DEP/DUA/1/46/24 (Transcript version)

John Sutherland

(1789)

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John Sutherland. at 40. N^o5.

Formerly repres case of this pat as being in some degree of compl. nature.

While viewed cough & dyspn as being catarrhal sympt. lookd on pains of head & breast as being of Rheum kind.

And From any thing that have since had occas to see of case no reason to alter opin.

And indeed some confirm of opin that to treatm directed with these intent disease in no long time yielded.

Began by direct for him what in Disp pract we call comp. powdr of Guaiac.

This consists of equal parts of Guaiac & Crem of Tart rubd togeth.

And is in my opin one of best mode of exhib the Guaiac.

Guaiac I need hardly observe has been long celeb. as a remed in Rheu cases.

And given under variety of forms as acted upon by diff. menst.

As for ex under that of Decoct.

For as far as decoct of woods, any med prep, farther than that of mere [deliv], is unquest to be ascribd to Guaia. diff in water.

In this way however very small prop only of resin matter can be introd even in large quant of the fluid.

Accord diffus attempted in water not by boiling, or interv of wood, but in state of pure Gum.

But in this every comb very diff.

For although has name of G. Guaiac yet in reality much more a resin [sub].

Accord cannot admit of even temp. susp. in water, without aid of some gelat matter as mucil, yolk of egg or like.

This therefore has lead to solut in spirit menst.

And accord has been often exhib as dissolvd in Rum, Brandy, Spt of Wine, Volat alk Spirt & like.

These menst the basis of simple & volat tinct entering our Pharm.

And I need hardly remark have often been highly extolld in Rheum case

Partic by late Dr Dawson of Lond who has written profess. with intent of recomm this remedy.

He however, in my opin, has gone much farther in praises than ought to have done.

And to form just estim of affects must recomm to you not merely the perusal of his work, but also the strict on his meth of treatm pub. by Dr Sanden.

But without entering farther into subj. can in my opin be no doubt, that a spirit menst. still more a menstr of volat alk. spirit in many cases highly except where Guaiac otherwise useful.

And besides this very much [illegible] dose.

While perhaps may be added as a still farthr obj. that to most indiv very disagr. to the taste.

All these obj in my opin very much removed by giving it under form here directed.

And from what have seen of its affects have for my own part no doubt that when prev divided by Cream of Tart suffers ready solut in alim cana.

This I think abund app. both from operat affects as encr. disch by surface & opening belly.

And also from benef derivd from it in disease.

Is I apprhen on these grounds that to explain benef from it in Rheum cases.

But besides rheum hoped also that in these ways might here relieve the catarrhal affect.

For by disch ment, determ also given from lungs.

But besides powder of Guac. directed also at same time for pat. the Theb. pills to extent of gr X at bed time.

In this quant. one gr of opium cont. a suff. dose for those not accus to use.

From this also expected some benef. both with view to Rheum & Catarrh.

Need hardly remark that no med more powerful than opium, in proc sleep & mitig pain.

And whatevr disputes may subst as to its being either stim or sedat. no doubt that every day empl to prod sedat affects

But while hoped that might thus have quieter nights exp. also that would allev. catarhal sympt.

For cannot be quest that is powerfu means, both of taking off affects of irrit & of dimin secret.

Is indeed it must be allowed except in some cases of catarh from [check] expect.

And if this happens, while secret remains, no doubt that attended with best worst affect in augm dysp.

But such cases excepted is highly useful in chron catarh.

And here trusted that any inconv resulting from it, partic tend to bind belly, would be counteracted by the Guaiac.

In affects of these med may now venture to say, were not disapp.

Is indeed true that comp powdr of Guaiac had not obv. oper which might have looked for.

But under use in conj with opium both cough, dyspn, & pains, were much relievd.

And had hopes that by contin might have been entirely rem.

But while former compl thus allev. became subj to an affect in some degree new.

For with contin of headach had consid inflam of eyes.

As a means of allaying inordin action which had here taken place, ordered a saturn solut by way of colyr.

From this need hardly obs. that in slight ophthalm best affects prod.

Here however would app. was inadeq to remov of affect.

In addit therefore to other med directed applic of blister between shoulders.

And to give more perman deriv from head, advised its being kept open by issue ointm.

That from such deriv good effects would have been obt. strong reason to presume, from almost immed relieve which thus afforded.

And perhaps not less, from return both of headach & ophthalm when blistered part allowd to be heald up.

From this therefore naturally lead to repetit of blister.

And again seemd to be attended with same salut conseq.

By this means while headach removed, was now also free from all other sympt.

Consid farther attend therefore as unnecess & accord dismissd him.

May conclude with observ. that look upon his recov. as being prin at least the effect of remed here empl.

But must at same time add that at this season of year can with no confid prom a perman cure.

And would by no means be surp. to find, that on imprud expos to cold patient had again recurr of all his compl.