DEP/DUA/1/34/04 (Normalised version)

James Frazer

(1783-1784)

---

James Frazer February 14^th

This patient you will observe still at a very early period of infancy.

And hence incapable of giving any account whatever of feelings.

From these circumstances often difficult to form any proper idea of complaint.

And no less so to have recourse to practices by which will be much benefited.

In case before us however several parts of affection were obvious.

In dyspnoea & cough to which he was subjected had evident catarrhal symptoms

While vomiting & looseness showed also affection of alimentary canal.

Had for my own part no doubt in considering both one & other of these as affects of cold.

And that not merely proceeding from inclemency of season but from coldness of habit.

Can be no doubt that from both these affections infants frequently cut off.

And from aggravation of either a fatal conclusion may yet occur.

But [neither] when came under our care to such height as to give much alarm.

And from mitigation of all symptoms which have now taken place may soon I think look for favourable conclusion.

This I am inclined to think in some degree at least effect of treatments here employed.

When came first under our care in exhausted state in which then was, frequent loose stools appeared to be one of most urgent symptoms

And to mere weakness indeed consider Dyspnoea as in part owing.

Seemed in first place requisite therefore that discharge should be moderately [checked].

And was with this intention that had recourse to a mixture of which the basis was Confection Japonica.

This article consider as one of mildest & safest astringents to which can have recourse.

But besides astringent from extract Japonica, contains also a small proportion of an opiate.

And hence influence as allaying tendency to inordinate action in alimentary canal

From use therefore expected mitigation of vomiting, as well as of looseness.

And with children in particular has often best effect in this way.

In case before us attended I think with evident good consequences.

For as soon as began use looseness diminished

And in a short time entirely left him.

This also, not only favourable change which took place

For breathing also became much easier

Had not however equal influence on vomiting.

For still subjected to frequent attacks of this.

While at same time cough [nothing] diminished

Was likewise rather frequent tickling & short cough as expressed in history, than [apparently] attended with much separation of mucus.

To this cough was inclined to think that vomiting might in some degree be attributed.

For besides what happens in cases of Pertussis no doubt that with infants in particular the one inordinate action apt to excite the other.

In place therefore of Confection Japonica which seemed no longer necessary had recourse to a mixture with a view to cough.

As basis of this had recourse to mucilage of Gum Arabic diffused in water

From which as lubricating fauces often best effects as allaying irritation there.

But still more effect to obtaining this end added a small proportion of Tincture Thebaic

From this medicine however did not immediately at least obtain desired effect.

For at succeeding report found that cough & vomiting still continued.

In other respects however patient continued much easier.

And while no return of looseness appetite for food somewhat mended.

Seemed unnecessary therefore at least for some time to adopt any other measures.

Hoped that by persisting in employment end in view might yet be accomplished.

And accordingly at last report found that from continuation of use had been free from vomiting.

From persisting in employment especially if conjoined with milder weather which every day reason to expect, am in hopes that cough also may be removed.

But if in this disappointed may try effects of Emetic or blister

But at same time with an infant at so early period of life & so much exhausted as this has been shall be better pleased to avoid both.