DEP/DUA/1/21/07 (Transcript version)

Ann Hossack

(1779-1780)

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Ann Hossack.

A case with regard to which as introd into regist. many diffic may be stated.

Have selectd it not so much as subj of pract from which can hope to derive success as afford examp. of doubts & uncert. which every day occurr to [pepl.] in pract of Phys.

Sympt. with which at pres. prin affected Dysp. & cough.

And these attended with expect of viscid white matter to consid extent.

Such sympt in common to catarrh & to Phthis.

And natur led to adopt one or other suppos. accord to other concom circum.

Here when hist of case at least taken patient not affectd with any sympt indic hectic fever.

Pulse not quickned a circum at least very commonly occurr in Phth.

Belly with const tenden to bound state, the oppos of that condit occurr in Pthis.

And while mucus accum in breast a suff. cause for weight & oppress for dysp & cough would seem that matter expect of no other kind.

Have not indeed had yet opport of trying it by those test which reckon to afford criter betw. matter & muc.

But from quantity alone presumpt of this.

For while to consid extent, disease had not been preceded by any of those marks which could lead to suppos of vomica.

While And matter spit up neither the disagr. smell nor taste of purul expect.

To these farther argt against Phth from state of Tongue.

Observd indeed to be moist.

But without that pecul clean & red appear. which has unif in Phthis from purul expect.

Notwith all these circum however reckon it by no means cert. that Phth is not the disease.

To this latter opin, of the two am even the most inclined.

More indeed from former knowl of patient than from any of pres. symp

This woman some months ago, long under my care for a disease app very diff from pres.

Then affected with sever very large indol. swellings of neck.

These was disp to consider as being affect of Lymph glands & of scrop nature

With view however to prom circul through them & thus obt. resolut had recourse to Cicuta.

And I think with very remark success

For from time that began use tumour grad began to dimin.

And during course which contin for three months got entirely rid of them

This indeed it is true conj with use of camph oil extern rubd on tum.

Am far from thinking that this applic entirely useless.

Yet to the Cicut am still inclind to attrib greatest part of cure.

But to whichever owing, under these means pat. had appar compl. recov.

Are not however from thence posit to inferr that disease erad from [constit]

And from former occurr, scroph habit so far markd as to give susp. in [fut] [ail]

Well known however how much has tend to induce Phth as giving rise to tub. in lungs.

This even so much the case that some incl. to consid all inst of Phth as arising from Scroph.

And although in this consid them as wrong, yet no doubt in viewing it as a very freq. origin.

Partic therefore to be suspected where former indicat of scrophul.

When to these circum add insid nature of Phth. presumpt by no mean weak

And have seen so many inst where Phthis thus made grad approach that am very appreh pres. will afford anoth ex.

Still however consid nature of diseas at pres as one of those doubtf points to be determ only by attend to fut. progr.

But besides princip disease, other circ also in case with regard to which equally at loss to give decis judgem.

And this partic case with Menst. disch

Has now seen noth of it for 3 months.

Is however a married wom & in course of child bear

Is therefore a very probab. suppos, as she herself susp. that maybe affc of Preg.

To be remarkd howevr that taken by itself gives no cert. indic of this.

And till more cert evid of pregn from motion of child, must remain in doubt whether does not take place as a morbid sympt.

Here also to be obser. in Phth freq. sym

And when occurr always progr indic great danger.

Probab as indic highly debilit state of system.

But even allowing that this no symp of Phth but of pregn, still does not follw that Phth. does not exist.

For this by no means uncom.

Is indeed true that during pregn other diseas more rare.

And observd that fewer women die in this state than at any equ. per. of life

Holds even with resp to Phth as well as other affect

But when pregn wom subj to this dis, progr. after deliv extrem rapid.

And such am appreh. may be case with pres patient.

Although do not consid pregn as giving sucur. against affect yet hope that during this period may not be cut off.

Yet can hardly flatter ourselv. with hopes of recov.

If however disease catarrh merely may look for more fav. termin.

And either during course of pregn or after it, reason to hope for recov.

Here however to be observ. that alth disease merely catarh, & alth pat conf herself to house, much against speedy [cure]

While at same time from viol of cough every pregn wom subj to no [illegible] danger.

Even on this suppos. therefore reason to appreh. danger & to dread a ted affect.

And although where so many uncert cannot speak with confid. yet in no view of the dis can I cons. it as slight, or free from hazard.

If uncert. as to nature some doubt in prognos, gives still greater with respect to treatm.

Here however whether Phth or Catarr gener. plan of cure to be followd in great meas. the same

When cure does happen in Phth is cheifly at least work of nature.

And utmost done by pract is to allev or obviate sympt

Allev. cheifly to be expected from counteract dimin of impet of circul at breast

And from counteract influ of [illegible] causes exciting cough.

On these princip also may expect allev of catarrh.

And in situat of pres. patient perh. nothing farther can with prud be attempt

These therefore foundat of pract hitherto employd.

And unless from alterat in sympt of disease, or from farther knowl. of nature, shall prob. cont on same plan.

Began by putting this patient on use of two diff med.

Cream of Tart. & Mucil. Mixt.

First hoped might be of some service from influ as refriger.

As thus from tend to dimin gener. impet of circul. hoped that might lessen moment at breast.

But cheifly led to it as means of obviating costiv.

Among other sympt will observe gener bound state of belly.

From counteract this therefore not only remove cause of irrit. but give also determ from Thorac to abdom viscer.

Should not indeed have wishd for any consid disch by belly with patient so much exhausted.

But this not to be expected from Cr. of Tart to extent of single dram.

Nor was such obs. to be conseq of use - But from anoth circ. led to interm use.

Patient compl. very much of being distressd with sense of cold.

Although therefore thought that derivd benefite from Crem of Tart yet as imag might aggrav this sympt wishd to see how would cont without it.

On this acct has for these two weeks past been cont on mucil mixt alone.

From this princip obj. in view is to take off irritat as merely lubric fauces.

Although held also that basis of it, the G. Arab. acts as demulc from [entire] syst. & being again collectd at [excret].

Under such gentle meas. shall prob. cont. patient till pres doubts in some meas. removed

And if pregn ascert. will still the rather be inclind to persist.

Recom. to her at same time use of mild & nutrit diet & avoiding cold.

If not pregn should wish here to give fair trial to Emet. freq. repeatd

A remed on diff prin useful both in Catarh & Phthis

And indeed of late recom also in cases of Scroph, from whence if Phthis exists in pres case suppose it to originate.

Whether pregn or not may have occas recourse to blisters or anod.

As from both reason to expect tempor. allev of cough

Thus at least may allev distress of patient

Without however any progr. to radic cure

And if appreh well grounded, this I am affraid hardly to be lookd for.

Still however during course of attend here, shall by these already prop or such other means as sympt may [indic] endeav to relieve her compl.