DEP/DUA/1/33/26 (Transcript version)

Elizabeth Reid

1784

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Eliz Reid. Janr 17^th 1784

Respect disease to which this patient was subj, some room for doubt.

And this prin as had never opport of seeing her, under fits to which subj.

As far however as could form judge from descript given, should have concl. that her own conj. with regard to affect well founded

That [viz] she lab. under Asthma.

Most indeed of sympt. most distress. to her, partic diffic of breathing & cough are also attend of Catarrh

And espec occurr with that affect when in chronic state.

Farther to be remarkd also that among vulg in this country, Chron. Catarrh very gener passes by name of Asthm.

A term indeed consid as applic to every inst of diffic breathing

Is also somewhat in fav of this supp that disease when first occurr. attrib. to imprud expos to cold

And at least nothing against it that had daily attacks of Dysp every morning.

For in Chron catarrh this almost never fails to be conseq of stagn & accum of mucus, during night.

In all these partic then, must be allowed, that at least very consid resemb. to a disease, very freq occurring partic at this season.

But on other hand, several partic from which should be inclind rather to supp of asthma.

This partic to be inferrd, from sudd of attack, with sense of strict & dang of suffoc.

Still more from sudden termin

For in most inst ended in space of hour & that too without expectorat

Or at least without expectorat of those large quant of viscid mucus which give relief in chron catarh.

But circum most of all in fav of Asthma, the pecul noise with which respirat attended.

This very rarely, if ever happens in catarrh.

And when does occurr in that affect is still probab. conseq of some spasm strict being induced.

Hence then, as far at least as descript to be depended on, gives strong presumpt of Asthma.

Age of patient likewise, more in fav of this suppos. than of Catarrh

As is also severity of fits, partic their being attend with Vertig & Headach

From these circum then, inclind to consid this patients case as example of Asthma.

Yet as never saw parox & cannot entirely trust to descript no cert.

But whether Asthma or Catarrh for pres at least pat again free from it.

Hence any obs. on progn unnecss

May only obs. that whether one affect or other, cannot consid her as free from danger of return.

For both, when once induced, very liable to recurr.

[Latter] almost unif renewed from expos to cold

And found And accordingly with many becomes habit the disease of winter season.

Former without any regul period apt to be renewd sometimes at longer sometimes at shorter interv, from diff accid causes.

Partic from any circum either encreas irritab. of lungs, or giving uncommon irritat there

Remiss however after last attack as record in hist cont for very consid No of year

Reason therfore to hope that pres at least for nearly equal period.

And on this acct I own, was less anxious that pat should contin attend after relief of sympt obt.

How far fav. termin which has here occurd, the conseq of pract directed, may perhaps be matter of doubt.

For upon suppos of Asthma, no quest, that affect has often salut termin by mere operat of nature.

Here however, am I own inclind to attrib not a little to blister empl.

From this on suppos that disease asthma & that asthma depended on Spasm had reason to expect good effects as tend to remov

But with pres patient the rather led to empl it, from relief which are told had formerly afforded to her.

At that time, as learn from [hist] of [case], had effect of remov. affect from which afterwards cont. free for more than doz of years.

Is therfore not unreas to suppos that relief again obt. to be attrib. to same cause.

And that may look upon case of this pat. as afford inst of good effects of blisters in Asthma.

Besides the blister however, anoth remed you will obs, also had recourse to.

An electuary viz of equal parts of Cream of Tart, & Sulph.

From this expected some benef from operat as gentle laxat, & diur.

By both determ to lungs [somewha] dimin & such affect allev.

And here in quant ordered [were] not disapp at least in obv effect of mov belly

In so much that at succeed report, directed it to be empl only to half former quant.

To this however, am inclind to attrib very little.

For in fact, relief obt from the blister, before it began to operate

And contin rather as placebo, [that] might seem not inact to pat, till should be able to judge how far relief perman, than with any other intent.

After finding that was so, [reckon] farther attend unnecss.

And As have since heard nothing farther with regard to her may concl. at least that remiss still cont.

And this I own am disp. to attrib very much to applic of blister.