, that from progress of Phthisis, has been unable to attend us any longer