DEP/DUA/1/23/16 (Transcript version)

David Dick

(1780)

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David Dick.

Another patient of whom since first prescript have seen nothing at this place.

Hence also hardly the subj of pract

Case in nature rather more doubtful than former.

But from every view, must be disp to consid it as an obstin & even danger. affect.

One of prin sympt. pain extending from left hypoch. region, to should of same side.

This may probab. have proceeded either from affect of abdom, or of Thor. viser.

But presumpt rather of latter from cough & copious expector.

When to these add quickness of pulse, with night sweats, gives at least presumpt of Phthisis.

And this presumpt somewhat corrob. by age of patient.

Was now at that period of life, when Phthis most common.

In this state with obstin catarrh sympt, attended with palness of count, debilit, & other sympt already ment, could not be without appreh.

And was disp. to consider it as being an example of a catarrhal Phth

But of this could have no certaint without other tests.

Partic evid whether in expect matter, any mixt of pus was, or was not cont.

This however from dissert of patient had no opport. of determ.

And by same means also precluded from other evid, which progr of case might have afforded.

Hence then in such state of [uncer] can say nothing of progn.

May only observe that even suppos it Phthis, was yet of most fav. kind.

And by prop treatm not witho pros. of recov.

Of intended plan of cure from late observat on Phthis need not be very partic.

Here became an object of import, in first place to free the lungs from matter already accumul.

But although this completely affec yet little in reality done till alterat induced in state of separ at surf. of lungs

And this alone effect obt. from rest due condit to superf. vessels on surface.

To these views then in pract. endeav would here have been directed.

And was as means of fulfilling first intent now ment. that had here recourse to the emet.

With some emet. consid as the only expect.

This however an opin which must own, can be no means adopt.

Yet have no diffic in consid as the most powerful.

Action thus arising indeed more immed tends towards evac of stom.

But has also very great influen as unload breast.

Besides this however, here farther useful as giving determ to surface & thus dimin impet. at lungs.

On these grounds then, from repeatd emet. expected some relief.

And as answering such intent am inclind to think that have often observd them of use, in Catarrh. Phth.

After emet was here intent to have had recourse to Peruv. Bark.

And from this hoped at least for some effect as tending to rest. due condit to vessels of lungs.

This pract however from his not contin under care had never opp of trying.

And indeed never even learnd which effect of emet.

Hence [precluded] from any farther observ resp pract in this case.