DEP/DUA/1/32/38 (Normalised version)

James Ingram

(1783)

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James Ingram. No 17^th

Disease to which this patient subjected somewhat of complicated nature.

Was subjected to cough & dyspnoea with such a state of expectoration as evidently [showed] a catarrhal affection.

And this as is indeed commonly the case with such affections begun during the winter.

But besides these subjected also to an affection of later date.

Pains viz in different parts of body but particularly in the back, the neck & the head.

These complaints when came under our care, of about ten days standing & attributed to cold.

From these different circumstances, could have no doubt in considering them as of the Rheumatic kind.

When however so free from fever were necessarily led to view them as depending rather on peculiar irritability than on state of active inflammation.

From this idea of affection, naturally led to form favourable prognosis.

For even from season of year alone reason to hope for recovery.

While by this also grounds to expect that catarrhal affection would be diminished.

For nothing more common than to find such complaints although periodically returning during winter, yet altogether removed during summer months.

Hoped therefore that even without aid of medicine, both affections would soon be terminated.

At same time by proper measures had reason to expect, that this might at least be somewhat accelerated.

Of the two complaints we have mentioned the Rheumatism was evidently the most urgent.

This therefore claimed first [cause]

And as means of diminishing irritability & alleviating pain had recourse to most powerful sedative with which am acquainted use viz of Opium.

This taken to extent of grain at bed time had effect not only of mitigating pain but also of alleviating cough.

Had hopes therefore, from first trial, that by continuation, cure might soon be accomplished.

But while alleviated cough had reason also to apprehend that would tend to check discharge under form of expectoration to which system for some time been habitual.

While also well known to have influence as binding belly.

From both these considerations then led to conjoin with it use of a gently laxative electuary formed of Cream Tartar & Sulphur

Though this however had effect of opening belly & though cough much mitigated yet headache continued

By this led to application of Blister

And in consequence of free discharge at last report found headache much alleviated.

At same time however electuary had rather more effect than could have wished in opening belly.

This therefore as well as Opium was directed to be intermitted.

And have put him on use of Red Peruvian Bark from which hope will soon be able to dismiss him free from all complaints.