DEP/DUA/1/43/39 (Transcript version)

Donald Mathieson

(1787-1788)

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N31 Donald Mathieson at 34

Formerly obs. that consid this pat. as lab. under compl. of affect.

And partic that while subj to dysp. affect to a very consid degree, was at same time lab. under a disease much more alarm & danger. viz Phthi. Pulm.

Hence could entert but very slight hopes of recov.

For of all affect which obj of pract very few more cert. fatal than Phthis.

And what still more deplor. see patient as it were dying by inches when he himself no appreh of danger.

But although conclus of Phthis gener fatal yet cannot be repres as univ so.

And in this as in other diseases danger in some degree connected with cause from [when] origin

And partic whether there exists tub. in lungs, a large abcess, or mere sep. of purul matter from inflammd surf.

These may I think be disting from each other by titles of Tuberc. Ulcer or Catarhal Phthis.

And of these as far as can speak comparat, 1st most. danger. last least so.

In case before us consid us as having examp. of middle kind or ulcer.

Hence reason at least to hope that hectic fever less exquis than if tuberc.

This opin of affect since patient came under care have had no reason to alter.

On contrary is I think conf. both by progress of disease & by app. which [has] since taken place.

Partic the copious purul. expector. as ment in report of 2d of Febr.

But before this took place, sympt by much most distress to him were stom ailm.

As these attended with much flatul. with view to free disch. downwards had recourse to Pil. Foetid cum Aloe.

While with view to strength tone of stom & thus allev nausea vomiting & cardialg had recourse to a mixt with veget bitters & aromat.

Soon after these med begun, his stom ailm, partic uneasin from wind, very much dimin.

But an occurr took place by which use soon interrupt.

During viol of cough in all prob. all probab. a consid vomica had burst in lungs.

And in conseq of this disch took place of consid quantit of purul matter mixed with blood.

Foundat. of this abscess prob. laid at time of former bloody expect.

And have little doubt that at time case taken was cause of pain & heat about right Mamma.

That indeed chiefly obs. when stom full.

This however probab. to be ascribd to disten of stom then prev. free motion of lungs.

But whether this case or not, now no doubt that an abscess of consid size existed in lungs.

And while after rupture had now taken place reason to think that cough would be means of disch purul. matter, was obj. to aid operat of nature, in forward healing of ulcer.

With this intent put patient on use of G. Myrrh. united with Cream of Tart

An artic which have formerly had occas to ment as of late strongly recom in Phthis.

And if can judge from own observ. [illegible] far from [reprs] it as useful in every Phthis case yet think have seen it serviceab in some.

And partic in cases of ulcer. phthis. With this med wishd also to conj anoth pract. the motion viz given by swinging.

This of late repres. by Dr Carmich Smith as most effic mode of cure in Phths

Imagines that from motion are solely to acct for benef of sea voyages.

That motion employd with greatest adv at dist from sea air.

And that while exercise a stimul. motion again a sedative power.

That while one accel [circulat] by other [renderd] slower.

Must own can by no means adopt all his reasoning on this subj.

Nor do any observ. which I have had occas to make confirm acct he has given of effic of pract.

At same time consid it as well deser. trial & accord directed in pres. case.

With our patient however has not hitherto been carried into execut.

And when consid state of weather perhaps no loss, as would necessarily have led to expos. to a cold.

Has therefore gone on with the Myrrh alone.

Hitherto however no app of any consid benef from it.

[At] same time cannot say that progr of disease very rapid.

And as know nothing promising more benef is intent still to persist in employmn