DEP/DUA/1/27/11 (Transcript version)

Janet Ranken

(1781-1782)

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Janet Ranken.

Affect of this patient as well as former cannot be entirely consid as simple disease.

Here also in conj with anoth affect. some complic of stom comp.

But these so slight, that as well as in formr case hardly consider them as claiming attent while other compl. remain.

And affect for which came under our care, cough, dyspnoea & pain of breast with expect of viscid matter.

Of these sympt as entering diff gener of disease have already had occas to speak.

And here as in case of Jas Low have no doubt in pron affect to be an ex of chron catarrh.

And was with view to treatm as such that here selected as subj of pract rather than lect.

In hist of compl. as introd into register does not appear to me that any singul.

Unless perhaps we are to consid as such, its having first attackd her, in middle of summer.

For in hist of affect are told, that disease began in June.

This however although somewhat uncommon, by no means to be consid as very singul occurrence.

And although look upon disease as effect of cold, yet when consider state of weather in this country, even in June, & accidents to which then often exp, from being overheated & the like, perhaps rather surpr. that does not even more freq occurr.

After first attack however during warmer part of season again got pretty free from it.

And little doubt I think that renewal of affect, about a month before she came under our care, proceeded from expos to cold in conseq of change of season.

With regard to prognos in this case, as far at least as [resp.] Chr. Catarr. nothing which can be consid as unfav.

Disease neithr to great height nor attended with any very dist. symp

Flatter myself therefore that nothing at pres to be appreh. from it.

At same time sever partic rather unfav to expect of speedy recov.

Season of year, probab. also [habit] & mode of living of patient, much against it.

But have still more unfav circum in age, to which advanced

For is already you will observe on border of 70^th year.

So that with her, disease may with suffic prop. be [termd] Catarrhus Senilis.

With regard to plan of cure here after what already obs. of case of Low, need not add much.

Is in first place necess. to free breast of mucus already accummul.

For in this way only that can allev or remove pres urgen of cough or dyspnoea dep on such accumul.

But after this for prevent of return of these sympt. is necess that morbid disch should be rest.

Of pract here employd with these views is now unnecess. to make many observat.

Will at once observe that was intent to try this patient with same course prop for Low.

Ordered Emet as means of disch mucus accum in air vesicles of lungs.

And at same time prescribed powder of Uv. Ursi as means of moder restr encreased disch.

Least however sudden effect in this way should be attended with inconv. ordered dose of ℥p only once a day.

The emet exhib prev to the Uv. Ursi had wishd for effect of prod full vomiting.

And to that perhaps fall more than to Uv. Ursi, may ascribe demise of cough & of expector. ment, in succeed report.

Could at least however vent to say that Uv Ursi here prod of no incon.

And this suffic inducem at least to cont. trial.

Still howevr reckond it most prud to contin with formr quant only.

At this report however besides acct of cough was told of a circum which had not formerly been ment.

Pain viz in left Mamma in conseq of stroke receivd upon it.

For this ordered [frict] to paind part with Camphor. oil.

An applic from use of which in such cases have often seen best affect

From inattent on part of patient however, did not get either this or the Pulv. Uv. Ursi as directed.

And whethr from want of these, or from any other cause will not pretend to say, but both cough & dysp. again aggrav.

In this situat directed merly contin of former meas.

And during course of last week when powders taken regullarly cough again became somewhat easier.

From this at least some ground for presum that by these allev obtained.

And therefore consid it as suffic encouragem to encrease quantity.

Have now therefore order ℥p twice a day.

And if can get patient to be regul in attend or in use of med. shall be anx not only to contin use but to encrease dose.

At same time from some [illegible] which have already had [often] irregul. can not confid expt it.

Unnecss. therefore to suggest other modes of cure where some reason to doubt whether shall even have opport. of giving fair trial to [present]