DEP/DUA/1/11/15 (Transcript version)

John Johnstone

(1776-1777)

---

John Johnstone

Of this case still less room for doubt than [precedn]

Have no hesit in referring it to same genus that viz of Catarrh.

And from contin alone may be pron of chronic kind.

Still farthr corrob. by state of pulse appetite & belly.

May however remark that absence of fever not essent.

And were it even pres in this case would give no addit diffic with regard to disease.

This the rather ment that not imposs that may soon occur.

For in advan stages of this disease fever superveens as conseq. of affect.

And seldom even that disease proves [fatal] be suffoc till some deg. of fever has [occur]

Perhaps more freq. patient cut off by fever induced [than] [prop] [suffoc.] from mucus

Will not therfore alter opin if such should occurr although yet no evid.

Cough & diff breathing great symptoms of this disease const. by much greatest part of patient compl.

And already of two years standing.

With that remiss however which change of temp in summer very natur prod in this disea

And which patient might even enjoy throughout year if able to spend winter in warmr climate.

Is said also indeed to be affected with weakness & freq. vertigo.

These however consid merly as conseq of his diseas

Proceeding from long contin & sever of cough.

And even indicating tenden to other conseq which have already observd result from this affect.

In this view more doubtful of Prognos than in formr case.

Not merly less chance of being able to cure or allev comp.

But probab. that greater danger that may soon prove [fatal]

Is indeed an affect by which few [are] suddenly cut off.

Yet as far as my observat goes is one proving [fatal] partic to many of [labr] [por]

Partic at advanced periods of life.

From manner in which necess. to live naturally liable to the disease

And from condit of habit, together with variab state of weather as much as sever. the disease supported.

Not surprizing that when from this [com] strength exhaust should prove fatal.

Have therfore I own some appreh [that] pres patient may not even hold out for this winter season.

Must at same time howevr observe that have seen disease even to greater height hold out for sev years.

And hope that may even be able to give aid in inst before us.

Of gener princip on which this to be attempted after what just said of last case nothing need now be added.

Here also cure to be cheifly expected by by secret of [mucus] in breast being restored to natural state.

But with this patient more [expect] necess to unload breast.

And to use means promot expect.

For from diffic in this cough greatly exasperated.

And from stagnat during night [acqur] such viscid that not disch without very great diffic.

These princip will explain any [plan] of pract in pres. case

Began patient with conjunct of two med in same formul commonly known by title of expect. viz. G. Am. & Squills.

From this mixt think I have very often seen benef. as promot expect.

Nor can I by any means be persuaded of contrary by doctrine of those, who from theory disp to maintain that no expul but emetics.

Yet although expect from this med did not intend to trust to it alone

Was intent to conjoin use with repeatd emetics & with an issue.

These the means which have hitherto followd & shall yet probab pros. for some length of time.

Must evid appear howevr that intended rather with view of relieving sympt than for radic cure.

And own that till sympt much relievd & breast unloaded should here be suspic of any remed dimin secret.

As would have reason to appreh. bad affects from restraining excret.

If however can obtain consid ease to patient may probab. make some [attemp] in this way.

May use on princip which mentioned in preceeding case, the Peruv. Bark.

Or may have recourse to other astring either from veget or min kingdom.

Is indeed cheifly from lattr that by introd into alim canal effects can be expecteded to be exerted over whole system.

Yet pres case requires from many circum that should proceed with caution

And I own that at commen at least at commen would be unwilling to try any strong astring.

One of vegetab astring which in such a case as pres. might I think be ventured on without hazard.

I mean the Terra Japon.

This long supposed an earth. now known to be a veget extract.

And prep. from species of Mimos.

Of astring powers on alim canal am well satisf.

Not however so certain that from [them] exerts affect on syst. in gener.

At least not so viol as to give ground for appreh.

May therfore introd this [as] part of pres treatment

And if find any benef from it may [have] recourse to more active astring.

Upon whole howevr greater probab. [that] shall never obtain suff. releif of sympt for venturing on use

And more than probab. that may rather be our object to think of other mean of allev. these.

After what already done however at a loss to think what can be employd with this view with greater probab of success.

May indeed have occas. recourse to blister as well as emet.

And may substit colchic to squills & G. Ammon.

But upon whole without more certain defence against cold whether by clim cloathing or lodging little to be expected

And disease may even be aggrav in spite of all efforts.