DEP/DUA/1/40/46 (Transcript version)

Elizabeth Jardine

1786

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No5 Eliz Jardine 9^th Dec 1786.

In sympt many partic highly alarming.

If not cert. at least strong susp of Phths

Has chief sympt cough dysp & pain of breast.

These it is true in comm to Phths with Catarrh.

But here many sympt gener. attend of former seld of latter affect.

Loss of strength & faintness.

Hot fits & flushing with headachs.

Prof. sweatings partic in morning.

Remark quickness of pulse.

Here then charact both of pneum affect & hectic fever.

In gener not even occur in incip state

But taking place only after dis farther advan.

And consid as decidedly mark affect.

This judgem corrob also by age.

Is at period when Phth most freq.

Corrob also by shape & app.

Light hair & eyes. Tall & delic make.

Presumpt also from family disp.

For brother we are told died of Phthis.

Presumpt even of infect.

For attend brother at time of death.

Idea [indeed] of disease being [induc] by infect one with regard to which doubts.

And has I believe often origin from two of same family falling vict.

Where in both effects of heredit or perhaps rather scroph taint

But sever. [pract.] of accur obs. who hold Phthis to be contag.

And partic often comm from husb to wife or contrary.

And that where in later neither family disease, nor any other cause to induce it.

Of late in own pract some obs corr this opin.

Gentlem of fortune in neighb. at pres. abroad whose wife died of Phthis.

In what manner infect does take place cannot pret to say.

But no less incl. to deny it than [former]

Not imposs. that from habit of [breath].

Not imposs. that from sweat [absorb] where sleeps with [one] lab. under dis.

Shall only say that if infect, this cause may have oper in pres inst.

But where cause or not from sympt. disease suff. markd.

Phthis however of diff kinds.

In pract course these modific Catarrh. Ulcerous. Turbercul.

Diff both in degree of danger & mode of treatm.

Into partic hist of each cannot enter

But formerly gave it as opin & still think an ex. of least danger.

That case viz of Catarrh. Phthis.

To this lead from copious expect. want of fixd pain & lying with equal ease on both sides.

In tuberc. cough from irrit which tub. gives.

Hence of what calld dry kind.

In ulcer const fixd pain [whence] large vomica seated.

And pat can ly only on affected side requir free mot of other for respir.

Here then marks pecul to both these wanting.

While copious expect of matter prin at least mucous.

A circum always case when purul. matter from surf. of [lung].

And [conc] disch from thence as from inflam surf. prod by blister conv into issue.

From these consid then concl it case of Catarrh. Phthis.

And on this ground, progn more fav than if either of other spec.

For no doubt that of all these this least danger.

Or rather admits of most freq. recov.

Some indeed hold that Phthis in every inst fatal.

Contend that where recov. catarrh merly mistaken for Phthis

But see no reason whatev. for adopt this opin.

Phthis indeed a very insid affect.

And in many cases for consid period diagn between catarh & Phthis very diff.

Nay in all prob. has made very consid progr. before distinctly markd.

But when distinct markd no reason to inferr that merly Catarh.

For these, all same sympt, as in progr to fatal termin.

And such recov. where even every reason to concl. that Phthis of [tubercl].

Nay even where at after period pat. falls victim to it.

Prob. from inflam & suppur. of future tuber.

From this however mean only to inferr that not to be consid as altog an irrecov. disease

And at least, most ground for hopes in catarrhal.

But every inst of Phthis highly danger.

Pres not only distinct markd but far adv.

Before came under our care had subs for twelve months

During that time grad encr.

On these grounds then express appr of fatal conclus

And still I own of same opin.

Yet since came under care app. somewhat flatter.

At least less alarm than at that time.

And she herself now sanguin hope of speedy recov.

For not only dimin of cough & spitting but consid recov, both of strength & app.

While at same time, one great cause of exhaust. colliq. morning sweats have alm entirely left her.

These fav app. however I must own consid as being only deceitf.

For not uncomm to have in Phths tempor. remiss.

And this am afraid will prove to be case in pres. inst.

At same time pres app [illegible] after unif progr for worse at least a desir. occurr.

And if no other benef. gives better opport for trial.

Perhaps even some proof of good effect from pract. already empl.

But before speaking of [partic] pract. may not be improp. to state gener. prin on which here chiefly [expec] cure

Supp. separ entirely from surface

Hence cheif obj.

1. Alteration in state of separ

2. Restor of natur cond to superf. vess.

With these intent success.

To dimin impet of circul both in syst in gener. & lungs in partic.

And to give such condit to vessels that state of action may be alter.

But besides this necess also to [supp] exhaust & debilit syst.

And to obv. such other urg. [sympt] as occur.

On these grounds some explan of common pract.

Partic use of bloodletting. Refrig blisters, demul, milk diet change of clim &e.

And from these in some inst at least recov.

Yet all freq. empl without success

At same time often at least aid [opr] of others.

Here you will obs. diff. remed.

At loss to say in what manner oper.

Directed Pulv. G. Myrrh. comp.

Consist of p. ae. Myrrh & Crem Tart

This have now for good many years emp

And deceivd if not freq. with advan.

At one period this as well as other veget bals. in freq. use.

But all fell into disrepute.

By best practit entirely reject.

Pass. by Dr Foster. Lond. Med. Obs.

But since that G. M. introd by other pract.

And even more used than ever.

For most partic acct Dr Simmon.

Espec. records use at Guys Hospit

Empl in some 100 of cases with adv.

Sometimes given purely by itself.

Sometimes united with Sal. Chalyb.

But oftener with some refrig as Nitre.

In formul. somewhat directed by state of belly.

Where tend to looseness rarely fails to encr it

Hence not unfreq. conj with opiates or astring as G. Kino.

Where tend to bound belly with Cathar.

And none pref to Cream of Tart.

Indeed consid formul. here used as best.

Directed to extent of tea spoonf. a day.

Each cont. about grX of Myrrh.

Consid as med dose.

For larger effect either in giving uneasiness at stom or mov. belly.

From this quantit more regul [cont] & thus more benef.

Soon after begin use some dimin of cough.

And after longer contin all symp much mitig.

While cough easier app. also encr.

And not wonderf. that with this [dimin] of weakness.

Became also less affected with morn sweats

And pulse from above 140, under 100.

That these chang. altog. effect of med. will not pos. affirm.

Yet somewhat prob. as here [occurd] [durin] use

And as besides auth of others have myself obs good effects in other cases.

Must however own that few [which] so consid in so short time

And where no [share] to be attrib. to any other pract.

For this only med directed.

Suppos. thus benef. would not readily think either of change or addit.

Hence intent merly to persist in employm.

And shall not be disp. to any other pract.

Even allowing however that sole cause of fav change does not follw that will be perman.

On accid cold or simil circum may expect aggrav.

And notwith pres fav. app. shall not be surp. if yet victim to disease.

If however on contrary unif prog to recov under Myrrh, shall not less consid pres compl of patient as distinct markd case of Phthis.

And even view it as already [exp] benef from employm of Myrrh