DEP/DUA/1/43/16 (Transcript version)

James Miller

(1787-1788)

---

N^o19. James Miller. at 28.

When formerly spoke of case of this patient expressd some doubts with resp to it.

Was inclind however to consider it as an irregul or rather anom inter.

But at same time as partaking not more of nature of ordin intem. than of gener tribe of nerv. affect.

And was on this idea that pract here empl were directed.

Begun by direct for patient an Enem. A remed not less comm in interm than in affect which have lately had occas to ment. Dysp. & Catarh.

Indeed has been said that by Emet. alone interm may be cured.

But without attempt this often useful as prel. to other mode of cure. Partic to Peruv. bark.

For that this may have full effect necess that stom should be empt.

Accord bark before failing has often succeeded when Emet [prem] to empl.

And here sole view to empt. stom. From this led to give pref. to Ipeca. Which indeed I must own I consid as best emet with which yet acq.

For by means of it can with great certain & saf. obt. full vomit.

When prescr. emet. directed also mixt of Peruv Bark & Valer.

To be begun after operat of Vom. And taken to extent of Tea spoonf., that is about half a dram [4ter] [indies]

Of first of these med as a cure for interm. effic now conf. by unquest exper.

While last, as have already [oftener] than once had occas to obs. consider as a very powerful artic belong to tribe of Nerv. antisp.

Resp. most success mode of exhib Peruv. Bark for cure of interm. diff opin are entert.

Very gener. however agreed that most success when given in subs.

But while some advis exhibit imm before fit, others as stren. recomm its being thrown in taken in large quan immed before after fit.

For my own part have never been able to see partic adv. from either mode.

For cure of Interm from one to two ounces of bark in gener. req.

And this, if taken in subst. in space of one or two days, will be suff. in whatever mode taken.

But very gener. easiest for pat. & most cert. retained in stom if thrown in by small doses freq. rep.

That also best mode of exhib Valerian.

For this still more than bark will often induce nausea & vomit.

These circum then will explain reason for giving med in form here directed.

In operat of vomit were not disap. And after use of powders fits became less freq.

In so much that during course of week in place of three had one only.

This however consid as no suff. reason for giving up use.

For well known to that interm very great tend to recurr.

That in many cases relapse happ. from use of Bark, being given up too soon.

And that often even occurs [notwith] contin. But while these circum induced me to persist in bark & valer. another [occur] which had taken place [dem] diff treat.

A severe pain viz in left ear. For this, consid it as an examp of [illegible]. directed Camph. oil with a small prop of Theb. Tinct.

An artic from which in simil cases think have seen manif ben. derivd.

Though at same time must acknowl. that consider it as by no means adeq. to remov. of pain at comm.

And that in most cases, even without aid of med pain in no long time of itself ceases.

Hence med sometimes app. to be success. merely from period at which exhib.

This not improb. was case in pres inst.

For not long after use begun was no longer affected with pain in Er. But whether had any share in giving rise to this change or not, now found that notwith use of Bark & Valer. former shiv fits returned.

And that too as patient imag with encr. viol.

Still however under same form as before.

That is mere shiv fit without any succeeding augm heat.

This led to add to former med anoth antispas.

The use viz of Calx of Zinc.

An artic which since introd by Dr Gaub. have often I think empl. with adv.

Partic in inst of Hyster & Chorea, to which pres. affect might be consid as having at least some anal.

For some time after began powd with this add. seemed to have but little influ.

But by persist in use again disap for second time.

And after entire freedom for more than space of forth night, thought farth contin altog unnecss.

To this rather led on acct of a new occur in case of patient.

Had become affectd with sympt of catarhal kind.

Partic cough & headach.

These sympt. imag. bark might even have some tend to encr.

For this often a conseq of what tends to restrain respir expect.

Accord not only omitted bark. But directed use of Squill pills, as means of augm & prom expect.

And during use this affect took place.

While at same time cough so far dimin, that reckoned farther attend [unn]

And this the rather as no return of sympt which led him to apply for assist.

How far Squill pill tended to [stop] catarrh will not pret. to say.

But think may with prob. ground infer that other med had effect of at least forward termin of origin affect.

And that Zinc even contrib to this effect as Bark & Valer before tried without effect success