DEP/DUA/1/14/01 (Transcript version)

Katherine Halley

(1777)

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Kath Halley.

Affection to which this patient is subjected one very freq. occuring.

And in case before us while distinctly markd is at same time without any complicat

When came under our care most distressn part of compl. consisted in diff. respir.

This at same time attended with freq. & troublesome cough.

And by that cough expectorated tough viscid white coloured matter in consid. quantity

From this last appeard that state of secret. by lungs diff. from natur. condit.

And in this I appreh. suff. cause for affording explanat of all other sympt.

Must look upon cough to be affect of that irritat which accum mucus [occas]

While at same time consider diff. of respirat to proceed from cir vessels vesicles of lungs & even shall ramificat of trachea being filld with matter prev. access of atmospher air.

Suppos. therefore augm secret. of [mucus] thus far [concernd] in prod all other sympt. natur. led to consid case to be catarrh

And when attend to durat. of disease as having now in some degree subsisted for near space of ten six years must necess consider it as a chronic affection.

This would even do were condit of functions indic affect of system in general, diff. from what here cure

But with pres. patient, heat & appetite two of princip circum from which can judge of pres or absence of fever in natural state.

Pulse indeed [somewhat] affectded.

90 pulsat in minute more than nat look for with a woman of 50.

This however naturally to be expectd where respirat so much impeded.

For diffic of performing this [function] leads to freq of action.

And indeed to be remarked that [where] breathing affected in this manner for number of years for most part leads to irregul of pulse.

For [such] irregul. on dissect a [suffic] cause in general found.

Appear. that diffic respirat induce even diseased state in large blood [vessel].

These often [affectdd] with distensions aneurisms or like.

And sometimes containing also found to cont. large & firm polyp. [conect].

Although howevr with pres. patient has not proceeded this length yet may [reason] consider affect. of breathing to be [cause] of quickened circulat.

And notwith. state of pulse therefore view disease of patient as totally of chron. nature

In inst before us from age of patient might bestow upon it common term of catarrhus senilis.

This applelat howevr consider as less proper since affection will often even occur with young people.

While therefore little diffic as to nature of this patients disease would distingis it by term of chronic catarrh.

An affect freq. occuring in this country probab. in some measure from vicissitud of weather coldness, but still more from vicissitudes of weather

And although not entirely confid to aged yet princip occurring with these.

Probab. from state of circulat on surface being with them less free.

And from want of those exertions by which can be properly supported.

From nature of this affection in [general] must appear that by no means without danger

This must necess. be case where a function so essent to life immed affected.

Yet in cough though in some meas. distressing to patient have in some meas as it were natural tendency to cure.

And although no influence as [prevent] return of cause affecting [breathing] yet gives immed removal.

Hence may in general observe that an affection much more tedious than dangr.

Such it had proved in pres. inst. even before came under our care.

And after having subsisted for space of six years could not look for easy or immed removal.

At same time no circum from which thought any [reason] to appreh. danger.

When fatal termin is for most part conseq. of constit being broken by excessive fits of coughing.

To such howevr pres patient could not be consid as subjected.

And hitherto as have already observd disease had but little affected gener. [health] of system.

Might indeed by imagind that in cause of affect before us somewhat pecul.

And this a circum in every inst to be taken into acct. in giving prognos.

Very univer. this disease derives first origin from imprud expos. to cold.

And afterwards in general supported by inclem of weather.

In inst before us, affect as is [common] observd to be much aggrav. during winter months

But ascribd to a cause seldom under that affect.

Want vizr of menst. discharge.

At least dated by patient from time menses left her.

Which howevr not soonr than the usual period

At same time observd that although affect. then [commenced] had been much aggrav. three two years before ago.

And that then patient exposed to much anxiety & distress of mind.

Both these circum patient herself imagind had share in inducing affect.

And will not pretend to affirm that for these no foundat.

At same time reckon it more probab that was prin. if not entirely in case before us, affect of common cause

viz Influence of cold.

Look upon these therefore as nothing unfav in prognos.

And from condit of patient in every [resp.] joind to season of year, thought that ground for hoping compl. might at least be allev. under our care.

These expectat I appreh. not altogth [disappointed].

For since became our patient both breathing & cough consid relievd.

And hope that from contin of med but still more from warm or at least mild temperat. affect. may be still farther mitigatd.

This however not sufficient to secure against fresh attack on ocurr return of winter.

And should we even [wish] dismiss patien cured reckon it by no means improbab that cold weather will bring back compl.

And perhaps with those who can afford it is of all others the most effect. practice to direct their spending winter in a warm climate.

Know few diseases in which change of climate of more matterial service.

But with one in rank of our patient such a recommend inadmiss.

And attempts to cure must entirely turn on such regim & med as can here be put in practice.

In this disease great object in cure is to restore secret to natural state.

And this unquest. to be consid as most affect. means of prev. accumul.

Restorat of secretion to natural state must turn on two partic.

Condit of secreting vessels.

And condit of supply of fluid at these for secretion.

These ends would lead to use of various med.

Partic means of allaying inordinate action & of prod. determin from breast.

And on these general principles various practices in common use.

Though such however most affect. means of cure yet not always most ready method of obt. relief.

For this purpose mucus already accum must be disch.

And before can expect to restore natural state of secretion must endeav. that be evacuated as accumulated.

Is with view of obt. this end that only med which have here employd has been used.

That is the Squill pill.

Have little doubt that stimulus of this vegetab. after entering circulat. capab [of] acting as collected at secret. of mucus, as well as of urine.

In this way indeed may be supposed rather to have bad affect as otherwise in augm. secret.

But this more than compensated by augm stimul to excretion.

And have little doubt that in inst before us has thus prev [accumul] in lungs when would otherwise have taken place

And to this together with warmer weather would ascribe all releif which patient has had.

If cont. in same easy state [should] not probab think of altering plan.

If grows worse may have recourse to emetics or issue.

But am hopeful that in place of these practices may soon venture to dismss her.