DEP/DUA/1/41/34 (Transcript version)

Thomas Aitken

(1786-1787)

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Thos Aitken

Of this case after what said of former now unnecss to add much

For here also a manif exampl of catarh.

But in this inst much more dist markd of chron. kind.

For here no sympt of febrile kind nature

Disease had alr. contin not for few days, but even for sev months.

And what served to mark it still more distinctly, for sev winters past had regul been subj to it during cold weather.

Thus not only manif ex of Chron catarh but of that occur as period disease.

These circum might upon whole be consid as unfav.

But at same time nothing in his case port. at least imm. dang.

For although of long contin, yet had not much exhaust vigour.

In former seasons on appr of warm weather, had spont disapp.

And although on this occas more severe than formerly obs. yet even when came under our care had markd it, as being rather on decline.

Had therfore reason to hope that even without interpos of art, would of itself soon decline.

At least if weather favour.

For on this, as already had occas to obs. more than any other circum, recov from catarh affect depends

And even where app recov, on slightest change of weather, aggrav of affect.

In treatm of this case, consid both cough & dyspn. as effect of mucus depos in breast, first obj. to unload it.

And was for this purp. that directed an emet to be repeated at interv of few days.

For of all expect emet most immed, & most powerful.

Besides this consid effect also as renewing circul on surface.

And thus giving chance at least of change in balance.

Thus in some degree prod of benef of warm weather.

Or at least as paving way for its influ.

Cannot however say that in these partic expect here answ.

May indeed have had effect of unload breast.

And of this presumpt, both from having oper. well, & likewise from finding that at succeeding report less affected with Dysp.

Now also little disch by expect.

Which might also consid as conseq of their being little, to disch

But cough even rather more severe than before.

A proof that still some irritat at lungs.

And prob. still tenden to [augm] secret

In this situat, had recourse to Vin Nicot.

Which hold to be one of best form for exhib this artic.

As by vinous menst both saline & oily parts most readily [extractd]

And highly probab. that both very consid influ on syst.

Nicot. long known to posses very active powers.

And long in some degree [used] in med.

But not hitherto perhaps so exten as it deserves.

Of late however has become more common.

And for its introd. are indebted to that very accur pract. Dr Fowl.

Partic has pointed out its strong powers as a diuret.

This indeed not an effect unif. result from use.

Nor indeed certainly arising from any one med whatever.

Even [illegible] in some cases entirely disch by other [illegible].

And this uncert. not surpr. when consider situat of organ.

For so placed as to be very much out reach.

While however no diuret certain yet unden that often consid diff from Nicot.

And while reason to presume, that narcot powers effect of oil whch it cont am inclind to conject, that diuret effect from saline [impreg]

This however I throw out merely as conject.

But may at same time add, that may admit of being determ by exper.

And am not without hopes that the Harv. Society having prop. Nicot as subj of prize dissert for 1788, may perhaps in some degree lead to useful investig of that quest.

But whether diuret powers from resin part or not certain that oil highly narcot.

This app. from accur. experim of the Albe Fontana.

For accord to his trials, with some animals at least, even by slight applic as by small quant on toothpick to wound on breast of pigeon, most remark affect of nerv syst. prod.

And what he has done, points out a variety of future trials by which circum of import may be determ.

Among others whether diuret power in any degree effect of oil or not, a circum well deserv to be ascr.

From diuret power which certainly does possess first empl. in drop cases.

And from advant derivd from other [diuret] in chron catarh as well as in dropsy was but natur to empl it in that affect.

And here besides diuresis reason to hope that might also be useful even by narcot power.

As taking off or at least dimin affects of irrit in excit cough.

But on whatever prin may oper. have no doubt that in such cases often highly benef.

And this am well conv have often found in my own pract.

Here directed Vin Nicot to extent of [gt.] XX ter de die.

This consider as moder dose for begining use.

And app. that with our patient at least could not have been [borne] to greater extent.

For as at first taken espec with empty stom in morning, excited vomiting.

But not to such extent as to lead to discont use.

In effect however of obtain [diur] expect were not answ.

For was not at least sensib of any consid disch.

But whether effect of drops or not felt breast consid relievd

From this then nat. led to contin.

But after persist in use for anoth week still found that cough freq.

And that no more diuret effect obs. than before.

From this led to try conj with anoth diuret.

And while directed contin as before ordered also ten gr of Squill pill at bed time.

Still however no obv change on quant of urine.

And evid proof that with him augm disch by kidney not eas. effected.

But at same time now so far free from cough, while in other resp in good health that reckond farther attend unnecss.

When thus disch however can hardly with and confid say that fav change on his disease, effect of med empl.