DEP/DUA/1/36/23 (Normalised version)

John Skinner

1784

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John Skinner. December. 18^th. 1784.

In history of this patients case as introduced into our register¹ but few symptoms enumerated.

These however sufficiently characterise an affection, in this country & particularly at this season of year very frequently occurs.

And particularly with patients advanced in life.

Catarrh viz in Chronic state or what with a patient so far advanced in life as present might with sufficient propriety get name of Catarrh senilis.

This sufficiently characterised both by cough, dyspnoea & state of expectoration.

And can have no doubt in [agreeing] with patient that two former affections were to be attributed to mucus to be expectorated.

And from this morbid secretion all symptoms mentioned in history of case were I think to be referred.

But besides these were at first report informed of another particular which patient had not before mentioned.

A severe pain viz in side occasioned by an accidental blow.

In both one & other of these might have had affection, not only troublesome & obstinate but even dangerous.

In general however of much less alarming nature.

And such had every reason to believe would be case in present instance.

But after has already had favourably terminated any farther observations with respect to Prognosis unnecessary.

Especially as this termination probably principally at least, affect of operation of system itself.

Probable however that in part at least proceeded from practices here employed.

Although at same time, found it necessary in treatment of case to do but little.

As at time of first prescription, pain of breast most urgent symptom directed with view to this friction of pained part with Anodyne Liniment.

An article which from combination of Camphor & opium has in allaying such pains the best effect.

And accordingly in present instance, to this the pain in a short time yielded.

But while thus endeavoured to obviate accidental pain, directed with view to catarrhal affection the use of composite powder of Cream of Tartar.

This formula [consists] of equal parts of Cream of Tartar & Sulphur.

And while operates as gentle laxative has in general also some affect in promoting free discharge of urine

To operation in these ways am inclined to attribute good effect with which [attended] in cases of catarrh.

For from determination of fluids thus taking place to other viscera that to lungs is diminished.

But whether operation to be explained in this manner or not, can yet be no doubt that here often attended with best effects.

Accordingly after continuation for space of fortnight cough so far gone that reckoned farther continuation unnecessary.

Although dismissed however in this situation yet cannot consider patient as radically cured.

And during present weather in particular readily subject to returns.

This however much more to be avoided by shunning exposure to cold than by use of any medicine.

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Explanatory notes:

1) References are made throughout the case notes to a dispensary patient register. However, no evidence has been found that this register survives.