DEP/DUA/1/13/21 (Normalised version)

Isabel Taylor

(1777)

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Isabel Taylor.

To disease of this patient as introduced into our register¹ must own should be much at loss in affixing any name.

And had afterwards no opportunity of being farther satisfied with regard to it.

For after first visit has never given any farther attendance.

From account however which we received would seem that principal part of her affection a stomach complaint.

And that here chief distress from violent pain which originated in region of stomach propagated to other parts.

Such pains from spasmodic stricture united with flatulence by no means uncommon.

Here however would seem that this not the case.

For neither obvious swelling of stomach during severity of pain nor any other mark of flatulence.

From transitory nature however & frequent recurrence cannot suppose that in any degree effect of inflammation.

This therefore would naturally lead to supposition that is purely of spasmodic kind.

But in this affection another circumstance to be mentioned perhaps not less deserving notice.

That is state of menstrual evacuation.

Would seem here that patient desired of connecting affection with state of menstrual discharge

For dates complaint from time of first appearance of menses.

And this evacuation we are told had first taken place about three years before.

Would not however seem that had any dependence on a morbid affection of menses.

For informed us that till two months before came under our care these had continued regularly.

But that for two preceding terms had been obstructed.

When in any affection obstruction of menses occurs always becomes question of importance whether in any degree connected with other complaint or not.

And where is connected whether to be considered as consequence or cause.

In case before us no manifest reason to suspect connection.

Affection now occurring not more severe than had been for years before.

And showed no marks of having been such exhaustion of system as could induce amenorrhea from inanity.

But supposing connection could by no means view it in light of cause of affection of stomach

For these according to account given us took place much sooner than obstruction of menses.

Notwithstanding this however patient herself seemed to consider this if not as cause at least as chief circumstance supporting affection

And principle anxiety seemed to be to have menstrual evacuation restored.

Was however by no means perfectly clear as to propriety of attempt for this purpose.

For while may often exist as morbid affection so may also occur with heat of system.

And during period of pregnancy should always be wanting.

And own was not altogether without suspicions that such a cause might here operate.

Was even tempted to suspect that other parts of complaint might be fictitious.

Or at least that might be unfairly represented.

And that affection of stomach no other than what are very generally the attendants of the pregnant state at early periods.

For while obstruction of menstrual pretended by those who wish to procure abortion common at same time to connect with it some story for which no foundation.

In this state of doubt then was aim to have attended to every circumstance which could serve to throw light on true nature of the affection.

And till should be more ascertained with regard to it, to suspend judgement regarding prognosis & to delay any regular plan of cure.

Was therefore rather with intention of gaining time than anything else that ordered for this patient Elixir of Aloes.

Which however hoped might have some effect in alleviating pain by keeping belly gently open.

But what effect of this first prescription have not been able to learn.

For as already observed patient never returned

And thus precluded from all farther inquiry to nature of affection or attempt to cure

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Explanatory notes:

1) References are made throughout the case notes to a dispensary patient register. However, no evidence has been found that this register survives.