DEP/DUA/1/47/18 (Transcript version)

John Miller

(1789)

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N^o30 John Miller at 32.

Can hardly perhaps be said that in this case have all charact of Asthma of spasm kind

And Partic patient not affected with that pecul sense of stric on breast which so comm attends the disease.

And which perhaps to be consid as one of princip proofs that the diff of breathing the effects of spasm.

Has not also the usual termin of fit a very cop sputum.

Or as happens in some cases a cop. flow of urine.

Both one & other probab to be consid as evid of resolut of spasm.

Here indeed it must be allowd this app not altog wanting.

For towards close of parox slight cough with some expect.

This however by no means that copious disch which gen takes place on concl. of parox

But although thus some common marks wanting can have little doubt in viewing it as an inst of that disease.

Thus abund evid from suddeness & freq of attacks without any obv. cause.

From sever [with] occur partic during night, & oblig him to rise out of bed.

And finally from pecul [whezing] noise with which respir during this state of diff is attended.

All these circum at least much more easily expl on suppos of spasm strict than any other.

And without entering farther into controv as to partic situat of spasm may I appreh consider this as constit disease of pres pat.

Here however perhaps proper to point out also, what may be consid as anoth pecul.

The return of affect viz on expos to cold.

Pure spasm asthma very gen at least much more distress in hot than in cold weath.

And when consider, that disease must natur be encr. by every thing tend to augm irrit this by no means surpr.

For little doubt that heat a tend to augm mobil of nerv power, cold again to prod torpor.

The contrary of this however seems to have taken place in pres inst

Or at least, after some interv ascribe occurrence to cold.

But even then prob. acted only as excit cause.

And disease you will obs. comm in Aug. when weather commonly at least the warm. Dog days.

But whethr in this resp much pecul or not, have I think, but little reason to flatter ourselves, that shall soon be able to over. this affect.

For when dispos to such inord action once takes place very apt to be renewed by slight causes.

Accord not a few who may be consid as subj to the disease for course of many years.

During that period however tend to fits sometimes greater sometime less.

And this prob. depend on corres states of morbid irritab.

Which at times even so great that fits induced by slightest cause by circum even altogh escap obs.

Hence title of asthma spontan.

Upon other occas however morb. irritab. will almost entirely cease.

And thus long interv without any fits.

As then tend to spasm so far dimin, that many excit causes, will act upon body, without prod any effect.

This in some degree points out to us what should be great obj in cure.

When threatning of approach spasm should be endeav if we can to antic or prev its occurr.

When has already taken place to bring about resolut.

But above all, when free from fits to remove that morb irritat of moving fibres, by which subj to inordin action from very slight causes.

Is with two first of these intent that have here had recourse to a mixt with vitriol aether.

And with last, that have directed the Zincum praecipit with valer.

From these hardly I own expect a radic cure.

Yet hope that shall be able in some degree to dimin both freq & sever of fits.