DEP/DUA/1/36/39 (Transcript version)

Margaret Morison

1785

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Margt Morison. Janr 29^th 85

Disease to which this patient subj one very freq. occuring in this country.

And in case before us so distinct marked that could have no hesit with resp. to it.

Had no doubt in consid it as being an ex of chron. catarrh.

A disease with which the only one in much dang of being conf. is Phthis Pulm.

And of this from many circum. there could not in pres. case be any susp.

And indeed pres affect suff. charact. not merely be cough & dysp. with which attended, but by age of patient length of time for which subj to it, period of attack & remiss & various other circum.

May indeed in some degree consid as pecul. pain of breast with which affected.

And espes as affect with so much severity a partic spot.

This however merely conseq of viol agitat prod from coughing.

And prob from some injury which in conseq of this, parts have receivd.

May also perhaps be consid as partic, that most affected with it, in spring & autumn.

For very gener. remarkd, that most severe during cold weather.

And many who though regul subj to it, during winter, very much free from it, in summer months.

This there can be little doubt, is entirely to be attrib to cold on surf.

And accord those long subj to the disease passing summer in warm clim often entirely escape.

And even in this country nearly simil relief obt. by keeping house during winter months.

Although therefore howevr winter gener. coldest season of year, yet prob. that from this cause, yet prob. that aggr. met in case before us still to be attrib to influ of cold.

As patient at these periods may be most imprud exp. to action.

And then at least must be univers. admitted, that from freq. viciss even greatest dang of expos.

In this manner then, few pecul which take place in this case to be expl.

And upon whole respect nature of affect no room for doubt.

May also add that for pres attack at least as little with [regar] to Prognos.

For patient already dismissd free from affect.

This however, when reflect on nature of the disease, can by no means consid as a radic cure.

And indeed am for my own part very doubtful how far at an adv. period of life disease can be said to admit of such.

At least have not for my own part, met with any inst. where those freq subj to it, have not again been liable to recurr from slight accid.

And this have every reason to appreh, will be case in pres inst.

Hence then would be by no means surp, to find pat, soon again applying for assist, as subj to form affect.

But for pres at least has got rid of compl.

And this tempor. relief may I think, in part at least attrib to pract. here empl.

In this affect. immed cause both of cough & dysp. is mucus accum in air vesic of lungs.

Disease therfore chiefly to be [comb]. in 1^st place by expelling mucus already accum.

And 2^dly by prev. fresh accumul.

While former chiefly to be effected by mechan agitat partic by emet. latter again may be ans in one of two ways.

Either by dimin secret, or by promot, more ready excret.

From the former, chief morbid condit which here occurrs or what may hold to be prox cause of the disease, immed & directly dimin.

While from latter both less quan accum at a time, & can acquire less viscid.

On these grounds may I appreh. expl. operat of diff remed. most success empl. in this affect.

And will I appreh fully illust. benefite reapt from pract. here empl.

Began treatm of this patient, before case introd into regist, by direct an Emet.

This, in such cases, cheifly & most immed useful, by unload breast.

For whether as some supp. vomit the only expect or not, yet can not be doubt, that in this way, has very powerful influ.

Hence where patient in state to bear operat of emet, few artic more success, in giving immed relief.

And very gener. after use, an easy night, if not longer remiss is obt.

Hence then in most inst at least very prop pract. for begining cure.

But besides unload breast, are also of farther advant. as giving determ to surface.

For in this way have at least tempor good affect in same manner as warm weather.

Hence then often of service not merely as begining cure but as rep. at prop. interv.

Was then intent here, to have again had recourse to use, if from urgen of sympt. rend necess.

But this hoped, might not be necess. from prescrib at same time, with the Emet, the use of Pil. Scillit.

These pills, as now directed to be prep in our Pharm, formd of powder of dry squills.

Which unquest most active state under which this artic can be exhib.

While at same time, less apt than most others, to affect stom in way of naus. or vomiting.

Can be no doubt that active parts of squills, thus introd into circul system.

And accord every day examples of influ, as acting on urin organs.

In my opin no less in prom. [expect] by breast.

In both ways then, useful in this affect.

For by former, determ to the breast is dimin.

While by latter mucus not allowd to stag, so long, as to acquire that viscid, which chief cause of distress.

From these, succeed emet patient derived some advant.

Could therefore have no hesit in direct. contin.

But with these comb. also the comp. powder of Crem of Tart.

An artic formed of equal parts of the Tartar & Sulph.

And which very gener. operates both as gentle diuret & laxat.

In former of these ways, had reason to expect, that would here be [serviceab] as aiding operat of squill pills.

While in latter may look for benef, as giving determ to intest canal.

And can be no doubt, that as thus operat. often prod of very consid relief.

As a diuret howver, neithr this nor squills, seem to have had any obv. influ.

But with gentle operat as laxat. cough & dysp. very much relievd.

And under use had, although not unif, yet speedy recov.

In no long time therefore dismissd free from affect

And prob may contin so till fresh renewal from cold.

But even in that case if patient shall again apply for assist. may still expect allev or remov. by repetit of same means.