DEP/DUA/1/37/39 (Transcript version)

James Fergusson

1785

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James Fergusson April. 2^d. 85.

Of case of this patient have but very few obs. to offer.

His disease a distinct. markd inst of an interm. fever.

And in app. which put on nothing which could be consid as singul or uncommon.

Had most common type that viz of Tertian.

And only sympt which could not be consid as necess constit of parox. pain of side & cough are what often occurr in interm.

Partic when these subs. during winter season.

A period at which catarrh affect are unquest the most common.

Perhaps indeed to be consid as [some] what singul, that patient not affected with more anom sympt.

And that had not been already attended with much more influ as affect constit in gener.

For had already you will obs. subsisted with this patient for great length of time.

Had been subj to it before came under our care for no less than space of three months.

Which though not long for some diseases is unquest so for an intermittent.

And thus an autum interm had run on even to appr. of spring.

When however interm of this long contin very gener. much varied in type

And in great major of cases in access. very irregul.

Besides this other sympt also very gener. superveen.

Not only great weakness but in most inst paralyt dropsic affect.

From these however this patient had contin perfectly free.

And in every respect constit & strengh less impaird than should have been inclind to susp.

A circum prob to be acct. for from two causes.

Though disease of long contin yet parox had never been very viol.

And during period for which had contin at times prob, consid remiss.

For told that had repeatedly taken bark with tempor. affect of stoping dises although cure had never been perm.

Hence then, less surp. that notwith contin, still retaind consid vigour & that few superv. sympt.

Even under these circum however expect of cure here could not be sanguine.

For had already repeatedly resisted most powerful remed yet known against interm

And season of the year approached which by no means fav to remov.

Indeed when interm run on for whole winter seld remov in spring

This for most part affected only during warm & steady weathr in summr.

And this, conj at least with change of situat, will often succeed where every other remed has faild.

Consid pres case however, as afford opport for trial of diff pract.

Partic those, which have been repres as sometimes succeeding, where bark has faild.

By bark here however you will readily concl. that I mean common pale Peruv Bark of which what in gener. esteemd best kind in quilld form.

But besides this two other barks lately introd, in many respects simil.

Yet not absol. certain whether prod of same species or even of same genus of tree.

Of one of these what now commonly know by name of red bark, have had consid exper.

And although certain that by pale quilld bark, greater part of interm may be safely & exped cured, yet have no doubt as to super effic of this article.

Of other the St Lucia & Carib bark have yet for my own part had no exper. in pract.

Nor have I yet had opport of perusing a late pub on subj by Dr Kentish.

But had lately some of it sent me for use of Dispensary.

And in pres case, where common bark had faild, at least in prod perm cure, was intent to give it fair trial.

For have been told, that this also, partic in neighb. of [illegible] & about [illegible] of Ely, found of super. effic to common bark.

And partic that operates in smallr doses.

In which indeed often necess to exhib it from influ both in excit vomiting & looseness.

This therfore reason for beginning use with doses of 10 gr only.

But with intent of afterwards encr. if requis or if patient bore it with ease.

Twelve doses to extent mentiond no effect in prod inconv. & as little in remov. interm.

This however consid as no suff or fair trial.

But now found that from circum of patient had not opport of pros it farther. As could not [support] himself any longer was obliged to recom him to the Infirmary