DEP/DUA/1/12/20 (Normalised version)

James Grewer

(1776-1777)

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James Grewer.

Case of this patient room for very few remarks.

While little ambiguity respecting the disease complaint at same time very slight.

No doubt that greater part of his disease a catarrhal affection.

And as when come under our care had continued only for space of fortnight could not properly be reckoned of chronic kind.

Yet inflamed state evidently over.

For now thin mucous discharge had entirely ceased

And was without that pain of breast or throat with which inflammation attended.

Disease even seemed to show some tendency to chronic state.

At least of this indication, in quantity, viscidity & colour of mucus

And still farther evidence of tendency from discharge taking place principally after sleeping.

Considered these principally part of affection as catarrh which if neglected would degenerate into chronic state.

But besides this, subjected also to another complaint.

Pain viz at times occurring in his bowels

From transitory nature however could have no doubt in considering it as of spasmodic kind.

And in all probability as dependent on wind.

Of which indeed afterwards stronger evidence in progress of the disease.

This complaint totally unconnected with catarrhal affection

And indeed had been of longer continuation

But never to such height as to lead him to apply for aid.

And probably had it not been for catarrhal affection would not have thought of doing so.

With regard to this complaint then although reason to presume that of two would be most obstinate yet no grounds for being alarmed

And was in hopes that every part of case would soon have favourable termination.

That this has in reality been the case may I think with some degree of confidence presume from patients having left us when complaint greatly alleviated.

Practice in this case at first totally directed to catarrhal affection

Exhibited emetic with view of discharging all accumulated mucus from breast.

And at same time of producing determination to surface.

This ordered to be followed by use of a solution of Gum Ammoniacum with squills.

From which hoped that by gentle stimulation to lungs regular expectoration promoted & by this means excretion equal to secretion.

Thus hoped that both cough would be mitigated & future accumulation prevented.

In this hope were not disappointed.

Vomit operated freely, cough became easier & during continuation of solution of Gum Ammoniacum that at last time he visited us only complaint from wind in stomach.

In this situation thought it unnecessary to continue solution.

And for wind in stomach gave him some of pill Gummosae

Which from assafoetida Galbanum & other articles they contain perhaps to be ranked among best carminatives.

What affect of these however have not learned.

But as patient has not returned may presume that if did not remove, at least alleviated complaint.