DEP/DUA/1/37/21 (Transcript version)

John Annan

1785

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John Annan. Febr 26^th 85

Respect disease of this patient somewhat at loss.

Am somewhat doubtful whether should consider it as inst of catarrh or of incip Phthisis.

In sympt to which patient subj when came under care, none which do not very comm. occurr in catarrh.

And indeed nothing which could be consid, either as alarm or singul.

While at same time, during this season, catarrh a very comm. compl.

No app marking even the incip state of Phthisis. espec no marks of [Hec]. [f]

One partic however ment in hist of itself suff. to give alarm.

That is state of affect at commen.

Began we are told with very consid haemoptysis.

This however well known freq. lays foundat for Phthisis.

While at same time as well known that Phthis often marks consid progr before any sympt by which can be detected.

Hence then not altog without appr as to that affect.

And from this, great uncertainty respecting prognos.

If either realy Phthis already, or if that disease induced in conseq of it, will in all prob. prove fatal.

At least even of most fav cases, a very great major. have that concl.

Here however am still I own disposed to consider as mere catarh.

And to hope that even indep of med by occur of fine weath may have fav [term]

And that this event may be somewhat promot. by pract which may here be directed.

As however doubts concern disease created uncert. in progn. so must [also] with respect to treatm.

And while pract. directed to catarh must however at same time have in view, the tend to Phthisis

Here from diffic of expect, depend on viscid of matter, seemd to be first obj to unload the breast.

Was with this intent, that began pract, by direct. the use of Emet.

These need, hardly observe, are unquest most imm, & effect expect with which are acquainted.

And accord in effect here were not disapp.

For while both operated briskly, as conseq of operat, cough & dysp. [relieved]

Here however while first obj to expell mucus already accumul. was of no less import. to prev. return.

This often to be accompl, by giving gentle determ from lungs, to other parts.

Partic. by promot free disch, both by stool & urine

Was with these views, that had here recourse, to [comps] powder of Crem Tart.

An artic consist of equal parts of Crem Tart & Flor. Sulph.

And which taken to extent of two or three tea spoonfuls in day, has in gener. affect of operat, both as gentle laxat & diuret.

To this the rather led in pres inst. as seemed well accomod to Phthis affect.

At least both as refrig, & evac tend to prev return of haemorrhage

In obv operat of this med were not disapp.

Had some influ on both disch.

And under these consid relief both of cough & dysp.

But from some accid interrupt of attend, med were for some time given up.

Upon this occas, sympt again consid aggrav.

Partic cough & dyspn.

A circum giving at least some ground for inferring that relief not improp attrib, to med empl.

At same time, can from thence draw by no means a cert. concl.

For affect of this kind often subj to aggrav from very triffling circum as accid change of weather.

Often from even without any obv cause.

But whether arose from want of med or not, on return to use had [again] some remiss.

Still however had reason to think that fresh accumul. had taken place in lungs support. cough.

Accord. had again recourse to an emet as means of unload it.

And hope that may again prod of good effect.

To this course then, of Emet empl occas, & comp. powder of Cream Tart. [used] during interv. am hopeful that disease may soon yeild.

Espec. if at same time a chang to milder & warmer weather.

If however mist as to nature of disease, or if affect shall after degener. into Phthis this event hardly to be expected.

If therefore from contin obstin shall have reason to inferr suspect this will have recourse to a blister conv. into issue.

Which also one of those pract. applic both to Catarrh & Phthis.

If still more decis proof of Phth may here make trial of Gum Myrr.

But in that case too much reasn to appreh. that all trials to little purpose.