DEP/DUA/1/27/20 (Transcript version)

Helen Lamb

(1781-1782)

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Espec. as patient happened not to be affected with any fits of coughing at times when brought to us

Helen Lamb.

From sympt as described in hist of this pat. case no pos. judgem could be formed as to this pat. affect

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But when these taken in conj. with other part. no room for doubt.

Esp. situat of patient & prevail epidem at time of first attack.

When came under our care compl entir consisted in sev. fits of coughing.

These return at uncert. interv. succeed by pecul. sonor inspir.

Or to use vulg. lang. which on this occas not [unexpress.] with back draught

In these sympts have descript. very exactly corresp. to pertussis in most simple state.

In that affect indeed freq. remarked that fits termin either in vomiting or in expect. of clear watery mucus.

Here however neither one nor other of these circum took place.

But this by no means any obj to suppos of Pertussis.

For neither one nor other can with least prop. be consid as const. sympt

And indeed this so much the case partic with resp. to vomiting which of the two the most freq. that when taking place very gener. rankd among fav. symp

And by some even consid as [illegible] that dang of disease passed.

From abs. of these sympt then no obj to suppos of Pertussis.

But again from concurr of all others cannot with cert. pron it pres.

For in many inst severe fits of cough even with what may be calld hooping where yet not pertussis.

Pertussis one of those febrile epidem depend on pecul & specif contag.

And a disease with which accord to most accur observat patients affected only once during course of life.

Although therefore ment. in hist that no child in neighb. at same time affected with simil compl. yet readily exposed to contag in diff ways

Hence then in form diagnos. two circum natur occur to be taken into acct

Whether viz Chin Cough prev as epidem so that pat. expos. to contag.

And whether pat. has or has not had the disease before.

As in latter case only that liab. to be affected by contag.

Answ to both these quest. would lead us to concl. disease to be pertussis.

For this affect has now for space of many months prev. very gener partic at time when pat. first affected was very common in Ednr & suburbs.

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And from tend age of pat. who when came und our care did not exceed first year may might have concl. that not bef. subj to it, although had not learnt this circum from parents

During summer indeed when but few months old cough in every circum simil to expect pres.

Except that at that time both vomiting after fits & some disch of blood

But these rather conf suppost. than afford obj to Pertussis.

And confirm also from long cont of affect as well as from renewal after some intermiss

For both one & other if not pecul to chin cough at least very freq in that compl.

Of all the febrile contag. [chin] by much the most ted.

Would not indeed cont. that during whole of that time contag so far prev as to be cap of giv infect.

But conseq at least will run on for many months even for years witho interrupt.

And noth more freq. than to obs. it disap. during sum months & again renewed in winter.

Hence then every lead circum in case before us corresp. very exactly to suppos of chin cough.

And this suppos corrob. by every other partic with which any [access.] to be acquainted.

This then opin as to name & nat of affect when pat came und. care.

With regard to prognos observat supersed from [term] which disease has already had.

Here however may remark that from begin saw no reason to appr danger

Not indeed that pertussis does not freq. prove fatal.

And partic so in early infan.

But then does not in gener. happ after disease of long contin.

Unless indeed where termin in suppurat of lungs giving Phthis.

More freq. inf cut off early in disease when febr. sympt run most high, & before what is calld formd.

Or by severe parox at that time termin in convuls.

These dangr however now passd with pres. patient

And no sympt indic any tend to Phthisis.

Was therefore led to concl. that in this case no immin dang. at least.

But must own did not expect speedy termin. in fav manner.

Such a termin however soon took place

In so much that after few weeks [illegible] pat. dismissd from any farth attend.

This am inclind to think in some degree at least proceeded from [treat] here empl.

Circum however by which this rend probab. will more partic app. from remarks on treat. to which next proceed.

Pertussis one of those affect which most comm at least termin by what may be calld natur cure.

And great obj of pract. to moder such urgent sympt as may occurr during course.

But besides this with view to artif termin of disease great variety of diff pract. recomm.

Of these many from which unquest no ground to entert any fav expect.

Yet others, good effects of which in cert. cases at least, attest on good author.

Some of them however such as influ of fear, action of other febr. contag &e which dare hardly vent to empl.

From these however app. that artif check to disease from such circum as have very powerf infl on Nerv. Sys.

