DEP/DUA/1/24/06 (Transcript version)

Margaret Ainslie

(1780-1781)

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Margt. Ainslie

Disease of this patient consists of set of sympt. very commonly met with in this country partic durin winter season.

And I think constit a disease which though may not have place in nosol. should enter pract. syst.

I mean chronic catarrh.

An affect which both in appear & methd of cure very diff from catarrh in acute state.

Here most distressing sympt to which patient subj severe cough & dysp.

Can however be little doubt that both one & other effect of that [mattr] which separ. from lungs.

And this we are told expector. with diffic under [form] of thick viscid mucus

Such a matter lodged in [illegible] ramif of [bronchia] & in air vesic of lungs must prev ingr. & egress of air thus giving rise to dysp.

While again from irritat, cough a natural conseq.

And severity, from that diffic with which the mucus matter, in conseq of viscidity is disch.

If matter expect then entirely mucus, no doubt with regard to disease.

But at same time this not certain the case.

And by no means impossib that though princip mucus, may yet contain mixture of pus.

If this the case must view it as much more danger disease.

And have not yet had opport of having recourse to any test by which cert. determ can be formd.

On this subj many prop. such as swimming in water – smell in burning &e on which little dep can formerly [reliance] put be put.

But now fully demonst. that none of these on which dep can be put.

Of late anoth test prop. by means of caust. alk. lixiv.

Said to be solvent of mucus even in most viscid state, while again renders pus more viscid.

For this test are indebted to the late ingen Mr Darwin.

And although all who have tried it not agreed as to result, for own part disp to think it a cert criterion.

But to such test in pres. inst have not had opport of having recourse.

From sympt of case howevr should be inclind to concl. that still merely catarrhal.

Some evid of this from quantity of expectorat.

For at least certain, that consid proport. mucus.

Still more from period at which cough most severe, & expect. most diff.

viz in morning after collect during night, & when from absorpt viscid enc encreased

But most of all from recurr. in cold weather during success. winters.

These are partic serving in great meas. to charact. Chron. catarrh.

While again very rarely if ever hold with respect to Phthis Pulmon

And in partic after patient once affected with it to consid degree, but rarely that recov. to give opport for future attack.

Upon whole then, concl. patient disease to be merely catarrh.

And from contin both in pres & former years no hesit in pron it Chron

From this view of affect. must pron it less danger. than if much ground for susp of Phthisis.

And especially fav for patient that yet at an early period of life.

For although disease not unfreq. fatal yet is cheifly at adv. period.

And accord in greater part of pract system has name of Catar. Senilis.

Prospect therfore of patient being cut off by it under this form still very far dist.

To be observd however that another way in which may prove more suddenly fatal.

Although at pres. concl. that no Phthisis yet may soon occur.

For hold degen of invet. catarrh into Phthis to be less rare than commonly imagind.

At same time hope that by prop means, this also may be provd

And hope that by prop contin flatter myself that at length affect may be allev, if not removed.

For this purp. chief intent of cure in first place to disch or facilit disch of mucus already secr. & accumul.

But in second still more import obj to restore action of secret vessels to natural state.

Is with view to these intent that have employd meas already directed.

Began by direct applic of blister between shoulders.

Such a pract useful not merely by disch. but as giving alterat in mode of circulat.

Is thus I appreh. that often [servic] in relieving diff affect of breast.

And whatever by princip on which operates no doubt that in these often attend with very great benef.

Accord. in pres. inst. on first applic while disch contin both cough & dysp. consid relievd.

But besides blister at first also recourse to anoth meas.

Use viz of Mist. Oleosa

Of this need not observe that basis oil.

And on this basis consider whole activ of the formula as depend

Few stomach however partic in this country that can bear veget oil for purp of med by itself.

Hence requis that should be diff in water.

May be effect in many diff ways

Often in partic by veget. mucil.

But perhaps no form better than union with water by means of alkal. with addit of small quant of sugar.

And this the form under which was here exhibited.

May seem that such a demulc. better fitted for recent than advan state of catarrh.

And no doubt that cheifly [unf] as taking off irrit in fauces

Was with this view that here directed.

For notwith what have said as to period of disease & state of mucus here reason to suspect that in part also proceeded from irritat at fauces.

At least was inclind to think that from this in some meas proceed severity of cough when first went to bed.

While therefore blister intended for prev farther accum in lungs, this meant for taking off irritat.

And hoped also that from use might be freed from inconven. [which] blisters sometimes occas, as exciting affect of strangur kind.

On this course then have contin patient.

And on second repetit of blister have directed that disch should be supp. under form of issue.

But besides this from circum mentiond in last report, led also to anoth meas.

Use viz of Nitre comb with G. Arab as in case of J. Ingram just ment.

For here also will observe that patient has had some bloody expect.

Am however inclind to consid it as merely of passive kind & dep on sever of cough.

Hope therefore espec. if shall be able to mitig cough that no other meas will be necess.

And after what just said of Nitre with G. Arab need add nothing farther.

For some time longer shall try patient with issue & demul

But if these unsuccess. have next thoughts of having recourse to emetic & expect.

Partic G. Ammon or Squills.

At the same time must observe that more to be expected from [temp] weather or from prop defence again inclem. than from any other meas.

This therefore must strictly enjoin

And indeed from this circum attend here rather unfav. as otherwise.

If therefore mitigat prod by mean already suggested, shall be less [amp] consid distance for recomm contin of attend.

If not must be directed in future course by state of comp at the time.