DEP/DUA/1/26/14 (Normalised version)

George Mathew

(1780)

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George Mathew

When this patient came under our care affection to which subjected said to be entirely stomach complaint.

And that too immediately proceeding from flatulence.

For that to this are to refer both pain & swelling at stomach seems very evident.

This sufficiently proved from single circumstance of frequent discharge of wind.

For although from such discharge no very great relief yet attended with obvious diminishment of swelling.

And that relief should not be considerable is but necessary consequence of swelling soon again returning to [former] state.

While from wind, account for swelling & pain at stomach to same cause also would refer other symptoms.

Particularly diminishment of appetite & bound state of belly.

This then may I think be considered as sole disease to which patient subjected.

And perhaps better entitled to name of Flatulence than any other.

For while has not characteristics of Dyspepsia as marked by difficult or [depraved] digestion is so much confined to region of stomach that cannot properly get name of Tympanites.

With respect to termination no circumstances in the case which can lead us to apprehend danger.

Yet must own, that when first came under care, was suspicion that affection would prove obstinate.

And although, has, been considerably diminished since treatment begun yet by no means certain that will not be case

Yet must observe that now probable hopes of speedy & favourable termination

In treatment first objective naturally presenting itself the immediate expulsion of wind.

And afterwards the prevention of fresh accumulation in stomach.

First to be effected by removing [causes] tending to obstruct [passage]

And by inducing such actions as tending to immediate expulsion.

Second again in some measure to be accomplished by avoiding introduction of such matters as afford large proportion of air

But still more by strengthening tone of stomach.

With these different intentions remedies [directed] in this case have been employed

Here first prescribed for patient every night at bed time Pill Foetid cum Aloe to extent of grain X

These consist of equal parts of Aloes Assafoetida & Soap.

While latter intended merely to give form to either [article] of [considerable] activity.

Assafoetida from antispasmodic power has effect of removing obstructions to passage of wind & from stimulation gives additional force for expulsion.

While Aloes again as means of obviating costiveness powerful influence in producing discharge downwards

With use of pills at bed time mixture taken also through the day.

Of this mixture the basis Tincture of Peruvian Bark used with view of strengthening tone of stomach

And if this properly effected will unquestionably be most effective means of preventing fresh accumulation of wind.

With view however both to giving form & also to immediate expulsion Tincture of Bark conjoined with peppermint water.

Than which perhaps from [impregnation] which has of essential oil of peppermint no article more powerful as tending to immediate expulsion of wind.

Some grounds for expecting that patient already freed from affection.

Under these medicines after patient had continued for space of week symptoms considerably alleviated.

And while pills had effect of keeping belly gently open, considerable & permanent diminishment of swelling at stomach was also obtained.

And at last report, after continuation for space of another week, patient was entirely free from complaint.

Still however to secure advantage, medicine was ordered to be continued.

And from not having since seen patient, may hope that has been attended with this effect.

If should not be the case however advantage already derived from present course will naturally lead to continuation

And if alteration made must depend on circumstances of which not now aware.