DEP/DUA/1/12/10 (Normalised version)

Janet Lyon

(1776-1777)

---

Janet Lyon.

A case in which many symptoms.

Cannot however as in last instance consider it to be one in which complication of diseases.

For apprehend that among all a manifest connection

And that whole to be considered as symptoms of one disease.

Principle complaint in this case affection of the alimentary canal

And in these have almost every characteristic of Dyspepsia.

Nausea, vomiting inflation, etc.

And these, at same time, as commonly case in Dyspepsia attended with bound belly.

Can be little doubt therefore in pronouncing patient to labour under that affection.

And although headache not a constant symptom of dyspepsia yet frequently an attendant.

And would conclude that affection in present instance not an idiopathic disease but merely symptom of stomach complaint.

But besides headache patient also affected with some other symptoms less frequently attending Dyspepsia

And these too the attendants of other diseases most nearly resembling it.

Some, as sense of ball rising to the throat impeding respiration, symptoms of hysteria.

Others as palpitation & watchfulness often attendant of hypochondriasis.

Patient however I apprehend cannot be said to be affected with either one or other of these complaints.

Am far, as have already oftener than once observed, from considering globus hysteria as pathognomonic of Hysteria.

And here other characteristics particularly fits, state of mind etc. wanting.

Same also may be observed with respect to hypochondriasis.

Patient by no means of that despondent disposition attending this affection.

Nor has she any particular marks indicating torpid habit.

Would conclude therefore both one & other merely symptoms of Dyspepsia.

And from presence of globus may even I imagine infer that atonia of stomach in dyspnoea connected rather with state of irritability than torpor.

This then idea of disease of present patient

How far conjecture well founded in ascribing it to hard labour will not say.

May at least however observe that not to be considered as a common cause of this affection.

At same time that by hard labour alone state may be induced can admit of no doubt.

And may affect stomach as well as any other part.

At least therefore some grounds for presuming that not mistaken

And on that supposition may serve at least to give greater expectation in prognosis.

As patient may probably again avoid action of same cause, as supporting complaint.

Yet may observe that symptoms have already gone to very considerable height.

And not to be reckoned in recent state.

For have already continued for space of two years.

And well known that when takes root often obstinate.

Especially with one so far advanced in life as present patient

Have here however some better chance from not having already used medicines.

And from what we have seen of her would not seem disposed to take my medicines.

For since first application has never again returned.

Shall however state briefly principles on which plan of cure here begun.

And which mean to continue if patient shall again return to us.

In this case great objective unquestionably is to restore proper tone of stomach & alimentary canal.

To be affected by tonics either to system in general or stomach in particular.

This however if ever to be affected must require some time.

Meanwhile a matter of no inconsiderable consequence to obviate urgent symptoms of patient.

And of these not least distressing are flatulence & constipation.

While at same time from these probable that others arise.

Reckon it therefore of no less consequence to observe such affections than to attempt radical cure.

With these intentions put patient on use of Pill Gum & Tincture Cardamom.

First as antispasmodic & carminative.

Second as stimulant & tonic to stomach

While at same time hoped that former might have some influence as keeping belly easy

Failing these should probably have had recourse to other articles of nearly same powers.

Presuming that something farther necessary with view of moving belly.

And with this intention may have had recourse to aloetics.

As tonics to stomach might employ Colombo root, Peruvian bark or like.

But with this patient perhaps unnecessary to suggest many plans.

As presumption that as has already laboured under complication now mentioned for some years without medicine may not think of anything farther.