DEP/DUA/1/44/45 (Transcript version)

Janet Baine

(1788)

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Janet Baine at 53.

When this patient came under our care, had no hesit in pron disease to be a distinct markd catarh.

And then of so recent date, that might be consid as in acute state.

From extent of expect however as well as from what had happ. in former year, had every reason to concl. that would soon verge to chron. state.

And this accord might consider as in no long time taking place.

For all sympt. indic slightest degr of fever soon left her.

And whole compl. might justly be consid. as depend on augm secret of mucus

When began pract here, disease as have already obs. but of recent date

Imag. therefore might be of some conseq to take off irrit to cough.

For no doubt that by this secret of mucus augm.

Accord with this intent had recourse to a mucil. mixt.

This, in cases of recent catarrh, often had recourse to with manif. adv.

Partic as dimin freq. of cough.

There I am inclind to think acts merely be lubric fauces.

And by involv. acrid mucus [otherw] proving stimul at larynx.

Operates therefore, in same manner, as various demulc. taken into mouth in solid state & allowed grad to [met] as refind liquor &e.

And of this kind what I own I consid as one of best is [illegible] [illegible] cum Opio.

As with demul. effect of liquor, obt also sedative effect of opium.

Thus not only is acrim of stimul dimin, but influ as far as contin to be exerted has less effect.

And accord partic useful in cases of mere tickling cough.

There however quant of expect. & tend to chron state seemd obj to it.

As then dimin of sensib apt to take of necess coughing.

And thus prev. breast from being unloaded of that muc. giving dysp.

Here accord. had recourse to [simple] demul

And as no limit necess with resp. to dose ordered an ounce as often as cough urgent.

Under this no remark change induced in state of cough.

But while not thus prod of good effect was in some degree appreh of bad conseq.

For with dimin of expect, there had occurd aggrav of dyspn.

This I own susp. might be conseq of accum mucus.

And of course in some degree arising from mixt.

Hence in place of contin use thought it necess to empl. a med encr. expect.

And as such had recourse to an emet.

Of all expect which Mat. Med cont. hold emet to be most powerful.

At least next to action of coughing that of vomit, most ready means of unload lungs

And as emet here, had recourse to what hold to be most cert. viz Ipecac

While directed Emet. ordered also comp powder of Crem of Tart.

That is powder consist of equal parts of Crem of Tart an Sulph.

An artic often oper. both as gentle cathart & diuret.

And thus by encr. determ to other parts dimin flow to lungs.

On this ground at least, am incl. to expl. benef which have often seen reapt from it in Catarrh.

For very much deceivd, if in numb. inst, have not seen patient derive great benef from it.

From effects however of these med as well as formr, had not all the good conseq that expected.

At same time little doubt in attrib. to them, some degree of relief which patient now obt.

From emet had all obv. operat that could have desired.

That is full vomit, without any excess straining.

And too this would attrib relief of cough & dysp. which soon after exp.

Prob. also had some influ in dimn expect. which as now without augm of dysp. was inclind to attrib, to dimin of secret.

For this affect emet often have by giving determ to surf.

But rather inclind to attrib it, to effect of Cream of Tart as mov belly.

From this med however though gentle cathars, yet no influ as induce diuresis.

Hoped however that this might be effect, of farther contin of med.

But while directed her to persist in use, imag that something farther might with adv be done, as dimin determ secretion at breast.

And with this view had recourse to a gentle [restring] med, the Uv. Ursi.

This artic in [catarhs] of chron kind have had recourse to in some former inst.

But cannot say that have yet had such exper of use, as to enable me to speak with confid of effects.

As far however as I can judge, have sometimes seen good, sometimes bad effects result from use.

For in some cases seems to have had effect of dimin secret & thus allev disease

In others of dimin excret merely, & thus augm dysp.

And thus very much in same situat with opiates.

Which however more freq. prejud as binding up cough breast as is calld.

When therfore direct empl. must always be regul by effects.

And can only with [freedom] cont use when no bad conseq.

When first began use for some time at least saw no ground for any alarm.

For at end of a week cont. in every respect rather better.

Both cough less freq. & expect dimin

Still however affected with Dysp. part in evening.

But this no more than might reason have expect.

And consid it as no reason for intermit med.

At succeed report indeed found that both cough & dysp had been very distress.

This however she herself ascribd to uncomon coldn of weather at that time

And in my opin with great app of prob.

For very few diseases on which cold has more manif influ.

In many cases as was indeed case with this patient, consid relief during summer, but recurr on cold weather.

And indeed for my own part know no disease, where greatr relief from passing winter in warm clim.

Hoped therfore that by milder week should find sympt dimin at succeed rep.

Reckond it unnecss. to make any alter with respect to med.

Were however no less disapp. as to change of weather, than in mitig of affect.

And whether conseq of cont. cold or of any other circum found her at next report even worse than before.

For cough very severe attended with much dysp. & little expect.

Did not still, as have already said, considr these circum as conseq of Uv Ursi.

But in this situat of patient though contin improp.

And at same time as a means of again freely unload breast, had recourse to repet of an emet

With this however still directed contin of Cream of Tart.

As still hoped that might be prod of benef both as laxat & diuret.

In these ways however operat still but unconsid.

Vomit indeed operatd well.

But even from this did not obt that relief of breathing which exp.

And cough even aggrav.

This however addit evid that formr aggrav. not effect of med, but of state of weather.

And as thus disapp. of relief, became now necess. to have recourse to some other mode of prod determin from breast.

With this intent had recourse to a blister

Respecting good effects of these in cases of Catarh all pract. are [agreed].

Diff expl. however given of mode of action.

By some entirely [referd] to antisp. power.

That in this way may have effect would not deny.

But for my own part ascribe much more to influ as evac. & to changing mode of circul.

Accord while disch contin & supp. had much relief.

But upon being allowed to dry up had again return of sympt.

This natur led to repet.

And on this again exper. same relief as before.

But either found it diff. to support running or disliked so painful a remed.

And accord as soon as consid relef again allowed disch to be stopt

Not however improb. that may again be obliged to have recourse to it.

Or to direct it, under form in which contin more readily secured that viz of Pea issue.

In mean time however have directed only contin of Cream of Tart.

And if with this shall now have mild weather, will do more to allev of affect of pat. than any remed we can empl.

If however any other med necess. may here have recourse to Nicot or Squills, from both of which have in many inst seen consid benef.