DEP/DUA/1/43/18 (Transcript version)

Agnes Sead

(1787-1788)

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N^o20 Agnes Sead at 18.

When formerly spoke of this pat. case obs. that consid her as subj to compl. of affect.

What most distress. to her how was the Diarrh.

And to sever with which had subs. for consid length of time was inclind to referr state to which reduced.

At same time however obs. that not without some appr. of Phthis

For besides pain of breast, cough & dyspn. sever other circum also rend it prob.

Partic quickness of pulse, intens thirst, imp app & failure of menst disch.

And to all these to be added that patient at a period of life when Phthis most com.

But notwith all these circum [could] not be said to be a decid ex of Phth.

That is had not those regul access of hectic fever & colliq sweats which chiefly obs to charact the disease.

From these consid led to think that Diarrhoea not here to be consid as sympt of Phthis.

And to entert more fav hopes than, as now app from event, were well founded.

Now little doubt that though no prop. hectic access. patient, had yet been subj to Phthis from comm of cough, that is for period of nine months

And that diarh. though of no less than four months contin was yet sympt of Phthis & of colliq [sweat].

In this then, as in many other cases, have evid of insid nature of this affect.

In some inst app. alarm where yet the affect merely catarhal.

In others & that much more freq. progr. of Phthis very great before distinct markd.

Although however in pres inst had been fully aware of danger of patient, would have made no alter. in treatm.

For when Phthis occurs & is even in incip state very little can be done with advant.

And in adv. states of disease know no pract on which least dep can be put.

Then if recov happens which inded very rare occur. is entirely operat of nature.

And art can do nothing more than allev. sympt.

In this case as have already obs. sympt most urgent was the diarrhoea.

And was with view to mitig. of this that had recourse to two med here ordered.

viz Pil. Theb. & Mixt with Confect. Japon.

Effic of first of these need hardly remark depends on Opium which cont.

Nor need I add that this most powerful artic as allaying inord. act with which are yet acq.

In this way a very effect means of restr. encr. disch in gener.

And every day in use in cases of viol [diahr].

Where oper. no less as prev. augm action of intest canal, than encr. depos into intest.

In same manner as restr. loosenss also allays cough.

And in this way then, might have been imag. that also serviceab in pres. case.

Where however cough with much expect & dyspn. the restr. it not always desir

For cough means of reliev. dysp. in conseq of expect.

Is indeed true, that by freq efforts in way of coughing secret at lungs augm.

And thus by dimin cough a less quant of matter to be disch.

But from restr. it very much still worse conseq.

This then necess led to caution in admin. of opium.

And accord seemd advis to begin at least with small quant.

Here directed opium under form of Pil. Theb.

In that form as unitd with Arom the Jamaica pepp. often sits more easily on stom, & gives less affect of head than when taken pure.

While at same time nothing in artic added of such active nature as in least degree to give restr. in empl. opium to any dose req.

In most cases for an adult unacc to opium a grain may be consid as full dose.

Here however as our patient a delic female, unaccust to use, & as uncert of effects of checking cough, [ordered] it in smaller quant.

To extent viz of half a grain only, quant cont in gr V of pill.

While however this taken at bed time directed mixt of Confect. Japon through the day.

Of basis of this artic the Succus Japon have already oftener than once had occas to speak.

And may only repeat that consid it as one of best veget astring partic in cases of Diarh.

Would indeed in my opin be improv of formul. if prep. with Succus Japon depur.

And if quant of G. Kino which enters compos either dim or even entirely thrown out.

For this much more an acrid & resin subst. But even as it is a very useful artic. And when diff. to quant of ℥ ii in ℥VI of watery menst. often highly adv in diarrh. Cannot however say that from either med our pat. have either reaps consid adv. or much allev of symp.

Both looseness & cough indeed [here] at times somewhat dimin

But still suff a very rapid dimin of strength.

And in no long time, as is case with by much greater part of Phthisic patients fell a victim to her disease.