DEP/DUA/1/32/18 (Transcript version)

Peter Campbel

(1783)

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Peter Campbel.

Case of this patient consists of very few sympt.

And I think clearly affords exam of a disease both very freq & very troub

Princip compl. cough with cop. expect.

Compl. also of Dyspn with weight & oppress at breast

This however consid. merely as conseq of matter accum in air vesic not fully or freely disch.

And from state of health in other respects can have no doubt in consid disease to be a cattarrh affect.

Has now however subsistd for space of about 9 months.

And for long time past has not been attended with any febrile symp

In this state obstin catarrh in this country in partic very common.

And from period of life at which most freq. have name of Catar. Senilis.

To this appellat however in pres. case, age of patient not yet 30 a strong object.

And indeed am inclind to think that at every period of life may with much greater prop be named Chron. Catarh.

To this affect then consider pres patient as subj.

And from this view am not inclind to look upon affect as dangr.

Yet when consid season of year & stat in life cannot expect speedy recov.

And not impossib that dangr greater than disp. to think.

For although not fatal by itself will in some habits induce phthis

And Phthisis an affect of that insid nature which often makes very consid progr when not observd.

Hence then notwith pres opin should not be greatly surp. at termin even in death.

Yet hope that by prop. attent notwith unfav circum affect may soon be mitig.

And that patient may even be in such state that farther attend here unnecss.

At same time cannot I think reason hope that till warm weath will be entirely rid of affect.

In treatment of this affection [great] object for relief of patient is remov. of mucus from air vesic of lungs.

But radic cure to be obtained only by restor secret to natural state.

First of these effectd by means promot expect

Last chiefly by deriv from lungs to other parts

Was with this [latter] intent that when patient came first under care directed use of blister.

And to obt. more perman the [affec.] of deriv. ordered that disch should be supported by issue ointm.

From blister itself copious evac & manif relief of sympt.

That attent however which could have wishd does not seem to have been empl. in supp disch.

As thus little evac imag. that contin would prove rather painf. than advant. to patient.

And that more might be reapt from repetit of blister.

For from freq applic even of [prop] blister to same place have copious disch with almost no inconven.

And in many habits of equal [advan] & much more easy than applic of issue ointm.

During that time trial of many remed without matter. benef.

Cannot now therefore expect sudden remov or allev of what in great meas constit.

But on other hand see nothing in case of alarm nature.

And may contin for years to come without any very consid diff.

If howevr shall again resume [attend] may at least try meas. both with view to allev. & radic cure.

First of these ends accord to idea given of disease, to be accompl. by counteract effects of mobilit.

Second by removal of it.

With both intent a variety of pract in use

And in some cases at least with no inconsid success.

Effects of mobilit as induc spasm & pain most effect counteract by strong impress on nerves.

Influ of these from action either on nerves of stom or any other sensib [extrem] commun to brain.

And thus from influ on sentient princip effects which would otherwise take place are prev.

Mind no longer affect in same mannr by impress former having influ.

This effect in many inst prod by impress of stim nature.

In many other by sedative.

Thus for ex. find prop hysteric fits anticip by large dose of Spt of [Hart] on one hand or Laud on other.

And that too after sympt commonly forerun of fits have occurrd

When consider oppos influ of these can neither I appreh with prop attrib anticip to stimul nor sedat effect.

For while influ of one to mitig pain, allay action & induce sleep that of latter other to excite pain & to rouse

Yet no doubt that from both same immed effect on disease.

Must therefore suppos that in both cases arises merely from strong or powerful impress.

And indeed among diff stimul & sedat. not cert. that from any two precis same impress.

Probab. even that not merely diff in degree but in kind also.

But such means then might have hoped in pres. case to mitig affect

But still cure to be obt. only from removal of morbid degree of mobilit.

And for this again change requis both in state of Nerv fluid & in moving fibres in general.

First to be effected by means alter state of action at brain as secr. org.

And last by means altering state of moving fibres as simple solids

With view to these diff intent [migh] here have recom various pract.

And none perhaps from which greater hopes of radic cure than cold bathing.

