DEP/DUA/1/34/28 (Transcript version)

Duncan McKay

(1783-1784)

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Duncan McKay. April 3^d

When this patient came undr care consid case as somewhat doubtf.

His most distress. sympt were such as every day occurr in cases of Catarrh.

For disease chiefly markd by severe fits of coughing with expect of yellowish matter.

And from this not improb. that all othr sympt. ment in hist of case may arise.

For none of them, even sickness at stom & vomiting which do not freq. proceed from this cause.

While however this not an impob. suppos. some circum giving susp. of affect of much more danger. tend. vizr Phthis Pulmon.

This partic the case with regard to night sweats & quickness of pulse

And was a circum no less susp than either that was at times affectd with shivering fits.

To all these also to be added that Phthis a very insid disease.

And that often makes very consid prog before distinct marked.

In many inst even less ground for suspic than in pres case.

And that too after has subsisted for some time.

Upon whole then could not help entert. some appreh. in pres inst.

But even from begining was most disp to adopt opin of being merly catarrh.

And that opin now rendered much more prob.

For since came under care sympt most threatening Phthisis have disap

And is very little if in any degree affected either with shiv or sweating.

While at same time pulse in place of 120 now little above 90.

Hence then can with greatr confid concl. that merely Catarrh.

On this idea need hardly add that must be disp to give fav Progn

If conject right may hope that even soon, a speedy & fav. termin may take place.

And to this, even reason to presume, that consid progr. has already been made.

But notwith app relief can by no means speak with absolute certainty against exist of Phthisis.

And if this the case notwith pres app & notwith every thing that can do for pat may soon fall victim to affect

In treatm of this case pract chiefly directed with view to Catarr

At same time however not overlooking danger which there was of termin in Phthisis.

Began with a remedy which often used at least with tempor advant in both disease viz Emet.

Whatever nature of affect had here reason to hope, that from unloading breast might relieve both cough & dysp.

Had at same time recourse to Cream of Tart.

Which from extent to which here directed hoped might both oper. as gentle diuret. & likewise as open belly.

And from either operat no doubt that breast very much relieved.

With cream of Tart however here conj a prop of Cicuta.

Prin with view to obt. mitig of cough from narcot powers.

From these med seemd at first to obt. tempor. relief.

But this prob. more affect of free operat of Emet than of Crem of Tart. with Cicuta.

And accord. at succeeding report cough rather more severe.

By this led to applic of a blister converted into an issue

And in place of Cicuta had [recors] to a more powerful med for allaying inordin action Opium undr form of Pil. Theb.

From use of these med sympt have been very consid mitig

And reason to hope that by contin of them, togeth with more fav state of weather may soon be entirely removed.

If this however should not be the case, although still reason to consider disease as only catarrh may have recourse to repet. of Emet, to Squills or to other expect & diuret.

If on other hand either be already Phthis or lands in that affect. may try Cicuta or G. Myrrh.

But in that case all endeav. will prob. be but of little avail