DEP/DUA/1/46/20 (Transcript version)

Martha Nixon

(1789)

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N^o3. Martha Nixon.

Formerly gave it as opin that in case of this pat, compl of diseases.

And as has not returned since last spoke of case no circum has occurrd to alter opin. Hold sympt to be affects of Catarrh & of Flatul.

In both one & other affect. have diseases very common in this Country.

And when occurring very obstin partic at this season of year.

What I here hold to be prin comp. is what I think best disting by title of chron catarh.

This disease abund charact by cough, dyspn, & mucous expect.

And can I think be little doubt, that two former sympt to be ascribd to latter.

That is encr. secret of mucus taking place into breast, gives dysp. from filling vesic fitted for recept of air.

And excites cough from acting as cause of irritat.

This however may be consid as natural [effort] for expuls.

And accord when by any accid, cough wanting, dyspn. augm.

For, as from want of disch, secret not dimin, encr. accumul must take place in lungs.

Thus then prin morb. affect, or what prod leading sympt, is encr. mucus secretion.

And this soon at it were becomes an habit disch.

Or at least easily renewed by very slight accid.

Among most consid of these may ment cold to surf.

For by this means free circul. there being dimin, balance changed.

And of course determin takes place to internal parts.

This accord to prev cond of intern parts, sometimes affect one org sometim another.

With greater part in health gives to determin to kidney.

And excret by that organ, compen. [excret] by surface, little or no inconv. [aris]

In other cases in place of kidney determin takes place occurs to intest canal.

And with them on every expos to cold or constrict of surf diarrhoea induc

From this need hardly remark that when to great degree disagr & distress conseq.

But conseq. no less disagr. & still more common from determin to lungs.

Is in this manner then that chron catarrh subj to period returns during winter.

And indeed best avoided, or after has taken place, best overcome by avoid winter of this clim.

Accord know no disease, in which passing winter, in warm & steady clim, of more conseq.

And where this unattain, by keeping much within doors, during winter & by def. when abr. by prop. cloath

Though these however, prop. precaut when disease has come on, yet not to be recomm to those in health.

On contrary [consid] that here best defence against clim is by habit body to its vicissitudes.

But after such a morb. affect has taken place, this condit of habit no longer to be expected lookd for.

And then relief alone to be expectd by [propr] defence against cold.

This however with lower class next to impossib

Hence with them the obstin of affect & diffic of remov. it at this season.

But besides this disease, patient subj also to anoth set of sympt.

This [consistd] in distent & pain in alim canal.

Which as not fixed to any partic part, & as remov. by disch of wind on eruct. we may with confid concl. arose from flatul.

Here however merely occas flatul & in no degree of tympan kind

Prob. even much more conseq. of encr of power of extric than of dimn of resist.

The circum from which tympan. perhaps entirely to be expl.

Nay there dimin of resist so great that perhaps even may be consid as paralysis at some parts of intest canal

But while proper tympan a rare affect. occas flatul to such a degree as to give great distress a very comm affect.

And partic among lower class confind to sedent life, & fed on [sparse] diet of flatul vegetab.

Is also, it may be supp. naturally augm, when state of weather unfav to exercise out of doors.

Hence this likewise in winter more obstinate

From all these consid then may view patient as at pres unfav situ for recov.

And even if that even should take place, will yet be const exposed to renewal of affect.

Hence utmost that can here reasonably expect is mitig.

And that too even if patient were to give [fairest] trial to remed empl.

In attempting remov. for combat diff parts of affect, diff obj. to be had in view.

Relief & indeed remov of catarrh, chiefly be be expected, by disch viscid mucus already accum in lungs.

And by restor secret to natural stand.

But where these not to be accompl is of great conseq. to prev stagnat giving viscidity.

Relief of flatul cheifly to be [expctd], by removal of these spasm contract, tending to retain wind in intest.

By encreasing action for expuls after is extricated.

But still more by augm force tending to prev extricat.

On these diff grounds operat of greater part of remed, operat of greatr part of consid, commonly found benef in such affect may I appreh be readily expl.

And of several diff pract in both affect, shall afterwards have occas to speak when treat of other cases already under [care].

Present patient however has hitherto been very little subj of pract.

Only remed directed for her was what in Disp pract we stile the Pil. Foetid cum Aloe.

These consist, of equal parts, of Aloes, Assaf & Soap.

And while useful in diff diseases, are I think in partic so in cases of occas flatul.

Was therefore against this part of affect, that chiefly calcul.

Need hardly remark that while Assafoetid as well as Aloes, is gently purgat. operates also, as powerful antispas.

While at same time gives that stimul to action tending to expuls of flatus.

Hence few artic consid as more powerfully carmin.

And few perhaps in actual pract. more benef.

By these means then expected that should both open belly & remove flatus.

And thus allev. pain & distens from wind.

But, even from prod these affects, looked for some influ, in remov. catarh sympt, partic dysp.

For no doubt, that this not a little aggrav, by distens of alim canal.

Might also expect some benef. to catarh, from keeping belly open.

For by this means, no doubt, that some determin from lungs, to alim canal.

And of all means of dimin secret at lungs, determn to other parts most powerf.

Accord open state of belly seldom fails to give some allev to this compl, constip again to aggrav it.

But besides this, expected also some benef from Assaf. as more im. affect lungs.

Can be no doubt, that is a very powerful & penet stim, in [hum] syst.

And unden, that to remark degree, affects breath at least by smell.

Need hardly observe how much in sensib. qual. approach to garlic, squills, & others of alliaceous tribe.

All these however, from giving addit stimul to excret of mucus esteemd powerfully extract.

And am much mistaken if this be not also prop of Assaf.

On this ground therefore expect some benef from it as comb that part of affect.

But at same time, far from thinking, that can look for remov. of compl. from use.

And if pat contin attend, may find it necess to direct other pract, partic against catarh.

May be necess. occas to unload lungs of mucus, by means of Emet.

And of all expect. action of vom may I think justly be consid as most powerful.

Or may aim at dimin of determin to lungs, by encr. disch by kidney.

And for this purpose may conj powder of dried squills with pres pill

But in directing these, must entirly be regulat by circum.