DEP/DUA/1/24/15 (Transcript version)

William Rob

(1780-1781)

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Wm Rob.

After what said of some former patients little of pres.

And especialy as from irregul attend little obj of pract.

Compl. simil to those occurring in several other cases already consid.

Consist of cough, dysp & expect of viscid mucus.

This disch as may natur be exp. not accompl. without diffic.

But when accompl. gives consid relief

Hence then little reason to doubt that this at least prin. cause of symp

And that may denom affect an inst of chronic catarrh.

Hence however selected as being somewhat singul.

Partic with respect to course to [which] attrib.

This patient by occup will obs. a flax dresser.

And attrib. his affect to nature of business.

Can by no doubt that air which flax dressers breath, must often cont very consid quant of dust & other extr matters.

And in this as well as other occup where simil state of atmosph. inspired, have often seen great incon.

Am not however disp to think that can be consid as cause of disease.

But where morbid secret of mucus will have very consid tend to aggr affec

For by meas of viscid very apt to be retaind.

And accord often even disch in large quantit by expect.

In this manner then from accuml must aggr dysp.

And from irritat must encrease cough.

Perhaps even on latter prin, with some condit of lungs may encrease secret.

But when this the case patient should be const subj. to disease while contin empl.

And have met with more than one inst. where on this acct. change became necess.

This however evid not case with patient before us.

For with unif contin of profess. has sometimes been subj to it sometimes not.

Hence then consider his occup. in life as being a cause merly aggr affect.

And although does not trace it to any partic occurr. when consid seas. at which has come on as well as form attacks, would look upon it to be effect of winter cold.

In sympt of case when came under care nothing alarm or uncom.

And patient, though past 50^th year yet not so far adv. in life as to give ground for appreh from that source.

When to these circum added former recov. little hesit in expect it also on pres occas.

True indeed said now more sever than ever.

At same time patients in gener. much disp to make pres evil the worst.

And sympt had by no means occ. with that degree of sever. which often observe.

From these consid then enterd on pract, in hopes that patient would soon get better.

And that although might not be able to bring about compl. cure should yet obt. tempor susp of sympt

In this expect. some ground for presum. that have not been disap.

At same time as patient has not lately attended & as have not seen him since cannot with cert. speak of pres situat

Of general plan of treat in this case or of partic remed empl. not necess to say much.

Here great obj for obt immed relief disch of mucus & other matter accum.

And for prod radic cure the prev of fresh accumul.

With these intent had here recourse to repeated emet & squill pills.

Former princip meant for immed disch of mucus.

And have already oftener than once obs. that know no means of prom expect. more certain or exped. than action of vomiting.

But besides this also useful in [illegible] affect. as giving determ to surface

With regard to squills can be no doubt that this root impreg with [pecu] acrim.

When taken to great extent acts very powerfully on alim canal.

In smaller quantity & more slowly introd equally little doubt that enters circulat.

And in this way effects partic app as encreas. secret. of urine.

By augm of this disch. often happ that in affect of breast in partic patien derives no inconsid benef.

Expected then that on this footing might here be of service.

But for my own part am of opin that more to be lookd for from it as acting upon lungs.

For have little doubt that on [secret.] organs there has simil [operat] as on these of kidney.

And that by inducing quicker & more ready excret prev. that accum on which both cough & dysp. depend.

This opin indeed with regard to action of expect. is by some altogeth denied.

But in adopt. this sentim I agree at least with by much greatr part of practit.

And indeed influ of squill pills as facilit expect. in such cases [confirmd] by unden. facts which are subj of daily observat.

In so much that with many patien become a famil remed to which have of themselves recourse without medic aid.

And whatever may be said by medical theorists may with confid venture to say would be imposs to conv. them that do not derive benef.

This being case may seem very extraord. that Squill pills rejectd from last prev edit of Pharm while [pla] in all former.

To this however Coll. not led from consid it as ineff. med or imp formula.

Reason of omiss was that these pills whether prep of recent or dry squills should always be made up for immed use & given in fresh state

And no doubt that few formul. of pills more apt to be inj. by keeping

Was thought also that anoth adv might result from it.

That greater latit. viz to pract. to vary prep of squils at pleas.

And mere opport of combin with any partic corrig best accom to pat stomach.

Notwith these part howev still think that want of fixd formula an omission.

And will probab be replaced in next edition

For, want of Rx in Pharm. has not ban. them from shops of [Apoth]

And in almost all kept as directed to be prep by last edition.

When here pres. then are to consid them as prep. by that formula.

Under two emet & pills patien compl. very consid relievd.

In this situat thought former unnecess but directed contin of lattr.

Since that however have not seen patient at this place.

What therfore pres state do not know.

Yet more probab that cause of [dessert.] has proceeded from having no farther occas for assist than any other reason.

Prob. howev that shall not see him again – Hence sugg. unnecess