DEP/DUA/1/31/18 (Transcript version)

Stuart Ailison

(1782-1783)

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Stuart Ailison.

In this case as well as former disease prin app. under form of affect of breast.

And cannot pretend to say that certainly or distinct charact.

But while no hesitat in pron. form to be a catarrhal affect, here again very strong suspic of Phthisis.

This may in some degree be inferrd from nature of cough which here takes place as well as from state of expector.

Especially when consid that these occurr with a patient at the cons. age.

But still stronger ground for appreh. from quickness of pulse & haemopt.

And susp not a little corrob. by what are told respecting fate of his brother.

He we are informed fell victim to Phthis nearly about time when dis of pres [patn] began

And to this cause some would be inclind to attrib origin of pres. affect.

For with many pract. Phthisis held to be a contag. disease.

For this however as far as my own obs. goes have never been able to discov any evid.

Admit indeed that when anyone sleeps with a consumpt. pat. from expos. to encreased heat, & still more to colliq sweats bad effects may arise.

And that may even prod catarhal affect at length termin in phthisis.

But in pres case patient not exp. to any such cause.

For informd that never slept with his brother.

Here then would have connect in very diff manner.

And inclind to consider Phthisis both with one & other as being a hereditary affect

When of this nature is usually of the tubercul kind.

And such take to be its nature in the pres. case.

To this indeed may at first [seem] some obj that has begun with Haemp

For from Haemop. a large vomicae or ulcer in general formd.

Here however to be obs. that spitting of blood never very profuse or consid.

And seemd rather to proceed from accid rupture of tender vessels than from haemorrh [affect]

Such however not unfreq. the conseq of that state of vessels [surround] tubercle.

And upon whole consider it as presumpt evid that Phthisis of this kind.

With this idea of nature of affec opin as to termin must be very unfav

Every inst of Phthis danger.

But tuberc. Phthisis partic so.

In so much that after once distinc markd, very rare to meet with recov.

Or at least of app. recov at one time, yet still fall victim to it at another.

But while of all Phthis the most dangerous so in general also the most slow in its progress.

In so much that in many inst patients will linger under it even for space of several years.

Probab. consequence of success inflm & suppurat of tumours diff tubercles in same mann as happens of Scroph tumours in other parts.

Must however be admitted that this slow progress by no means unwarrant.

And even in same family where affect heredit course often obs. very diff.

While one cut off in few months anoth will remain subj to it for several years.

In case before us am inclind to think that even without interpos. of art has app of being of slow kind.

For although has already subs. for near space of year, yet still retains consid strength.

And although const quickness of pulse indic certain degree of fever, yet no manif exhaust of habit.

From this then better opport may at least be afforded for trial of medical assist

But must at same time own that from any remed I can think of empl. hopes of recov. far from being great

If this can be effected, is I think to be looked for from means of resolv Scroph tumours.

And is with this view that with pres. patient have had recourse to the Cicuta.

An artic the use of which in Scroph have already oftener than once had occas to mention

This med hitherto princip empl. as diff in a Mucil. mixt.

From which hoped that might at same time obt. some effect as mitig freq of cough

Now however as cough [somewht] easier am empl it under form of powder.

And in this way is intent to give it full & fair trial.

Rather however by due contin of course than by large doses at once.

Since Cicuta begun have occas had recourse to other meas.

Such for ex. as applic of blister with a view to pain of side which consid as depend on active inflam on some tubercle.

On simil occurr. may again have recourse to same pract or to other meas. such for ex as blood letting.

And for obv. partic sympt diff remed may be employd.

But with view to radic cure of [affect] is my intent to employ Cicuta alone

If that accompl. shall I own be disp. to consider pres case as afford strong presumpt fact in fav of this remedy in such cases

At same time recov not be expected but from long contin of med

And hence cannot be certain that if even should take place may not be [entirely] work of nature