DEP/DUA/1/29/41 (Transcript version)

Alexander Burns

(1782)

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Alexr Burns.

Case of this patient evid of compl. nature.

Most distress. compl. consists in severe pains, affect diff. parts of body.

And these can have no doubt in consid as being a Rheum affect.

This demonst. by situat of place which are affected.

Still more by remiss & exacerbat which take place.

But most of all by encreased severity during the night.

This hold to be charact, not only of exist of Rheum, but also of partic state of it.

That viz of irritabilit.

And follows in conseq of heat [incr] impet of circulat.

But besides these pains is also subj. to anoth affect.

Cough & dysp. viz with viscid expect.

These sympt evid in no degree connected with pains.

For latter only a superv. disease.

And to pect. compl was subj for two months before pains began.

But while pron it distinct disease, from former, as little doubt with [regard] to cause from which origin nature of affect.

Here no reason to suspect Phthis

For all those sympt, which its concomit after any long contin entirely wanting.

Necess. led therefore to view it as being a catarrh affect.

And probab. to be attrib to same cause from which catarrh common arises, expos viz to Cold.

At least in hist of the case nothing ment. which could lead to diff opin.

As induc. pains indeed a pecul. cause mentiond.

Stroke viz on head.

But for this prob. no other foundat than that happ. about time when pains first commen.

Stroke on head indeed a cause suff to give rise to many diff. affect.

But if has prod pres. pains, is at least first inst I have ever met with where has given rise to any such affect.

Hold it much more prob. therfore that Rheum here to be attrib to cause by which ordin induced.

And that while this escaped observat, stroke had merely happened accid, at same time.

And that neither in catarrh nor rheum any thing pecul.

With regard to prognos. as affect comm at diff periods, same will prob also be the case with respect to termin.

From neithr, at least unless app. very much changed from what are at pres, is any danger. to be appreh.

Yet both one & other often turn out to be obstin affect.

And after being overcome again very apt to be renewed from slight cause

This not more the case with regard to catarh than rheumat.

And as both affect excit by cold cause in some degree unavoid.

But as catarh first affect am [inclin] to susp. that will turn out most obstin.

And the rather as from greater urgen of rheumat. will naturally claim first attent.

Accordingly since first came under care to this cheifly pract employd have been directed.

This patient you will observe [have] put upon use of Guaiac.

A remedy from which as used in diff forms have often in Rheum seen best effect.

Here employd in one, if not the most effic, at least most simple.

That viz of powder.

Am indeed inclind to think that have seen more benef. from it, when used in state of Vol. Elix.

But in this form, both more commd commod & cheapr which at least inducem to preferr it in Disp pract.

Here given as comb with a prop of Cream of Tart.

From which action as stim to stomach is dimin & tenden to open belly encreased.

Both of them affects desirab as encreas benef from it.

After contin for space of week pains somewhat allev.

Still however so distress to him that besides persist in use ordered also anod balsam.

And under use of these, this part of affect has now very much dimin.

Am hopeful, that by persist, may soon be compl. removed.

And that in conj. at least with fav warm weather, may also have effect of remov. catarrh affect

Expect therfore, that in pres case, no farther med will be necess.

But if in this expect. disapp. meas must be accomod to state in which shall then find patient.