DEP/DUA/1/30/07 (Transcript version)

John Reid

1782

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John Reid Novr 23^d 1782

When this pat. app. for assist. was doubtful as to nature of case.

But I own then entert strong susp. that subj. to a very danger. disease.

Many of worst sympt. cough, dysp. & diff. expect. such as well known to occurr both in Phthis & Catarrh.

And here undoubtedly several partic rather against suppos of Phthis

Pat. past that age at which Phthis comm. occurrs.

For most part a disease from 15 to 25. Our pat. however already app. to 40 year.

If age against Phthis, so likewise was habit.

For in place of sanguine temp. with which most freq. was here marked. of melanchol. habit, with which perhaps most rare

Disease in greatr numb. of inst, occurs with fair flor. compl. light hair & light eyes.

Our pat. however, of dark eyes, black hair, & swarthy compl.

Disease also occurd from a cause oftener giving rise to catarrh than Phth.

Exp. viz to cold, after body much heated.

But what still more in fav. than any of these, had no evid hectic fever.

Pulse at 80 & not affected with hot or cold fits.

But notwith these circum, still diff partic in case giving appreh.

Matter expect. had not indeed evid charact of pus.

But at the same time, of that kind which often cont. mixt of purul.

And this espec to be susp. when as in pres case much pain of breast.

For with mere catarrh, after has been of any consid contin, this rarely the case.

If however ground for appreh from pain of breast, still more that affect of respirat.

For not only lab. but quick also.

Something also alarm in state of pulse.

For though not quick yet feeble.

Though no cold or hot fits, yet [illegible] flushing, at times in cheeks.

A circum indic at least some deg. of febrile attack.

But from all circum, none from which more alarmd than state of tongue.

Had a pecul clean & red app.

A circum which although may proceed from diff causes, yet almost never fails to be concom of purul [expect]

Hence then where from other circ. reason to susp. this, serves very much to corrob susp. from diff [source]

While from these circum susp of Phthisis must also obs. that among various partic fav idea of Catar, nothing in [compat] with suppos of Phthis.

For although most comm in early life & with sang. temperam yet no age or temp exempt.

Though cold most comm cause of catarrh, yet also sometimes induces catarrh Phthisis.

In some constit, hectic fever though existing, not distinct markd in state of pulse.

In some inst of Phthis does not take place till disease has made very great progr.

Hence then from none of them ground for cert. concl. against Phthis.

And farther to be added that Phthis in its nature a most insid disease

So that in many inst has made very consid progr. before known to exist.

Upon whole then though not free from doubts with regard to case yet very appreh. that subj to Phth

And can at least say that have attended many patients, where much less reason to be alarmd, & who in no long time fell victims to that affec.

In pres case however now I think app. that appreh. without danger.

For patient again so far recov. as to be able to return to usual empl.

A circum superceding all observ. on prognos.

From pres. case however in way of prognos. learn at least one partic.

Shews us that Catarrh even with more threat app. may in short time have fav. [term]

And that too by powers of syst alone.

Here even on suppos of catarrh, at time when pat. came under care should not have given it as my opin that it would have term so soon.

For when that disease degen into chron state often contin with great obstin.

Is partic aggrav by any expos to cold, & accord. remark distress during winter months.

In so much that few diseases, in which greater benef. derivd from chang to more temper. climate.

Was not therfore to be exp. that during so severe a winter, would soon go off with pat. who from occup. must pass great part of time in open air.

Change for better then, which has here taken place, more I own than should have suspected.

While at same time this fav change could I think in no degree be attrib to the pract. here empl.

For in treatm of this case as you will obs. from register have had opport. of doing but very little.

And as far as treatm went, was [entir] directed to suppos. entert with regard to nature.

That viz of Phthisis

Was with view to this affect, that had here recourse to a remed, of which I own have good opin

I mean Gum Myrrh.

This artic as well as others of simil nature, has for long time, been with some empl. in pres. affect.

But pract. by no means gener. agreed respect. prop. of it.

For by [some], this & indeed all healing Balsam, as calld, have been condemned as pernic.

That such their effects in Phthisis, you will find strongly contended for, in paper in Lond. Med. Obs. by accur. obs. Dr Fothergill.

Later observ. however than his, made at same place have been pub. in support of the med here empl.

Partic highly extoled by Dr Simm. in late treatise on Consumpt.

And among other author in supp. of it ment. being empl. in great numb of inst in Guys hospit. under direct. of Dr Saund. with very remark. success.

How these obs. to be recon. with those of Dr Fother, will not pretend to say.

Can hardly I think be denied [that] in some degree contrad to each other

Yet am inclind to think that would be found less so than might at first imag. if prop attent paid to [diff] [sym] of Phthisis

For in this disease, I appreh. three distinct species may be estab.

These in pract course shall endeav to describe & illust under titles of Catarhal. Ulcer. & Tubercl.

At pres would only observe that while imag, that in most cases may be read. disting by sympt. so also consid diff in mode of treatm.

And that Myrrh. though in one prejud, may be advant in anoth.

Am inclind to think that prin useful in ulcer.

That often used with advant in cattarh.

And that of all Phthis least fitted for Tubercul.

In this way, then, when speak of Phthis in gener, contrad observ. with regard to cure, may each of them be well founded.

But besides this must also add that Dr Fothergills observ. do not apply to Gum Myrrh in partic.

And obj. which makes against [healin] balsams in gener, may not be so strong against this, as some others.

But in whatever way to be expl. must here obs. that for my own part have good opin of Myrrh.

Since Dr Simmons public. in [part] have freq. empl it in Consumpt cases.

And I think in many of them with advant.

At same time must obs. that opin not so high as from Dr S. pub. one would be inclind to form

But am much mistaken if have not seen good effect from it.

And same also sentim of some other pract. at this place who have of late freq. used it.

Was then on footing of former exp. that had here recourse to this med.

And on suppos of Phthis, hoped that on fair trial might find it prod of some benef.

From termin however which disease has already had, can have little doubt, that idea of Phthis is a mist one.

And as little, that relief which pat. has obt. in no degree to be attrib to med empl.

For some time indeed, took med regularly.

But during part of that period, dis in place of being allev, became so much worse, that was conf. to bed.

Consid this however only as conseq of progr of Phthis affect, & of loss of strength, to which subj. those lab under it, thought it advis to persist merely in same plan.

At succeeding report was I own surprizd to find sympt consid relievd.

This on suppos of Catarrh might perhaps in some degree have attrib to Cream of Tart. with which Myrrh here united, if had eithr been attend with effect of moving belly or encr. disch of urine.

But as neither of these the case more prob. that relief obt. was natural effect of progr of disease to recov.

And this not a little corrob. by a circum which afterwards happend.

Contin viz of progr to recov. with [aid] of any med.

For although Myrrh with Cr of Tart ordered to be repeated, yet med were never sent for.

Hence then upon whole, consid case as example of simple Catarh having fav. termin.

And at least serves to shew that some inst threat Phthis, where yet affect may have speedy fav. termin