DEP/DUA/1/41/16 (Transcript version)

John Sutherland

1787

---

John Sutherland March 3^d. 87.

In case of this patient a very distinct markd inst of Phth Pulm.

An affect of which in pres course have already oftener than once had occas to treat.

Partic in cases of Eliz. Jardine & Peggy Hislop.

Formerly obs. however that [consid] as afford modif of disease diff from both these.

For state of purul in lungs giving hectic fever, & therfore [strictly] Phthis admits of diff cause.

In partic compreh I think three diff species which though not always yet often readily disting from each other.

Catarh. Tuberc. & Ulcerous

Of first an exam in case of Jardine.

Of second in that of Hislop.

While considr pres case as examp of ulcerous.

For that here vomica of consid size in lungs may be inferrd from various circum.

Renderd prob. by origin, a copious spitting of blood in gener. prelude to consid ulcer.

By fixd pain of breast.

But above all by copious expect of a matter evid purul.

This species of Phthis consid as in point of danger interm betwen other two.

Less so that tuberc more than catarrhal.

At same time no modif of Phth without immin danger.

And partic to be appreh while hectic fever so acute as in pres inst.

Accord now promises worse than eithr of others.

For while one already dismissd other has had consid allev of symp.

And reason to hope that for pres at least may get better of affect.

But of this little ground for expect in case before us.

For disease has made such progr & loss of strength such that has not been able to attend us for some time past.

And much I think to be dreadd that this progr will contin till fatal conclus takes place

In treatment of this case had recourse to same remedy empl in other two

Use viz of Gum Myrrh.

And in inst of ulcerous phthis have I think obs. more benef from it, than any other.

This however cannot say of pres.

For while in two other inst app benef. here no good effect.

From sever of cough, dyspn. & pain of breast soon led to applic of blister

And to convert this blister into an issue.

But notwith both, affect cont to be aggrav.

And from severe colliq. diarh superv soon led entirely to [direct] use of Myrrh.

And now I own but little prosp. of return to this or any other mode of cure, from which much prospect of success.

Prob. cheif attent empl. merely in attempt to obv. some sympt.

Is with this view that have directed Infus Japon. comb with a prop of Tinct. Theb.

One of most useful artic with which am acq. as checking diarr.

And accord in pres inst seems to have had good effect.

At least were at last report informed that looseness consid [modr].

Still however all more alarm sympt contin as before.

And this mitig probab. merely temporary.

Hence have directed contin.

To what other pract may here think it necess to have recourse will very much depend on circum for the time.

If however suffic strength to admit of it, may here try a pract of late highly recom in [Phar]

I mean exercise or rather motion given by swinging.

For introd of this are indebted to Dr Carmichael Smyth of London Phys to Middlesex Hospit.

Has lately pub. treatise [professed] on this subj. & has done me the honour to send me a copy of it.

In this treatise fourteen diff cases are related, all of which Dr Carmic consid as decided examp of Phthis

In 13 of these during this pract patients got well.

And in 14^th though disease in end fatal, yet swinging seemd prod of good effect.

To this pract Dr Carm. led from analog to motion in sailing.

For whole benef derivd from sailing is he thinks to be ascribd to motion.

Endeav even to shew that sea air is pernic.

Motion, that is [where] merely quick passage through air, he [cons] as having very diff effect from all exercise.

That is from all cases where exert of volunt muscles.

Contends while one stimuli quick pulse, the other sedativ dimin its velocity.

And this he holds to be of great advant. in Phthis.

Respect his theory here out of place to enter into any inquiry.

With regard to his facts, can place greatest confid both in his integ & in his accur.

But must at same time confess that my faith somewhat [stagered] from greatness of success.

For no idea that any species of motion whatever capab either of remov tubercle from lungs, of prev. termin in suppur. or of curing that suppurat when has taken place

At same time cannot help consid it as mode of cure which in this, & also in some other affect deserves at least fair trial.