DEP/DUA/1/24/02 (Transcript version)

William Robinson

(1780-1781)

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Wm Robinson.

When case of this patient at first introd into register at some loss with regard to disease.

From method of attack so suddenly during night.

From singul. diffic of breathing.

And from pecul noise with which attended some grounds for susp, a disease often suddenly fatal in this country viz. Croup.

An affect respect nature of which many disputes.

For while some consid it as spasm & reffer to head of Asthma, others as stren contend, that of inflam kind, & refer to genus of Cynanche.

But what ever may be diff as to nature, none with regard to diagn of affect.

Such disting from other affects by pecul croak sound in inspirat.

Of this howevr pract. must always judge, rather from having himself heard it, than from any descript.

When patient brought to us [altho] pecul hoarseness still remaind, yet yet nothing which could be calld croup.

And indeed no more than freq. observd in many catarrh affections

From trust to descript alone then could not here speak with cert.

And indeed from event, is now more than prob., that even from begining no attack of Croup.

Cannot it is true pos. assert that such is the case.

Croup may have existed [though] Cin cough has since succeeded.

For now no doubt that this the disease to which patient at pres subjected.

Well known that chin cough often begins in forms very diff from what calld regular state.

And though not distinct markd at begining yet even then some presumpt of it from the disease then prev among neighb. children.

At pres no doubt with regard to disease

Distinct markd both by appear of fits of coughing – by kink or back draught - & by succeeding [vom]

Must hold chin cough therefore to be only affect to which observ. either on Progn or Pract to be applied.

With regard to termin cannot at pres speak with great certainty

Several circum in the case rather unfav as otherwise

Patient from begining affectd with consid degree of fever.

And although disease new formd, that fever rather encreased than dim.

Fever however, next at least to inflam affect of breast, reckon most danger appear.

And not unfreq. a fatal conclus.

Besides this age of patient unfav

In case of some other epidemic contag, is of conseq. that patient should be affectd at early period.

But with this disease on contrary is a matter. circum that before attack, patient should have cons. vigour.

And much more fatal in early infan, than at any other period.

With our patient therefore still in second year, more to be appreh than if farther advanced.

But if these circum unfav, others again of contr nature.

Now disease is what is calld distinctly formd.

And after this, at least danger of inflam affect of breast less, than before it

Besides this anoth partic still more in fav of our patient.

That is ready termin of fits in vomiting

When this occurrs, has in gener. effect of putting period to fit, without distress. patient.

And of all sympt in chin cough, is in gener. reckond one of most fav.

In so much that after this vomiting once begins, with many, danger of chin cough is thought to be passd.

Although far from being of this opin, yet look upon it as a fav circ.

And would fain hope that with prop manag. disease may be overcome.

For this purp. however will not prob. be in our power to employ remed, with that regul. which could be wishd.

For while patient conf. to home at comm. of disease, & has within these few days been remov. to country at some distan. from Edin.

Such removal a pract. from which am inclind to think more good affect may be derivd than from any thing we can do.

Here however benef. by no means to be attrib to freer & purer air, but to change of air & situat.

And may again be benef. by rem from country to town.

Advant in both cases manif from immed influ in dimin freq. of fits.

On this therefore whatever may be prin on which operates am disp to place some confid in pres inst.

At same time advant. derivd from it may be encreased from conj. with other measures.

And these may be directd as occas requires either with view to obviating partic sympt, or to rad. removal of disease.

Was with first of these intent that directed meas, when began treat of this case.

Then indeed was not certain of the affection.

But whatever the disease, could be no doubt that sympt aggrav by bound state of belly.

As means of obviating this therfore had recourse to gentle laxative.

As such employd Tinct of Jallap combind with simple syrup.

Use of this mixt as purgat. for children, was first taught by one of those gentlemen who innoc at this place in conjunct with Mr Sutton

And have found it by exper. not merely useful in Small Pox, but one of most conven. cathart in almost every case with inf.

In pres. inst expect were not disappointd

For by this means easy disch by belly was readily proc.

While at same time from blister also obt. all effect that could be wishd.

In this situat howevr urgent sympt. being removed, reckond it advis to employ some meas. with view to artif termin

As such have here had recourse to Cicuta.

Cicuta of late highly extolld as certain cure for Chin c. by Dr Butter of Derby.

And although can by no means subs. to all praises which he best upon it yet think very fav of it.

And is I think, partic where tend to costiv, in many respects pref. to Laud.

In order however to reap advant must I think be given in larger dose than done by Dr. Butter.

And these advant more affect obt. by exhib in powder than any other form.

In this case however something farther requird to give form.

For this purpose have directed Merc from view in hopes that will at same time tend to keep belly easy.

On this med, in as far as patient can be obj of pract. is intent to keep him till have at least fair trial of effects.

And hope that may afford us some evid of virtue of the med.

If however after fair trial disap still anoth meas which have in view with this patient.

On this authority have myself oftener than once empl. it.

That is the use of Vitriol Aether.

This, as far as I know at least, still a more recent pract than the Cicuta.

For a long time indeed, diff antisp Caster, Opium &c in use.

There was therefore natur. [analo.] for employm of this most powerf.

But never either saw of indeed heard of its being empl. in this disease till used last spring by my Coll. Dr Webs. in some of his Disp. patient.

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And with such advant too as are at least suffic to encour to future trials.

If therefore shall be requis will here employ it.

May however be first necess to emp. other meas with view of obviating such occur. as may take place.

Of these however cannot at pres say any thing.