DEP/DUA/1/11/08 (Transcript version)

Edward Byrymner

(1776-1777)

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Edward Brymner.

Disease very distinctly markd.

And at same time one not less freq. than troublesom & obstin.

With pres. patient not to same heigh as with some others under care.

Partic in case of J. Johnstone who lab. under same affect.

From this variety in diff stages has diff. names

Not only among vulg. but even among people of science.

Thus with pres. patient some would referr it to head of cough.

For by most nosol. Tussis rankd [amon] genera of diseases.

While in case of Johnstone might [from] diffic of breathing being greater be referrd to genus of Asthma

What has been termd Asthma Humid.

Cannot help thinking howevr that these appellat improper.

And that both diseases not only of same genus but even same species.

In my opin pres & simil affections of which at pres sev. instances under care to be referrd to title of Catarrh.

Do not indeed corresp. to catarrh as defind by sever. author

And as referrd to class of Pyrex.

Cannot help thinking however that this method of arrang. except.

And if merly consid profluv. as morbid encrease of natur disch. form an order of diseases among which great affin.

These either may or may not be attendd with fever.

When however occurrs not to be consid as essent. but merely as accid sympt.

Taking profluv in this sense would referr catarrh to it as being an affect the essent. part of which consisted in encrease of mucus disch. by lungs.

And either may or may not have fever.

One species of Catarrh indeed which may seem strong object to this

And in which fever probab. essent. part of disease.

What I allude to is the epid. catarrh.

This however cannot help thinking with great improp. referrd as species of [this] [Gen].

Is evid a disease which in nature no essent. agreement with catarrh from cold.

Depends upon a pecul. febrile [illegible].

And no more analog. with catarrh from cold than small pox with cutan erupt. having some resemb. to them.

These observat respecting nosol. of catar reckond necess. before giving name to this disease.

And in view now given of it case of pres. patient without hesit to be referrd to it.

Is sufficiently character by copious viscid expect.

For can be no doubt that troublesm cough merely conseq. of accumul of this matter in breast.

Will occurr however as second quest. how far gen. now defined of diff. species

And to which of these pres. case to be referrd.

Must own that am one of those who reckon multip of species of disease both unneces. & improp.

True indeed that gener. cure will be no means apply to all cases [falln] under it.

But neither will cure of species apply to all varieties.

And in practice cure must in every inst be adapted to pecul. of the case

Would only subd in gener. therfore by great & leading marks.

And here two condit which [requir] being disting.

That is whether disease occurrs as acute or chronic affect.

In first case appears as almost immed affect of partic accid.

Is attended with consid degree of fever

And in no long time terminates either in health or in some other affect.

Of all others most common sequel are either phthisis or chron catarrh.

Any observ on former hear out of place

And at pres more than one instance under care which will afterwards lead us to consid.

By latter chron catarh understand encreased disch of mucus by lungs without fever.

And most commonly without any degree of inflammat.

This disease as I observd at commen both common and troublesome.

And as such is subj. of discussion with most pract. authors.

Commonly disting by appellat of Catar Sen

And cannot be refused that is chiefly a disease of old people.

Yet as sometimes occurs at early period of life consider chronic catarrh to be less except name.

And indeed could hardly be termed senilis with pres. patient a man not 50.

From these diff. consid then would say that Edw Brymner is affected with chronic catarrh.

A disease in the end often proving fatal

But for most part not suddenly so.

Rather by wearing out constit than in any other manner.

Although sometimes indeed kills by immed suffocation.

With pres. patient however has not gone to any great height.

And strength little impaird.

Besides not yet arrived at very advanced period of life.

Hence some grounds for hoping even complete recovery.

More probab. however that will not be able to rid patient of all remains of disease.

But that will continue more or less to be affected with it during winter season.

Hope however that under prop. treatment compl. may at least be consid allev

Partic if situat of patient at home can cooperate with our meas.

In this affection great object must be the restor of secret. to natural state.

And princip means of affecting it is by dimin determ to lungs.

Hence no less necess. to avoid cause promot. determin there, than to use such means as will encrease flow of [blod] to othr parts.

Of all causes determ to intern viscer. most consid is cold to surface.

Hence this affect. unif. observd wort worst during winter months.

And one of these in which passing winter in warmer climate of highest utility.

Where that as in pres case unattain cold partic to be guarded against by prop cloathing & comfort. lodging.

As by this means uniform circul. cheifly to be supported.

But besides this breast also relievd by encreasing flow to neighb. parts.

And with this view nothing more perm good effect than some drain in form of issue or setton.

With same intent also Emet often useful

Have partic effect of giving powerful determ to surface.

Although indeed not perman.

But in this disease farther serviceable from anoth circum.

Uneasy sympt although ultim from encreased disch. yet more immed the effect of accumul. mucus in breast.

Hence consid relief from all means unloading breast by promot expector.

And with this intent no remed [more] immed serviceable than emetic.

These however at utmost to be repeatd only at certain intervals.

Hence relief to be expected from some thing more perman prod same affect.

And with this view if be any such would naturally think of these remed which after collect at lungs produce tend to excret.

Exist of all such indeed some med writers are disposed to deny.

But must own that cannot help holding on this subj. a diff. opin.

Can see no more diff in supposing it possib that effects of med entering circul should appear at secret. organs by breast than by kidneys or saliv. glands.

And am farther persuaded that such an action confirmed by observat.

Partic observ from effects of many of same subst. which after introd into circ system shew effects on kidney.

Such for example as squills.

And have affect in relieving compl. by affording addit stim to excret.

While aid expectorat seem also to produce change on state of secreted [mucs]

And as excreted is evid of less viscid & tenacious consist.

This probab. not effect of any alterat on state of mucus as excretd secreted.

But happens merely from excret. occurring before in conseq. of stagnat viscid [acquird]

By these means therfore although little tenden to cure yet of consid serv as allev. the disease.

On these gener. princip have begun & mean to conduct practice in this case

viz By Issue by Squills & by repeatd Em.

Last however to be used only occas

That is when from much diffic of breathing reason to suspect consid load on breast

Hope that by proper use of former these may be less necess.

And indeed know no med. from which greater reason to expect consid benef.

May indeed change drain to diff situat or to diff form.

And with squills may conjoin G. Ammon or Assafoetid.

Or may subst. to it one or other of these.

But such changes excepted will probab make no other unless from circum of disease with which are not at present acquainted.