DEP/DUA/1/29/32 (Transcript version)

Rose Campbell

(1782)

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Rose Campbell. July. 5.

Concerning disease to which this pat. subj no room for doubt.

For although cough dyspnoea & oppress at praecord. such as occurr in catarrh yet many other sympt here charact. Phthis.

This might even be inferrd, from state of expect.

Have indeed, from patient going to the country, had no opport of determ, by most accur. tests what proport of purul. matter it cont.

And some evid marks as viscid blush & green colour, such as in common both to pus & mucus & to mixt of both.

But in pecul bad taste & still more in tinge of blood have strong evid of purul.

This suppos also corrob. by state of tongue.

For notwith feverish state sympt & although white furr about edges yet is clean at point & towards middle

Such a clean state of tongue an almost unif. attend of pur. [expec]

And indeed after cert. contin not only prod painful rawness but even ulcerated state in mouth & tongue.

But this evid of purul. expect here neither only, nor even strongest proof of purul. expect. Phthisis

This still farther demonst by hectic fever.

Now often affected with shivering fits at uncert. periods

And these succeeded by encreasd heat with hectic flushings

With these sympt also pulse unif acceler. to great degree.

And to all others to be added copious night sweats.

From all these partic taken [togr] then, no doubt not only of pres of hectic fever, but to great degree also.

And accord when consider both nature of disease & progress already made prognos. must be very unfav.

In estim danger of Phthis howev diff kinds of it to be attended to.

Have elsewhere endeav. to estab. charact marks of these diff. kinds.

And these disting by names of catarrhal, ulcerous, & tubercul.

Of these there catarrhal phthisis unquest the most fav.

And as of this kind am inclind to view affect of pres. patient.

For according to acct of origin, was effect of fatigue, & much expos. to cold.

And from appellat which she herself gives it, that viz of [sittin] down cold, may concl. that for some time under form of catarrhal. affect.

From these circum then presum that purul. separat princip from surface of lungs.

Even suppos. this to be case however cannot led us to entert any sanguine hopes of recov.

For although more recov. from this, than other inst of Phthisis, yet in most majority cases is fatal.

And with pres patient as has already been remarked many unfav. sympt have already taken place.

Among these may rank tendency to haemorrh. with which commen as well as bloody expect with which often attended.

But still more ground for alarm from degree of hectic fever & of night sweats which have already ensued

And is also a very unfav. circum that menst. disch has left her.

For while want of this evac will tend to aggrav affect, indic also failure of circul. at extreme vessels at least in some parts.

Upon whole then have very little expect. of being of service to this patient.

And opin is that in no long time will fall victim to her disease.

Still however not in such a situ that attempts may not be made to recov.

Even operat of nature alone have in some such cases done a great deal.

And something at least may be effected by prop. applic of art.

With this intent have had recourse with pres patient to a med. which have of late years tried in many diff cases of phthis.

And although not in all or even in majorit of cases with success yet I think in some, with manif. advant.

The remedy to which here allude is the Gum Myrrh.

For most satisfact acct yet pub. of advant to be derived from this remedy in Phthis, may referr you to Dr Simmons treatise on consump.

Will there find, that for sever. years past, very much used by sever emmin pract. in London

And that too in all species & varieties of consumpt.

In many my own pract here both before & since Dr Simmons publicat. have very freq. used it

And unless where from pecul. irrit state of alim canal had effect of induc looseness never saw any evil result. from it.

Do not however hold it equally useful in every case

As far as my exper. goes is prin serviceable, in ulcerous Phthis.

That is where vomica of consid size formd in lungs & has burst.

In such cases am inclind to think that good effects prin. depend on its inducing adhes. inflam.

And thus prom healing of ulcers.

At least this opin may I think be supported by much more prob argt. than that of Dr Simmons who is disp. to referr effects to antisept influence.

Into this inquiry however cannot here prop to enter.

May only observe that while has effect of altering state of inflam on same grounds will have influ. also in alter state of separ at surf of lungs.

And thus in catarh Phthis, where purul. furnishd from that source, may also be useful.

But in most cases, where to be employd, with view to action on stom, requis that should be comb with refrig.

And in cases of catarrh consump. this partic necess.

For these often requis to dimin impet of circul. both in syst in general & at lungs in partic.

In most cases, as refrig with the G. Myrrh, recourse had to Nitre

Here however from bound state of belly induced to employ Cream of Tart

And as imagind that benefite might be derivd from obv. costiv ordered it in pretty large prop.

To quant viz of ℥p. thrice a day united with ten grains of Myrrh.

And as already obs. this last also of itself tend to open belly.

This med, taken at least without inconven.

And had effect of keeping belly natural.

But during course of first week, could not say that prod of any farther benefite.

And as determin to lungs still seemd to be very great, recourse was had to a blister

With view of encr. determin to part, was directed to be converted into an issue.

While at same time with inten of operating both as a demulcent, as counteracting strangury, & as obv. thirst, was advised to use an infus of Linseed gently acidulated.

These pract however did not seem to have very great influ.

Perhaps in some degree from blister not rising well, & not being succeeded by cop. disch.

But whatever might, be cause as intent not answered from issue was [unnec] to cont. it.

Especially as while not attended with disch, was a source of irritat without, being prod of any benef.

While issue omitted however powders of Gum Myrrh & Inf. Lini for drink directed to be contin as before.

And at last report were informd that sympt consid allev.

But whether this in any degree to be ascribd to med employd very doubtful.

Not improb. that anoth circum had more influence.

Change viz of patients situat from town & country air.

Well known that in Phthis few pract. more benef.

Here therefore reasonable to inferr that had some share in change for better which had taken place.

But from whatever cause it may have arisen, am inclind to think that this change but tempor. only

And very appreh. that notwith every meas, that can be employd will in end prove fatal.

At same time still no discourag at least, in persist in use of Myr.

And is my intent, to give it here a fair trial.

Mean also to encrease dose, as find that patient can bear it.

And if, under this course, patien. has recovery, unless some obvious circum leading to diff conclus, shall be inclind to attrib. something to this med.