DEP/DUA/1/37/58 (Transcript version)

John McPherson

(1785)

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John McPherson. April 23^d.

Sympt in case of this patient not very numer.

Suffic however to mark a pect affect even of an alarm nature.

From cough, & pain of breast alone ground for susp of Phthisis.

And this presumpt not a little encreased from feverish fits & night sweats.

But still more from bloody expect, with which cough has at times been attended.

And upon whole though no certainty, yet here but too much ground for susp. Phthisis.

Still however could not be consid as of most danger. kind.

Of this suffic proof from reflect that before patient came undr our care had been subj to it for 12 months sever years

In much shorter period, where Phthisis of most exquis kind, not only distinct markd, but even fatal.

This accord generally the case in the Tuberc. Phthisis.

But in pres. case no app of scrop habit or any other mark which could lead us to susp. that of this kind.

Wanted also, that copious expect, which very gener, perhaps univ the attend of Catarrhal.

While again, from constant fixd pain, referrd to partic part of breast, had strong presumpt of vomica in lungs yet unburst.

In point of danger hold this spec to be interm between other two.

More so than catarrhal, less than tuberc.

Upon disch of matter some chance of recov.

But upon whole prob. is that will fall victim to the affect.

In treatment of this case intent to make trial of G. Myrrh.

A remedy which as have already had occas to obs, in pres course, much celebr. In Phthis affect by some of London Pract.

Partic by Dr Saunders of Guy hosp, & Dr Simmons, to whose treatise on consumpt, may referr you, for best acct of it.

From slow progr of this case, may have opport. for full & fair trial.

Have here accord directed it, as comb. with Cream of Tart.

For to be obs, that with use, some refrig is in gener. requird.

And am inclind to think, that in most cases at least, Cream of Tart, prefer to Nitre, which has been gener. used

On this med, then is [inten] to contin patient, for some length of time

Using however occas. such [other] pract, as circum might render necess.

And here imagind, that some benef. might be derivd, from a gentle Emet.

As such, had recourse you will obs. to Ipecac.

And here took this opport, of trying in way of Exper, how far the Emet power of Ipecac, counteracted by acet. acid.

From some late Exper, by a very ingen Gentleman, Mr Irving, app. reason to inferr that has in this way very consid influ.

While at same time, determ action to intest canal.

Perhaps acting by restr. inordin action of vomiting as it does hiccup.

Here therefore directed that Ji of Ipecac should be taken in ℥i of Vin.

But on this occas. while vomit well, had no effect in prod looseness

As a second trial, took future opport of giving same quantity of Ipecac in ℥iii of distilld Vineg.

And on this occas also, was in usual time, followed by some vomiting.

But prod also two or three loose stools.

Upon whole, would app, that with this patient the Acet. acid did not take of, at least entirely, the Emet power of Ipecac.

And from some other trials, am inclind to think, that this will happen with most stom.

But at same time from these also am convin that by acetous acid may determine action to intest canal.

And this I am inclind to think a partic of no inconsid import in pract.

Besides Emet. have also in conj with Myrrh directed for this patient, a mucil mixt containing [small] proport of Tinct Theb & Vitriol acid.

From first have in view the mitig tickling cough.

From the last, the restraining wasting sweats.

If answers these intent may be contin.

If not is still my intent to go on with the Myrrh conj such other pract. as circum may occas require.