DEP/DUA/1/26/20 (Normalised version)

Unnamed Unnamed

(1780)

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For without regular discharge by belly may expect that stomach complaint in spite of every measure will continue obstinately.

And few measures more effective in alleviating these than the keeping belly gently open.

With this intention then had recourse to use of Aloes.

Which in most habits at least one of most convenient & best purgatives in such cases.

But here also with same intention as mentioned above, thought it advisable to conjoin Aloes with Assafoetida.

And therefore here directed use of Pill Foetid cum Aloe a medicine which have already oftener than once had occasion to mention.

From commencement of this course patients symptoms very considerably [relieved]

But after continuation for space of [fortnight] had again some return of vomiting

In this affection, as have just observed consider removal of morbid state on which depends as more to be affected by [regimen] & course of life, than by particular medicines.

By this means best chance both of restoring due mobility & counteracting occasional causes.

Recourse then had to medicine chiefly with view of obviating urgent symptoms.

And with this intention prescription for present patient principally directed.

Began by directing for patient a mixture of Tincture Fuliginis & Infusion Amarum

This will readily suppose principally intended with view to affection of alimentary canal

Utility of vegetable bitters as promoting digestion well known.

In few articles purer or stronger bitters than in gentian, the basis of infusion amarum.

Which not only one of best modes of exhibiting it, but where virtues improved by vegetable aromatic Cortex Aurantia & [ Sem] [Corrin]

Hoped therefore that might have some influence as restraining vomiting & promoting digestion.

In case however where so much discharge from wind & where reason to suspect torpor, imagine these advantages might be increased by additional stimulation, of foetid Gentian

With infusion amarum therefore conjoined a proportion of Tincture Fuliginis.

An article deriving name & perhaps in some measure also medical virtues from soot.

But perhaps still more of activity depending on Assafoetida.

Which of all the Foetid gums is unquestionably most active.

From this conjunction then hoped that advantage from vegetable bitters might be improved.

But while these employed with view to flatulence vomiting & indigestion, seemed also necessary that measures should be taken to obviate costiveness.

Now however not attended with same distressing flatulence as formerly.

But in place of this accompanied with copious eruptions, giving very itchy sensation

This fresh complaint as have already observed no uncommon occurrence in Hysteria

And when does occur in such cases in general I apprehend to be attributed to want of free discharge.

And indeed would in general seem, that in this disease, very great irregularity in all discharge.

In this situation former medicines [no] longer particularly indicated

What now seemed most advisable measure was to promote free discharge by surface.

At same time however still thought it necessary to keep belly gently open.

With latter of these intentions had now recourse to electuary of Cream of Tartar with Sulphur

And with former employed crude Antimony reduced to fine powder.

An article from use of which in cutaneous affections have often I think seen best effects.

Particularly in cases where nature of eruption such that no reason to suspect local disease on surface.

And where grounds for apprehending that topical application attended with bad [consequences]

From this course, obvious operation such as had reason to expect.

While electuary gently moved belly, from antimony, moderate diaphoresis even some sweating induced

With this operation eruption soon diminished.

And although did not uniformly decline yet in space of few weeks almost entirely gone.

While at same time so far free from other symptoms that farther continuation of medicine seemed unnecessary.