DEP/DUA/1/42/31 (Transcript version)

John Logan

(1787-1788)

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John Logan at 25.

In hist of this patients case sympt of diff. disease.

But of these affect of hearing never so consid as to become an object of attent.

Is therefore of pneum affect only that now intend to say any thing.

And this also as will observe from our regist has already come to success. termin.

From this strong evid afforded of opin formerly given respect case

That viz. merely a catarrhal affect.

Then indeed observd that some ground of suspic of [Phthis]

For [Phthis] at commen often merely cough & quickness of pulse pain of breast

Freq. for consid time without any hectic fever.

Or at least without any other sympt of it than quickness of pulse.

And with our patient pulse you will obs. nearly at 100.

Also addit ground for susp. of Phth from age of patient.

Was at that period of life when Phthis very most common.

But then also patients by no mean [illegible] from catarrh.

And with this at comm in partic a degree of fever very comm.

Was in favour of that suppos. that patient here affected with no great loss of flesh.

For in Phthisis remark wasting of body a very const sympt

And in gener. takes place even to greater degree than loss of strength.

Besides not that app. of eye or tongue which comm in Phth.

For while former depr. of all red vess in conjunct. later in general acquir remark redness partic at point.

And while these comm app of Phth absent none pres. which are not strictly catarh.

Hence led to conclude it an exam of that affect.

Catarrh a very comm disease often seen under two diff form.

viz its acute or its chron. state.

Former disting in some degree [meas] by period of duration.

Still more by some degree of febrile affection.

But most of all from not being attend with copious expect.

For at this period rather irritab than augm. secret.

On these grounds then concl. pres. case to be of this kind.

But at same time, some appear of its verging to chron state.

Partic Espec in cough occuring with uncomm severity at partic hour in the morning.

For this sometimes happ. soonr sometimes later in morning one of most common ocur in chronic catarh.

And is as it were necess conseq of mucus accum & acquiring viscid during night.

Here howevr though thus [severe] period cough yet without that expect which in such a case should have exp.

And without the const. Dyspnoea the attend of Chron. catarh.

Hence expressd hope that might be able to remove affect without its degenerat into that state.

And this hope, event of case has now confirmed.

How far, fav concl. which has now taken place, effect of pract here empl, cannot pos. pretend to say.

But am inclind to think that in this way had at least some inf.

In acute catarh is sometim necess. to take off inflam, by bloodl. & other evacuants.

Sometimes to remove irritat, by demulcents.

But in pres. inst. did not seem partic necessary to aim at accompl. of either of these obj

What here seemd princip necess was to disch viscid matter already secreted acting as cause of irrit

And to prevent farther secret. by giving determin from lungs to other parts.

Was then with these intent. that remed here empl. were directed.

Began pract. by prescr. for this patient the use of an Emet.

An artic from which in diff. mod of catarrh often very great adv.

And while of highest utility in chronic state often also benef. in acute.

As an emetic have had recour to Ipecac.

An artic from which as already obs. am inclind to think that full vomiting more readily obt. than from any other

From full vomiting here howevr very great advant.

Not indeed that is partic necess to evacuate the stom.

But as more compl. evac lungs than perhaps any other remedy with which are acquainted.

For of all expect, excepting coughing the action of vomiting may be [cons] as most powerful.

And often even succeeds when cough for a long time exercised alone in vain.

Of this a remark example in inst of Pertussis.

And often also in other obstin coughs where fit necess. termin by superv. vomiting.

Here cough of our patient of that kind, in which, on this princip. from vomiting benef might be expected.

For told that upon awaking from sleep, would often cough for upwards of quarter of hour without interrupt.

A conseq in all probab. of irrit induced by mucus thus accum.

And at same time, of viscid being such that not easily disch.

But emet besides being [thus] [illegible] often advant also as promot disch by surface.

For from free circul. on surface & free disch there can be no doubt that catarrh, allev

Is from this circum that much less freq. a disease of warm than of cold clim.

Is from this that change of clim or passing winter where temperat moder often of great benef. in relieve it

And from this that to acct for benefit of wearing flannel shirt next the skin, or simil warm cloathing.

Is indeed true that determin to surface prod by Emet not perman.

But no doubt that during action of vomit, at least gives very powerful determ there.

And cannot be quest. that circul. fluids pushd even to extreme vessels.

This abund app. both from flushing of surface & even from sweat inducd.

Hence little doubt, that circul. often renewed through vessels before obst.

And by this means, opport. afford for its being afterw contin.

Hence Emet often advant. pave way for introd of other pract.

Or for powers of syst itself afterwards support equab. [circul.] on surface

While with these intent. ordered an Emet. directed also use of Pulv. Crem Tart comp.

An artic consist of equal parts of Cream of Tart & Flowers of Sulp.

In this need hardly obs. that powers of a refrig. cathart & gentle diur. are united.

Nor need I add that from both in such cases very great adv.

Certain that in febrile state of Catarrh nothing tends to aggrav. affect more than bound belly.

And that in chron, patient very generally easiest, when belly loose.

A conseq very naturally resulting from determin to intest canal [dimin] that to lungs.

And thus dimin secret.

But if this effect from gentle cathar still more from diuresis.

In what manner indeed this change of determin should have greater influ hard to say.

Perhaps in some degree effect of partic matter thrown off.

For certain that kidneys afford chief outlett for saline matter

And that this saline matter in cases of catarh often highly impreg. mucus.

Of this incontest proof not only from acrid taste, but from [excorciat] of lips & other parts.

By free disch of urine then mucus secreted may be rend. less irrit.

But whatever explan may be, no doubt that from encr. of disch of urine in such cases often great relief.

Was on these grounds then that expected benef. from med here directed.

In operat of Emet were not disapp.

And am inclind to look upon it as conseq of this that for some days cough consid easier.

In operat of the powder our expect not equally answ.

For although gently moved bely yet had no obv. affect as diur.

A circum not to be wondered at when consid uncert of operat of whole class.

Under use had recurren of cough with as great sever. as before.

And now attended even with more copious expect.

From relief formerly exper. from Emet. was again naturally led to repetit.

And hoped that by persist in Crem of Tart. might at length by prod of full effect.

For not unfreq happ. that artic failing at first to operate as diuret, have yet that effect from contin.

Is partic case with those comb. cathart & diur. power.

And with none more than Cream of Tart.

Here however cannot pretend to say that this was case.

For on contin of use no more effect than formerly.

But operat of Emet. not less adv than before.

For while induced brisk vomiting also followed by remark relief from cough

A circum affording addit proof that advant before obt to be attrib to same cause.

At succeeding report found patien almost entirely free from cough & other sympt.

Hence consid farther attend as unnecess. dismissd him

But at same time cannot with any confid speak of perman of recov

For at this season of year very liab. to recurr.

And indeed, with those obliged to work for bread hardly possib to avoid cause.

Must also add that if disease does recurr. would by no means be aston to see it asume diff form.

And notwith what have said could consider it as in no degree surp or uncommon if patient yet fell victim to Phthisis