DEP/DUA/1/40/50 (Transcript version)

James Scott

1786

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Jas Scott. Decr 16^th 86.

Anoth case where susp. of Phthis.

Not so distinct marked as Eliz. Jar.

But still suff. to give strong pres.

Not indeed same marks of hect. fever.

Nor pulse unif. quick.

Even slower than nat. stand.

But at times cold fits alter. with heat.

And these followd by sweating.

Also lassitude & emaciat.

And to these superadd. Cough Dysp & pain of side, prin & com sympt.

May add also app of tongue.

Not only red clean but clean red tow. point.

Alm univ attend of purul. expect.

But above all prof morn sweats.

These in ever inst of obs. cough alarm

Upon whole then strong pres of Phth

At least many cases where long [exam] though less markd.

Cannot indeed say that certainly or decided marked.

For neither cert evid of purul [expect] nor hect. fever.

And hold those alone to be inst of Phth Pulmon. where hect fev. from [pur] of lungs.

But much more evid both of one & other, than in major of cases of such standing.

Hence stronger pres of Phth than any other dis.

Supp. Phthis next species.

Wheth viz Catarrh. Ulcer or Tuberc.

This distinct of import in pract.

And although not always easily determ yet of conseq. where can.

In former case reason for supp Catarr

Hence diff species – think Ulcer.

This is vomica of consid size.

To this led, not more from [absen] of sympt of other [respec], than pres of those charact this modif.

Did not begin under form of Catarr

On contr. cough super. only after some time.

Is not app of scroph habit.

And no reason to think hered.

These however if not pathogn [sym] at least comm marks of Catar & Tub.

While here again charact of ulcer. in fixd pain & consid dyspn.

Cause also such as gives susp. of this

Effect of accid injur to breast from strong exert.

Thought felt fail at time.

And though mist as to noise yet not improb. that some intern. rupt.

And from such accid large vomic more freq. than from any oth cause.

To these still anoth circum.

State of pulse.

In this [spec] much more natu than other.

And by no means markd by same [quick]

Prob. as matter formd more ordin [mild] & bland pus.

Cert. that less effect on circul than ichor. absorpt.

Hence very acute heat in tuberc cases

And hence long contin without any hectic in some cases of ulcer.

For with disch of pounds at time pat. for years without any.

Indeed much case in ulcerat at other parts where mild & bland pus without [feator].

But when change in app. – bloody or ichor hect. very soon ensu.

State of pulse then among other partic evid of this spec.

And upon whole inclind to look upon it as ex of ulcer. Phthis.

With this idea of disease no great hopes of recov.

For great major of inst of Phth. fatal.

Can only say that less imm danger than tuberc.

And where in end fatal only so after long time

Some pat to cert. degree at least sub to it not for one or two merely but for 10 or 20 years.

Upon whole indeed more [danger] than catarh.

Yet perhaps of longer durat which prov. fatal.

For in catarh in most inst either compl. recov. or fatal concl in shorter time.

Hence often at least afford opport for fair trial of med.

And this may exp in pres case of pat. contin attend.

Hence diff pract from former.

In that case trial of G. Myrrh.

Might also have been used in pres.

For in such often empl.

But wishd first to give trial to P. Bark & Vitriol acid.

In this case as already said supp ulcert. of consid size in lungs.

The healing of this must be entirely work of nature.

And case of [pract] to be cheifly empl. in prev & obv. sympt in first inst

In this case as obs. hect. fever at least mod.

And no uncom quckn of pulse.

This ascribd to pus of bland nature

Was with intent of [pres] [such] that empl. bark.

While thought that might in some degree [form] adhes inflam.

Thus both prev occur of more alarm sympt, & prom cure.

But besides this directed also Vitr Ac

This empl. with view to astring [power]

Chiefly meant for obv. a distr. sympt

Colliq. sweats to which pat subj.

For to these chiefly attrib loss of [strength]

Infus of Vitriol acid in this way well know

And although inadeq for every case yet sometimes at least success.

Never more so than in [simp] [state]

From taste however req. dilut.

And for this purp add to Mucil jul.

Under these med was intent to cont pat. for some time.

And from last report in regist, though no remark benef. yet no reason for desert plan.

But for some time past has not attended

And prob. may see nothing more of them

But if returns is intent to persist in plan, or rather to renew it.

At least unless affect then puts on diff app.

In that case treatm [must] be accomod to circum.