DEP/DUA/1/29/20 (Normalised version)

Mary Rawlinson

(1782)

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Mary Rawlinson

Of case of this patient very little to observe

From history of affection indeed as introduced into register¹ would appear [that] labours under complication of affections.

In sickness at stomach with headache had evidence of a dyspeptic affection.

In cough with viscid expectoration had evidence of a catarrhal complaint.

While spasmodic affection of oesophagus probably an hysteria symptom.

To all these, farther to be added, an uterine affection.

As indicated by irregularity of menstrual discharge, & fluor albus.

But although all these symptoms might in some degree exist, yet had reason to presume that were to no great degree & that patients representation of affection rather exaggerated.

And since applied for assistance have seen very little of her.

While at same time this irregularity has not proceeded from her being unable to attend us.

At commencement of disease could not propose to form any opinion of termination.

And now as much at a loss as ever.

Yet may venture to assert that in appearance which this case at present exhibits nothing alarming.

And that by proper attention, reason to hope, that in short time may be soon freed from greatest part if not from all of them.

In practice could not at first [direct] endeavours to every part of affection.

From remedies employed however will observe that attention turned to affection of alimentary canal.

Hoped that by strengthening stomach both sickness & headache might be removed.

This purpose however not more effectively answered by any medicine than by vegetable bitters.

And these accordingly have very commonly got name of stomach medicines.

Had here recourse to one of [purest] & best of vegetable bitters viz Gentian.

For this may justly be considered as basis of Infusion Amarum.

The small proportion of Orange skin & coriander seed which enters it [rather] to be viewed in light of corrigent than anything else.

This however with present patient thought might with advantage be still farther increased.

And accordingly added proportion of Tincture Aromatic

[By] which while rendered more warm & grateful to the stomach medical virtues improved.

Besides this however was necessary also to counteract costiveness.

For nothing more effective in [supporting] stomach complaint than continuation of this

While with this view resolved to have recourse to aloes, imagined that some additional advantage might be obtained by employing at same time assafoetida against hysteria symptoms

By this determined to employment of Pill Foetid cum Aloe from which hoped that both intentions would be answered.

After these medicines ordered saw nothing of patient for some time.

But when did return was with a new complaint

Were informed that after began use of medicine discharged a great number of worms from description of Ascarides kind.

Here two questions naturally present themselves.

How far viz these worms were cause of other symptoms.

And how far discharge occurred from medicines here employed.

On both conjectures might be offered.

But these unwilling to risk till shall learn something farther with tolerable certainty respecting case.

In mean time have ordered one of most powerful medicines against ascarides with which I am acquainted

Use of lime water viz in way of injection.

If duly employed have little doubt that will remove this part of affection

And of complaint which shall then be found to remain if patient continues attendance, which not indeed very probable may then speak with more confidence.

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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.