DEP/DUA/1/41/22 (Transcript version)

Kath Sutherland

(1786-1787)

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Kath Sutherland March 24

One of many inst of pulm affec which have had occas to treat during pres. course.

But still at least app under diff. form.

For while in these examples of diff modif of Phthis. have only what will prob. [land] in Phthis.

And in pre state to be consid as complic of Haemopty. & Catarh.

Evid here a consid haemorrh from lungs as app from state of expect.

For when came under our care coughd up blood daily to extent of three or four ounces

Could not however be consid as a haemorh of active kind.

For disch only in conseq of severe cough.

Was not, on other hand that very slight haemorh. aris from diseased state of lungs.

Such for ex as slight tinge of blood, occuring in tubercle.

For that in gener accomp. merely with tussic, or slight efforts to cough.

Consid inst, such as pres. as being much less danger than either of these.

For on cessat of cough may expect also termin of Haemor.

And accord. had subsisted with this patient, for more than 12 months before came under our care

At same time even from contin for this length of time ground for alarm.

For reason to fear that diseased state induced in lungs.

And no doubt that haemorr & cough would tend mutually to support each other.

Hence I own appreh is, that notwith any thing we can do, affect of this pat. will term in Phthis.

And partic if contin in pres. occup, by which much exposed both to exert & cold.

From these more mischief than any good from all pract. we can direct.

Or at least if from these rem remission at any time obt. will soon again be thrown into former state by accid [means]

And this accord. app. to have been already oftener than once case since came under our care

Began treatm by direct for patient a mixt consist of equal parts of Crem of Tart & G. Arab united with prop. of Nitre.

This need hardly observe intendd to operate as refrig & demul.

Did not here as already said consider haem as of active kind.

And both contin of disease & state of pulse obj to blood letting.

But concl. that by dimin impet of circul. tend to haem would be less.

And that from empl of dem taking off irrit less freq. repet. of that action by which immed excited

In these [efforts] not altogth disapp.

From first doses indeed some sickness & vomit.

Conseq. neither exp. nor wishd for

But after contin for some time haemorrh. ceased.

But though this the case still both cough & pain of breast severe.

And unless mitig of these every reason to dread that haem would return.

From this therfore led to direct applic of blister to breast.

And with view of contin [determ] from lungs to support disch by means of issue ointm.

Effects of this pract seemd so far fav.

For while contin free from any return of Haemopt. cough also mitig.

This however when consider length of time for which disease had already cont. reason rather for persist in use of med than relinquish them.

Directed therfore that both powd & issue should be cont.

Pat. however prob. of diff opin.

And while hoped that disease overcome, was unwilling to contin a pract so painful as an issue.

Which partic distress. to those obliged to work.

And accord both heald up this & gave over powder.

But conseq. was that in no long time severe return of Haem

Which while prob. in part the conseq of want of med, no less of expos to cold.

Hence not surpr. that did not immed yield to repet of [form] med.

And indeed could hardly exp her to be free from haemopty. while cough very severe.

With view to mitig of this, when directed contin of issue and refrig powder [adv] also a mucil. [mix]

And with view to sedat & astring effect added to it propor of Theb Tinct & [weak] Vitriol Acid.

Under use of these med blood expect has again ceased & at least some slight mitig of cough

And again from uneas & inconv arising from issue has allowd it to dry up.

This second remiss. must own hardly expect that will be more perman than first.

In pres. situat diff. or rather imposs for her to avoid accid expos. to cold.

And from every aggrav of cough, imm danger of renewal of haemorh.

By contin remed howevr already [direc] may I hope at least be mitig.

And if cough contin severe may still mitig by encr. opiate.

But at same time as already obs. think prin chance of recov. from leaving situat which must expos to renewal.

And going to country where can enjoy [free] air, gentle exercise & milk diet