DEP/DUA/1/37/17 (Normalised version)

Robert Cowie

1785

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Robert Cowie February 19 1785

Of this patient since first prescribed for him here have seen nothing.

As has hardly therefore been subject of practice reckon it necessary to say but very little respecting case.

Especially as in symptoms nothing uncommon or peculiar.

Can hardly however venture to add nothing alarming.

For although inclined to conjecture that favourable termination has now taken place yet was not without doubts respecting it at commencement.

Affection consisted entirely in pain of breast, cough, dyspnoea & difficult expectoration of viscid mucus.

In these have the symptoms which occur in every instance of catarrh

And when consider that affection had subsisted for space but of few days that attended with impaired appetite & considerable thirst, could have no doubt in considering it as in acute state.

Such affections in no long time have in general even of themselves a favourable termination.

From these alone therefore should not have been apprehensive of danger.

But here to be remarked that combined with [distortion] of chest.

A circumstance, which has always been considered as giving predisposition to Phthisis

And that affection here the rather to be dreaded, from remarkable palpitation mentioned in case.

For from these joined with severity of cough in narrow & difficult breast had reason to be apprehensive that haemoptysis might be induced.

At same time if severity of cough allayed had no less grounds to hope for speedy recovery.

Was with this intention then that had recourse to practices here employed

Directed the application of a blister to pained part of breast.

From this hoped that if pain in any degree effect of internal inflammation might be mitigated

That by giving determination to the part affected might alleviate both cough & dyspnoea.

And that would give temporary alleviation of all symptoms by taking off affects of uncommon irritability.

While however thus aimed at mitigation imagined also that might not be improper to endeavour to counteract effect of irritating causes.

And with this intention had recourse to a mucilaginous mixture.

To which as means of allaying disposition to inordinate action added a proportion of the Tincture Thebaic.

But whether these practices have been employed or what affect has resulted from use have never learnt.

Reckon it however most probable that affection had that favourable termination which often occurs in catarrh even without aid of any medicine.