Influ of this as tending to brace syst. & remove morbid deg of mobil, now well estab.

And advant, to be derivd from it in Hysteria conf by daily pract.

Here while no circum tending to forbid use, farther indic by atten to [illegible]

For observd by patient that compl. easier during cold weather in winter than heat of summer.

A circum which while leading to use tends also to corrob conject as to nature of affect.

To this then may perhaps in end think it necess. to recomm [patn]

But pres. a very unfav season for commen.

Wishd therefore, at least in first place, to make trial of other meas.

Reason however to hope that state of weather will not much longer aggrav. affect. or counteract influ of remed empl.

In this case howevr have not you will obs. had recourse to many diff. remed.

Began pract. you will obs. by direct. an Emet.

From this hoped that should [both] unload breast.

And that thus might both [relieve] cough & dimin tend to inord action.

For well known that by one inordin action, anoth often most [effect] removed.

Thus nothing more influ in stoping singult. than action of snezing.

Besides this led to use of Emet also from diff. consid.

Advant viz often result from it in cases of Croup.

In that affect when fits of dysp the greatest no remedy of equal eff. [illegible] [illegible]

There indeed it is true, relief the conseq. of free disch of large quant of muc. matter retaind in Trachea

A circum in all prob. not taking place with pres. patient.

And could not by any means repres. this case as an inst of croup.

Still however the analogy such as naturally to suggest empl of an Emet.

With view of excit vomiting here had recourse to Ipecac.

An artic from which I am inclind to think can with more certainly dep on excit vomiting than Emet. Tart.

There however expect. dispn.

For in place of vomiting looseness excit

And that too by a dose which with an infant at so early a period of life might have [expec] vomiting

Of effects therefore as an Emet [were] entirely disapp.

And whatever good conseq. resulted from it to be attrib to inf. as open belly.

Not improbab. that this may have had some share in prod. that [relief] of which inf at succeed. report.

Was however more inclind to attrib relief to anoth med empl. at same time.

For when ordered Emet directed also you will obs. use of oily mixt.

To this also prin led from [analog] to Croup.

In that affect for my own part at least, but little exp of it.

Am however informed on what reckon good authort. that has often been emp. with success.

And at least certain that impress. which makes has often effect of [takin] off inord. action.

In this way then imagined that might here be of some use.

But was still farther led to it from hoarseness with which pat. affected.

For this as well as some degree of labor. respirat you will obs. a constant sympt.

And have already hinted that though it no improb. supposit. that cause of severe fits of dysp. conn. also with case of these sympt.

Well known however that noth more effect in hoarseness than oily mixt.

From these consid then led to hope that might be useful in pres. case.

And in this hope have not I think been disapp.

For as already obs. during course of first week though vomit did not oper. patient consid relievd.

This then at least suff. inducem to contin employm.

But at same time still expected benef. from an Emet.

While therfore advised that he should persist in oily mixt. directed also Solut of Tart Emet with view of excit vomiting.

And though Ipecac had faild yet this attended with des. effect.

Here however not to be concl. that Tart a more cert. Emet than Ipecac.

For notwith what happ. in pres. inst. is of the two most liab to operate by stool.

From vomiting here excited howevr patient derivd evid benef.

And accord at succeeding report directed contin of Mist Oleos alone.

Hoping that by this alone, remain of affect might be overcome.

At last report however although the mixt cont. yet found that attacks of diffic breathing more freq.

This however as well as pat. [mothr] was inclind to think might be attrib to state of weather

But as Mist Oleos. had now been contin for some length of time directed that should be omitted ordering repetit of former emet.

And if patient again as much relieved as formerly, will confirm sentim of advant.

In that event may perhaps be in condit to be dismissd without any farther med.

But if attacks shall still contin freq. have now thoughts of trying him with some of those antispasm of tonic nature.

Partic Zinc or Peruv. Bark.

By these hopeful that returns may be prev.

If this howevr shall not be the case, or if any circum shall occur prev. use of them, pract. must then be accomod, to condit in which shall find patient.