DEP/DUA/1/43/24 (Transcript version)

Alexander Ross

(1787-1788)

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Alexr Ross at 31.

Formerly expressd doubts as to disease to which this pat subj.

Could however consid it only as ex either of Catarrh or Phthis.

And when began treatm rather inclind to former of these opin.

To this led from sever diff. cons. But partic. From long contin of disease.

Had subs. for five months without at least being distinct markd as Phs.

From age of pat. Had passd 30^th year & consq. past com. Cons. per.

From cause to which attrib. Referrd to cold & hard lab. much more freq cause of catarrh than Phs.

And lastly from regul. sever attacks of cough at all hours in morning.

An occurr. very comm in catar while rare in Phthis

And marking even chron state of disease.

But notwith all these partic from what after saw of disease inclind to alter opin.

From period attacks of shiv fits from loss of strength – From const quick of pulse – But above all From night sweats soon led to concl. that disease realy Phthis.

And accordingly to alter opin not more as to nature of affect than dang tenden.

If furnish therefore no other lesson is at least ex of insid nature of Phth.

Of this however was not [unavoi] when last spoke of case

And accord. then [illegible] that both in prognos & pract. danger of Phth to be had in view.

Began by direct for patient the use of an Emet.

This both in inst of Catarrh & Phithis a remed of great use.

And accord very freq. empl. Cannot indeed do so much essent serv. in latter as in form affect.

But even in Phthis of worst kind that is tuberc. by some recom as [illegible] of radic cure.

For my own part howevr cannot say that ever saw any thing to [count] suppos. of its prod resolut of tuberc.

But at least useful as mitig cough for time & giving determ to surface.

Still more so in catarh as unload breast.

For little doubt that emet the most powerful expect.

In expect of benef. however in these ways altog. disapp.

For Ipecac though taken to quant of Ji did not oper as Emet.

Prod merely sever loose stools. An operat as cathartic a very commn conseq of alm every emet sub.

And among others of Ipecac whn given in small doses.

But perhaps more rarely than from any other emet. are disapp. in effects of excit. full vom.

While [ord] Emet. directed also simple mucil. mixt.

This likewise on idea either of catarrh or Phthis equally app.

Could not indeed in either case exp. much benef. from it.

And more fitted for cattarh in recent than in chron. state.

But in every case will at least have some effect in remov. irrit at fauces.

And thus tends to mitig freq. of cough.

Here however cannot say that in this way had much influ

For cough cont. nearly as before Patient indeed thought that after use expec more freely than before.

This however could hardly [thin] to be attrib to the med.

But state which disease now assumd, served to shew that great secret of mucus took place. Hence imag that might be adv to dimin that secret by givn determ to some other part.

This often accompl. by [encrs.] [disc] by kidney.

And to prod this effect had recourse to vin nicot as a [diuret].

The introd of Tobacco for this purp but of late date.

[Indebted] to Dr Fowler.

Since his treat have freq. used it. In no compl. more useful than chron catarh.

Prob. oper. both as diuret & sedat. For have found that even prior to encr of urine consid effect in [illegible]

Cannot however say that in [eith] way with pres pat. much benef from it.

And under use belly became very bound.

This occur. whether effect of med or not was necess. to obv.

For no doubt that by bound state of belly pect compl. in gener. but partic chron catarrh much aug.

Here as cathart had recourse to an artic from which also exp. [som] diuret. affect.

I mean comp powder of Crem Tart. This to ext of tea spoonful daily hopd might both have effect open belly & aiding Nicot in prod diures.

For this also directed to be cont. In these expect however were disap. And this prob. in part at least effect of new occur of which [informd] at succeeding report.

His having very gener. [vig] vom his med.

This effect was I own disp. to attrib. to mixt itself.

For with some very small proport of Nicot has this effect

And when consid that even [scrup] of Ipecac had no infl. shews how much variety in state of stom as affected by diff. emet. subs.

While from this however led to discont. former med, another occurr still more alarm.

Prof. sweatings during night From these conj. with quickness of pulse loss of strength & other circum now inclind to adopt opin of disease being Phthis.

And accord while Nicot prod of inconv. little to be exp. from contin.

Omitting use therefore now ordered for pat. another med more partic [illegible] [illegible]

A powder viz consist of equal parts of G. Myrrh & Crem of Tart

Of use of G. Myrrh in Phthis pract of late a good deal div in op.

While some extol use by others totally condemed.

And indeed this condemn extended to whole of healing bals. as have been calld among which G. Myrrh may cert be rankd.

Alledgd that from all [circul.] [quick] hectic parox augm.

This however attrib. by others to [them] being used without any refrig. conj.

But alleged that by such addit. incon in other resp from action on stom obv. while contin prod of good effects in other resp.

Accord strong adv for use in Dr Saunder & Dr Griffiths

But for most satisf. acct yet pub Dr Simmon

And from own exper. inclind to think fav of use.

Here therfore intent to have given fair trial

But since praescr. nothing of pat. Dissert. I am inclind to conj. [cons] of loss of strength & of progr of Phs.

But whether conj just or not prev from any farther obs. on [case]