DEP/DUA/1/45/22 (Transcript version)

Peter Paterson

(1788)

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N^o19 Peter Paterson. at 25.

When formerly spoke of case of this patient expressd doubts with regard to it.

And although contin under care for upwards of two months, now nearly in same state of uncert as before.

Was however evident that [most] lead sympt. consisted in pector affect comb. with hoarseness.

And was inclind to hope that might be merely an example of [Parass] catarrhalis, as stild by Sauv.

At same time from contin & [comp] of affect, some reason to be appreh of Phthis.

A disease which while not unfreq. arises from catarrh [influ], well known to be of insid nature.

And in many inst accomp with loss of voice in diff ways.

Reckond it therefore necess to have both in view in pract.

Began treatm by direct for this patient the use of an oily mixt.

This consist of olive oil diffus in water, by means of veget alk. [Salt] of Tartar as comm calld.

Here need hardly observe that was from oil alone that lookd for any benef

And that alk empl only to prom union with water.

Nor need I add that such an [union] effected by saline subst of diff. kinds.

Most freq perhaps a prop of volat alkaline spirit is empl.

But from this a pungen given to the mixt often disagreeab.

Which however few stom in this [const] at least able to bear

Hence for my own part, very gener preferr mild vegetab alk. as giving more pleas mixt

An union indeed with water may be affected by artic still more mild

Such for ex as veget [mucil], sugar or syrup, or yolk of egg.

And accord with these oily [illegible] are freq formd.

But with these [intermed], union [when] merely mechan much less intim.

And when separat takes place a fresh union less easily obt.

Hence does not so readily answ intent, of prod diffus of oil, which may easily sit upon stom.

And in oily mixt this great obj in view

For otherwise more advant may [certain] be expectd from oil in pure state.

But oil, when swallowd in any form, well known well known to be one of most powerful means of lubr. fauces.

Accord as a pect med, or rathr as a remed in catarh affect, is every day in use.

And partic benef where much affect of voice in way of hoarsness.

Indeed often empl. as remed for affec of voice of diff. kinds.

And may even add, that where Aph. or Paraphonia has occurd as curab. disease, am for my own part unaq with any med from which greater benef. may be obt.

At same time must allow, that greatr part of these, which I have had opport of treat in pract have baffled all efforts I could empl.

And patients have left me in no bettr situat than came under care.

Hoping however that pres might be of less obstin nature here expected some benef from this remed.

Did not howevr find that soon prod of any change for better.

For although cough rathr easier yet hoarsness nothing [reliev].

Still however relief of cough no ground for [giving] removing appreh of Phthis.

And when consid, that affect had commen from influenz. was even inclind to fear that of tuberc. kind.

By this consid had here recourse to mixt of Cicuta & Bark.

A combin from which in some inst of scroph. have I think seen advant.

And most if not every tuberc Phths of this kind.

Here however consid affect as a [sequel] of Influen. had still anoth reason for empl. it.

For reason to believe that after this as well as after some inst of Pertussis cough supported, by mere morb. irrit.

But as remov. this the sedative [power] of Cicut. united with tonic pow of Peruv bark, may natur be supp. to have consid influ

And in actual pract have I think seen matter benef from it.

On both these grounds then had recourse to it in pres. inst.

And was at same a remedy which without smallest inconv might be cont in conj with other.

Cannot however say that from this any more flattering prosp of advant.

On contr. not long after use begun sympt of Phthis even more alarm than before.

For although hoarsn somewhat dim yet pulse became more quick.

In so much that in gener exceedd 100 in min.

While at same time much affected with sweatings.

And tongue also app remark clean espe at point.

A circum always unfav in Phthis.

And indeed very comm the attend of some degree of purul expect.

Still however did not see that any meas could be pros. with greater adv. than those formerly directd.

But anoth occurr now took place which seemd to claim some attent.

Became affected with flying pains in diff. parts of his body.

These from transit nature did not consid as alarming.

But from sever. were at least very distress.

With view therefore to tempor. allev. directed frict with Anod Bals.

And this seemd at least to be attend with desired effect.

For after frict became consid [easier].

In this situat contin of use seemd improp.

As might natur expect greater benef on renewal after interm.

Still however cough & other sym contin much as before.

Directed therefore contin both of oily mixt, & of bark with Cicut as formerly.

During time for which this course has now been cont, cannot say that susp of Phthis eithr conf or removed.

But upon whole appreh by no means dimin.

And I own my expect from med are not great.

And after trial already made without success, am inclind to think that patient may look for more benef from country air, milk diet, & gentle exercise than from any remed which we can recommend.