DEP/DUA/1/31/16 (Transcript version)

Alexander Burr

(1782-1783)

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Alexr Burr.

Disease of this patient could not be repres. as very distress to him or in its nature very import.

Yet little doubt in consid him as subj. to a complic of diff affect.

Compl. first mentiond & hist & [illegible] indeed chiefly the subj of pract was a catarrhal affect.

This evid indic by cough, dysp & state of expectorat.

These indeed sympt in common both to catarrh & phthis.

But here there could be no susp. of latter affect.

That merely catarrhal evid indic by absence of hectic fever, & of all other sympt. indic catarrh Phthsis.

Partic by strength being very little if at all impaird.

Indic also by age of Patient.

For while had long passed that period at which Phthisis most freq. had arrivd at age at which catarrhal affect known to be most comm.

In so much that with him the disease might justly be stild an inst of Catarrh. Senilis.

When consider however that affect occur at early periods of life more prop. calld chron. catarrh.

And this appellat could have little diffic of best. upon it when consid that had already subs. for space of sever. years.

As is common indeed with that affect had not unif. contin

But while suff. consid mitigat during summer again aggrav. in the winter.

This howevr often obs to happen & as well as long durat another object [against] any suspic of Phthisis

Besides common sympt of catarrh sever others in pres case evid refer to this cause

Partic headach & watchful durin night.

For both one & other we are told arise only as conseq of severe & freq. coughing.

Perhaps also to consid as in some degree sympt of catarh, the [sickness] & inclin to vomit with which often affected

For no doubt that both espec. [vom] often conseq of severe fits of coughing

Here however other stomach compl.

For when vomiting takes place, obs. to be attended with disch of sour or bitter tasted matter

To these sympt also, flatul. at least at times superadded.

Hence then besides disease of [breast] here also affect of alim canal

But to these two diseases still a third superadded.

And that too prob. unconn. with both.

Need hardly add that what here allude to is local affect of tongue

To this disease do not know that any prop. gener. name that has been given

Yet an affect not unfreq. to be met with in pract.

And in sever inst which have had occas to treat have found it both distress & obstin.

And while resisted diff modes of cure was also prod of very severe pain.

Here neither pain nor obv. affect so consid as have often met with

Yet I own was appreh that would not be soon termin.

And must acknowledge that this event has taken place more quickly [than]

How far the conseq of remed empl. shall afterwards have occas to consid

With regard to stomach compl. these but very slight.

And during time that he was under care were very little an obj of attent.

Although evid markd an affect of that organ yet hardly consid them as what required to be subj of [that]

And event I think has shewn that this suppos. not erron.

For during course of attend, without any partic pract directed against them stom compl entirely disapp.

Of Catarrhal affect also fav. term has so far taken place that pat. now dismissd from farther attend.

This no more than from prop. manag. & mild weather had reason to expect.

At same time cannot by any mean look upon that affect as compl. removed.

And still reason to fear that by any accid. expos. to cold affect may be again be renewed.

To such however lab. poor at this season of year necess. very much exposed.

Will not therefore be at all surpriz. if find him soon again subj to return of this part of affect

Yet may still obs. that in begin of pres. month all compl. so far removed that farther attend unnecss.

How far this affected by treatm empl. in this case next our business to inquire.

Began pract by directing for him the use of an Emet.

And here you will observe that employd Ipecac to extent of ℥p.

To this led from a circum mentiond in hist of case respect. a former Emet.

Ipecac to quant of Ji slow in opera.

Was therefore to [secure] more exped effect that ten grains more empl.

Here may perhaps be matter of disp whether this addit prop or not.

For respect doses in which Ipecac ought to be exhib many controv.

By some contended that in general over dosed.

Or at least that though from giving it to quant of scruple no bad effects, yet that from much smaller quant. all same effects prod.

And that greatest part of what taken rejected by first vomiting without prod any effect.

And that thus a superflu quan unnecss. expended.

That this may in some degree be the case I will by no means deny.

When Ipecac taken in powder a great part again disch. app. very little chang.

And no reason to think that is in an inactive state.

But although thus some Ipecac lost yet no doubt, that from encreas of quant. operat quickned.

And not contended that from large dose any bad affects.

Prob. from this circum of being rejected before activ excited that in some degree to acct for safety of Ipecac as an Emet.

For almost never attended with effect of prod excess. vomiting [illegible] danger.

Prob. from greater part of it being rejected as soon as any of it has induced such naus. as to occ. vomit

Here therfore to use of thirty grains no other obj but very small unnecss. expense.

While at same time with a stom not operated upon without diffic had at least better chance of speedy affect.

While ordered the Emet. directed also the use of the Pil Scillit.

These well known to be one of most common remed used in such catarrhal affect.

And for my own part, no doubt in consid it as being often attended with very excell. effects.

These by much greatest part of pract. ascribe to power as [expect]

But others admitting good effects deny that it can possib have any such influ.

And attrib power in allev affect of breast to influ on urinary organ.

That by diuresis catarrh. sympt often relieved is undoubtedly true.

And that Squills have effect of promot diuret undeniable.

But if act on this organ as [introd] into circul. syst. may also infer at least the possib of acting upon others.

And in my opin observ of effects in actual pract. fully demonst influ in prod more free & easy excit of mucus.

Prob. from afford stim to excret before prom stagnat has acquired any great viscid.

And from use in pres case hoped that should be able to obt. that effect.

While emetic & squill pills intended against catarrhal affect. anoth prescript directed with view to affect of tongue.

Such affect have already observd often in nature obstin.

Sometimes however overcome by tonics as astring, such for ex. as Peruv. Bark Infus. Rosar. &e.

But where resists these, have still more powerful modes of cure, in gentle escharot.

And as such [burnt] [alumn] in form of powder & blue vitriol in that of solut not unfreq. empl.

Here used an artic in prop. somewhat app. to both.

Vitriol acid viz diluted with large proport of water.

In such a state nothing to be feard from escharot corros power, yet had reason to hope for benef. both as gentle eschar. & astring.

For obt. [these] directed to be used in form of gargar. for wasting tongue

And this pract seems to have been prod of very good effect.

For in short time pain & uneasiness very much allev.

From emet also good effect seems to have been prod.

For although operated but little yet after operat both cough & headach easier.

In this situat repet of Emet seemd to be unnecss.

Was satisf therfore with merely direct contin of Squill pills, & of gargarism with vitriol acid.

At succeeding report affect of his tongue you will obs. still more dimin than before.

But cough again rather aggrav.

While therefore gargar. seemd now unnecss. directed repet of Emet with contin of pills.

But on this occas did not seemd to be followed by same benef as formerly.

And as cough & dysp. still distress to him directed a blister.

Than which few more effect means of relieving breast.

But though here prod of consid disch. had not that effect which might have expected.

In this situat directed dose of pills to be augm.

And as anoth means of prod determ from breast, had recourse to a gently laxat elect. of Crem of Tart & Sulph.

Under use of these remed affect so far allev. that reckond farther attend unnecss.

This however was I own inclind to attrib [full] as much to mild weather as to influ of remed empl.

And while season temperate if patient can avoid accid cold reason to hope that may cont. free from affect.

At same time cannot by any means considr affect as radic cured.

On slightest expos. during inconst weather, renewal of affect to be dreaded.

And should not be at all [surprizd] to find him soon again applying for assist.

But even if catarrh should be renewd still reason to hope that will contin free from other part of disease affect of tongue.

And pres case has I think affordd ex. of power of vitriol acid as counter this compl.