DEP/DUA/1/42/18 (Normalised version)

Jean Robertson

(1787-1788)

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N^o18. Jean Robertson at 36.

In symptoms of this patients affection have evidently a [complication] of diseases.

And these too requiring different [perhaps] in some respects opposing modes of cure

Hence shall not probably find it an easy matter entirely to overcome affection.

Some of them however, which may at least hope shall be able to alleviate.

Of all her symptoms the most distressing are her pneumonic affections.

For to this class may refer pain of breast & side, cough, dyspnoea & viscid expectoration.

These here take place to very [considerable] degree

And particularly distressing to her during night

But no reason to think that are anything else than catarrh.

At least does not here occur [those] particularly giving suspicion of Phthisis.

No indication here either of purulent expectoration or hectic fever.

While age of patient state of pulse & state of expectoration all against supposition.

Would consider this part of affection then as example of chronic catarrh

A disease which well known very difficult to combat at this season of year in this country & among lower class.

But in other respects symptoms in case of our patient not unfavourable.

For unless with old people & as a habitual affection seldom fatal.

And patient yet far from that period of life at which most apt to become [such]

While however patient subjected to some affection referred to breast is subjected also to others referred to head.

For not only severe pain in fore part of head, but this accompanied by vertigo sometimes even followed by syncope.

In this at loss determine whether have an affection properly idiopathic or only symptomatic of other complaints.

Am however rather inclined to latter supposition.

For headache & vertigo not infrequently consequence of severe cough.

Still oftener however of another set of symptoms to which patient also subjected viz dyspeptic symptoms as indicated by cardialgia, nausea, vomiting & flatulence

With these symptomatic headache if not constant at least very common symptom

And particularly as thus occurring often accompanied both with vertigo & syncope.

Here therefore viewed catarrhal & dyspeptic affections, as those chiefly to be combated.

But besides these may be thought that should here take notice also of another.

State viz of menstrual discharge. This we are told while returned at shorter interval also to greater extent than natural.

[There] however none of other symptoms of menorrhagia.

And perhaps to be considered as merely constituent to patient.

Practices therefore hitherto directed to two former affections.

And after [prescribed] use of vomit have directed mixture of Vinum Nicotiana with Bitter & Aromatic Tincture.

But remarks on practice reserve to future occasion