DEP/DUA/1/45/03 (Transcript version)

Isabel Middleton

(1788-1789)

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N^o22. Isabel Middleton at 39.

Of disease of this patient at a loss to form any decided opin.

And several diff suppos. may on prob. grounds be entert. with respect to nature of affect.

Chief sympts those which the common occurr in catarrh.

But well known that between catarrh & phthis often diffic to form a distinct.

And here some appear. giving at least ground for alarm.

Such for ex as debilit, feebleness of pulse, want of menst. &e.

May perhaps among others [men] alledged sympt of intermitt fever.

For with this hectic fever often confounded.

And partic at comm. patients often flatter themselves, that entirely of that nature.

Here howevr if these had been sympt of interm hectic, should have expected that would rather have been encr. than dimin.

And alleg of former interm leads to still third suppos.

That viz pres affect to be consid merely as sequel of that disease.

With this uncert as to nature can say nothing of prognos.

Upon whole however look upon suppos of catarrh as most prob. & and inclind to expect fav term.

For obt this, have in first inst at least had recourse to treatm of catarrh

But in future pract. must be directd by circum & future opin.