DEP/DUA/1/39/32 (Transcript version)

James Hutchinson

(1785-1786)

---

Jas Hutchinson. April 8^th

Of case of this patient reckon it necess. to say very little.

For he also but short time subj of pract here.

In histor of his case formerly ment. that had many of those symp which occur in Phthis.

And during short period of attend saw no reason to alter this opin

On contrary from variab state of pulse, & partic great quickness rather confirm of it.

Of Phthis in this case [presump] even from obv. app of patient.

Partic from emaciat. as indic by approach to facies Hippocrat.

And from pearly cast of eye destit of red vessels.

But with these were conj circum much less equiv.

Partic, pain of breast & cough

With these freq. hot & cold fits through day.

And often consid sweatings during night & in morning.

Often also distressd with severe Diar

To this to be added that pulse unif. quick.

Never obs under 85 in min.

Sometimes at 130.

Had farther indic of Phthis in pecul cleaness of Tongue.

And, in conjunct with other symp, contin of tolerab app., also in fav of that disease.

But perhaps might be consid as still stronger circum that disease in some degree hered with him.

For his mother we are told died of that affect.

Upon whole then, from all circum taken togeth, not only concl. this to be Phthis, but even consid it as far advanced.

And may at least venture to assert, that in many inst, after much longer contin, disease less dist marked.

With this idea of nature of affect, opin of termin could not be fav.

For in great major of inst, notwith utmost efforts of art, Phthis proves fatal.

And from contin of colliq. sweats & diarrh, had here reason to appreh, that pat. would soon fall victim to affect.

This so much case that thought very little to be done but to obv sympt.

And thus render pat. at least somewhat easier.

Of diff sympt when came first under care most urgent was loosness.

And with view of obv. this, for my own part know nothing equaly efficac with Laud. Opium

While at same time that dimin encr. disch. also takes off, both gripes & tenesm.

To employm however in pres case one circum in pect. compl, occurrd as an obj.

As dimin freq. of cough indeed nothing more powerful.

Success allays this, as well as other inord actions.

But here, cough, at times at least, attended with cop. viscid exp.

And no doubt that in such cases, greatest distress from accumul.

Hence then prev to employm of opium, here thought it necess, to unload breast, by free expect.

And with this intent premised to use of Pil. Theb. a dose of Ipecac.

In obv. operat of this not disapp.

And under subseq. use of pills, loosness at least somewhat dimn

Still however cough contin to be very distress to him.

And with great quickness of pulse, though morning sweats rathr [dimn] yet upon whole still very consid.

In this situat, while directed contin of pills, for loosnss, thought it advis also, to do something for cough & sweatings.

And thought that at least some chance of allev from Mucil Julep, with diluted Vitriol acid.

But since this prescribd, have seen nothing more of patient.

Hence may at least concl. that has not given it fair trial.

But had that been case, still I own, had by no means high expect from it.

What circum, led him to give up attend, do not known.

But confess suspect it may at least in part have arisen, from progr of disease, & inab. to attend.

But whatever cause render any farther obs. unnecss.