DEP/DUA/1/44/13 (Normalised version)

Janet Baine

(1788)

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N^o13. Janet Baine at 53.

In case of this patient the common symptoms of catarrh.

Cough viz & Dyspnoea, [dependent] on viscid mucus collected in lungs.

And accordingly this to considerable extent [discharged] by expectoration.

For little doubt that whole matter here spit up entirely mucilaginous & in no degree purulent.

And indeed to supposition of even tendency to Phthisis here, Pulse, heat & all other functions strong objections.

Catarrh though without fever, at present but of recent date.

Had however been subjected to similar affection during whole course of last winter

And although mitigated during summer months yet returned again on cold weather.

An evident proof of tendency to chronic state.

A form under which as have already had [occasion] to observe this affection often occurs here among labouring poor.

And under which very generally gives both an obstinate & troublesome disease.

Such it is not improbable shall find it in present instance.

Yet here occurs with some favourable circumstances

For patient neither so old that can be called Catarrhus senilis, nor so long subjected to disease, that can be considered as habitual to constitution.

For in that case cure often dangerous.

As from want of cough & expectoration very great distress produced.

And indeed only wanting when in other respects bad.

Here however nothing at least to prevent the attempting cure

In accomplishing this objectives to be chiefly aimed at are to discharge mucus already accumulated, & to prevent farther accumulation.

And is with these intentions that practices here directed have chiefly been employed.

First medicine indeed, ordered for patient, could not be supposed to answer either intention.

A mixture viz basis of which mucilage of Gum Arabic.

This as demulcent may have had some effect in taking off irritation giving cough.

And by this secretion somewhat diminished.

For no doubt that frequent agitation & efforts to excrete, given even additional [secretion]

Hence something at least might have been expected from it.

And in recent catarrh, is often product of considerable benefit.

But after continuing for week, though expectoration diminished, yet cough rather aggravated.

Concluded therefore that greater accumulation in breast.

Hence as one of most powerful expectorants have had recourse to an Emetic.

And this may occasionally repeat as circumstances found to require.

During interval have directed employment of composite powder of Cream of Tartar.

That is Sulphur & Cream Tartar united [p.a.]

This mean to give to such extent as to produce determination from breast both by some degree of catharsis & diuresis.

And if thus beneficial shall try to secure advantage by some tonic.

Probably by use of Uva Ursi.

But if this used shall explain intention more fully when come to treat of case at length