DEP/DUA/1/35/22 (Transcript version)

Andrew Ross

1784

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Andw Ross. June 25^th 1784

In history of this patients case have many of those sympt which are in common to Phthis & Catarrh.

Partic pain of breast cough, dysp. & expector of viscid yellow matter.

And indeed no sympt. mentiond in hist. which does not often occur in both diseases.

Hence then diagnos here must be diffic.

Espec when consider how far Phth an insid disease & how great prog has often made before distinct markd.

Would by no means therefore with confid pron. that pres. patient may not be subj to it.

Or even that has not already made consid progr.

Yet at pres at least, sever circum leading to contrary opin.

Has nothing of shiving fits or febrile access. indic hectic state which may be consid as great constit of Phthisis.

Pulse never remarkd to deviate from natur standard.

A circum which if ever takes place in Phthisis is at least very rare.

Pulse seldom more quick than should expect at his time of life

While pain of breast though distress. yet rarely for any length of time fixd to partic part.

To these to be added that patient hardly arrived at consumpt period of life

And that disease derivd origin from a cause very freq operate as inducing similar affect merely of catarrhal kind viz expos to cold.

Hence then although here danger of Phthisis & thus fatal termin yet upon whole disp to hope more fav.

And flatter myself that by meas counteracting catarrh affect may in no long time be overcome.

To this disease therefore pract hitherto empl. almost totally directed.

Began by ordering applic of blister to [paind] part.

From this hoped that as far as pains conseq of inflamm. tend, might be counteracted.

But expected still more advant from dimin of [encreasd] secret to breast by giving determ elsewhere.

As a means of still farther allev cough had recourse to a mucilag mixt.

With view of gently [acidul] this & thus rend it more pleas [added] to it a prop of Syr. [Acit].

And as means of allaying & mitig irritat such a prop of Tinct. Theb. that gr V in every spoonful of mixt.

From these remed then expected mitigat both of pain of breast & cough

And in this expect. not altogeth disapp.

For after applic of blister, which rose well pain of breast somewhat mitig.

But neither from this nor from mixt any app. mitig of cough.

And while copious expect still cont. was obs. to have disagreeab. taste & smell.

This was inclind to ascribe rather to stagn of mucus, than to purul.

And seemd therfore to indic empl. of some remed which would have effect of compl. unloading breast.

As such directed use of Emet

And that purpose might be most certainly answ. orderd that should be twice repeated before next weekly visit.

Besides unload breast expectd also that would have consid effect as [change] mode of circul.

For no doubt that by determin from lungs, to surface have often good [effect].

From these therefore conj with contin of former mixt. expectd mitig of cough.

But in this also disapp.

For although both vomits operated well, yet cough & expect still contin.

But although had hitherto faild yet [expected] that on same princip relief might be afforded.

And in order to dimin determin to breast seemd necess that more perman determ should be made to some other part.

For this purpose not only [directed] repetit of blister, but convers into issue.

Issues indeed as being both inconv. & troublesome should in gener. be [avoided] where can be done.

And partic with young subj on whom the [entailing] a habit disch must always be disagreeab.

But at same time in diseases where change of determin requis few remed of greater effic.

And accord in case before us has already had consid influ both in mitig cough & relieving breathing

But patient as may indeed be suspected from pain which prod [averse] to contin.

And from this [joind] to circum already ment. shall be desir of persist in use no longer than abs. necess.

Hope however that effect may be such as soon to enable us to omit use.

And that be contin of mucil mix alone cure may be accompl.

If this not case have thought of adding to mixt a propor of powdr of Cicuta.

And if this also fail, practices then directed by situat of patient at the time.