And if at all acq. with prin on which remed here empl. oper. in this affect is I appreh in this way.

Remed to which had here recourse the powder of Cicut.

And this empl. with intent of trying how far would give artif termin to the disease

Need hardly observe that Cicuta under use of which in pract of med introd by Dr Stork of Vienna first [recom] as cure for scurvy by Dr Butter now Phy in London.

He pub. not many years ago a short treat prof. on this subj.

In which holds forth [illegible] as an exped & alm infallib remedy in that affect.

But from many unmeas direct which gives with regard to exhib & from small quant. to which empl. it exp. himself very much to attack.

And indeed not altog. without some grounds of imput of quackery.

For among other partic obs. that would not be answ for success if hemlock empl. was not prep. by his own Apothec.

From this circum while public severely lashed not many disp to follow him in pract.

And the rather as Cicuta [on] that time had fallen into consid disr

Am however acq with sev pract of accur. obser. who have made trial of it & from there have formd fav op of [use].

For my own part the results of my pract leads me to adopt same sentim

Would [by] no means indeed agree with Dr Butt in supp. that in every case cap of giving speedy artif term

But in sever inst think that have seen manif good effects from it as mitig sever & freq of fits of cough.

And reason even to believe that had consid influ as short. disease

With expect of simil effects then had recourse to use in pres. inst.

Cicuta here empl. in subst & under form of powder.

Which of all modes of exhib Cicut consider to be most cert. & most effic

Here given as comb. with Pulv Cret.

This however prin meant with view of giving form.

But expected from it also some good effect as destr. acidit

And by this means check looseness to which pat subj by which influ of Cicut might otherwise be counteracted.

Exclus of Pulv. Cret. however Cicut given to extent of gr VI indies

Which with child so young utmost dose that thought could be vent. [upon] at least at comm.

After cont on this med for space of week fits of cough had almost entirely left her.

This change however could not with confid entirely ascribe to Cicut.

For during that time anoth circum had also occurrd to which uncert. whether relief was not to be attrib.

Disch viz of worm of lumbric kind.

Sympt aris from worms in diff cases very much varied.

And indeed hard to say to what sympt may not give rise.

Among others well known that irrit which occas in alim canal not unfreq gives rise to severe cough

Hence then notwith circum already ment as evid of pertussis might be supposed that compl here prin from worms.

Or at least that by pres in alim canal affect much aggrav.

And therefore that change which here took place for better prin. arose from disch of worm

If this however really the case could in no degree be attrib to Cicut.

For worm disch before any of powders taken.

Here however was for my own part disp to attrib relief to Cicut.

Prin as one worm only disch when but not followed by immed relief of affect.

But that relief had occurred in grad manner during time for which Cicuta used.

But whatever might be cause of relief cough now so far gone that did not seem to be any longer immed object of attent.

At same time disch of one worm gave reason to presume pres of others.

And this the rather as pat. now subj to some other sympt comm. reckond test of pres in alim canal.

Partic picking of nose & app. [rather] more vorac. than natur.

These app indeed may arise from diff causes.

But perhaps more freq from worm than from any other.

And from circum of worm before disch presumpt not a little heightnd.

On this acct. therefore to Cicuta now substit remed directed against worms.

Was with view of expelling these that directed pill with Calomel to be succeeded next morning by brisk [cathar].

And as such notwith tender age of patient empl. Tinct of Jallap.

Which when comb. with simp Syr. & thrown in by small doses in manr here directed one of easiest cathart with which am acq.

While at same time equally safe & cert.

From the Merc. & Purgat as here directed have seldom faild to obs. good effects in worm cases.

I [means] in cases of Lumbrici partic with infants.

Do not indeed repres. this pract as with these an infalib mode of cure.

Yet in most cases suff for cure

And where worms pres. will very rarely fail of bringing away some

Here however notwith brisk operat no app of any more worms.

From this concl. that no more exist in alim canal at time.

While by this pract however led to interm cicuta, severe parox of pertussis again returnd.

In this situat had again recourse to Cicuta in same manner as formerly.

And relief once more derivd from it arising upon use gave strong presumt that that mitig formerly obt. proceeded from use of med.

At succeeding report so far free from affect. that thought might be safely dismissd from fut. attend.

And upon whole consid this case as afford exampl of good effects of Cicuta in Pertussis.