DEP/DUA/1/31/08 (Normalised version)

Janet Armourer

(1782-1783)

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Janet Armourer

Symptoms to which this patient subjected when came under care not numerous

Consisted entirely in affection of alimentary canal.

And there chiefly under form of vomiting with peculiar acidity & bitter taste.

Besides which inconvenience also from flatulence at least in bowels.

From these circumstances then, though vomiting most urgent symptom, yet better distinguished by title of Dyspepsia [than] of vomitus.

Those stomach complaints commonly distinguished by title of Dyspepsia in general at least no less obstinate than common. Hence then in giving prognosis of present case, might have been [inferred] that would not soon be terminated.

+ For although now in some degree subjected to it for near space of year, yet in most instances of Dyspepsia may be considered as a recent case.

Had taken place at a season [where] stomachs of young people very apt to be [overloaded] viz. about begin of January

And I own if had stated opinion at time when patient came under our care would have been less favourable than has really turned out to be the case.

At same time can be no doubt that several circumstances very favourable.

Disease when she came under our care not at least of very long standing

Presumption therefore that had arisen from some accidental cause, operation of which, would soon cease.

Present complaint connected with no other disease, & had in no degree produced any general affection of system

Farther to be observed that in the case nothing urgent.

For though vomiting frequent yet not with any pain.

Hence then reason to presume that mere effect of uncommon irritation than of [any] other circumstance

From this however much less to be apprehended than where consequence of relaxed & weakened state of stomach.

On these grounds then should have been inclined to consider case as a favourable one.

At same time hardly expected that would so soon have had favourable termination.

This termination have little doubt in ascribing to practices here employed.

This however will more particularly appear in speaking of different remedies which were used.

First article directed was the Peruvian Bark.

This well known to be one of best tonic medicines of the Materia Medica¹.

And while by [interval] of stomach has very great influence on system in general can be no doubt will act to most considerable degree on that viscus itself.

But operation in this way could not be immediately expected.

Hence then, necessary to do [something] with view to obtaining retention of aliment in stomach, & to promote digestion.

These intentions where weakness of stomach exists, not unfrequently obtained by aid of hot [illegible].

For by means of these operating as stimulus, acts with greater vigour & natural peristaltic motion augmented.

Was with this intention then that mustard & pepper directed to be taken with food to considerable proportion.

But while disappointed of effects looked for from these, could expect as little from Bark.

For while food very soon vomited, bark almost never retained for such length of time that could expect any effect from it.

In this situation however would have been in vain to persist in use

Had recourse therefore to a remedy from which expected if not same tonic powers yet more influence as allaying inordinate action viz Confection or Electuary Japonica.

In this article, with the Succus Japonica as astringent, are conjoined different vegetable aromatics.

And to this is added a small proportion of Opium.

From this combination may naturally look for good effects as allaying inordinate action.

Particularly in alimentary canal.

Accordingly am acquainted with very few remedies from which have seen more benefit in restraining Diarrhoea

And have often also found it remarkably serviceable in [allaying] [vomiting]

In present instance however from use of this as well as former articles was disappointed.

For notwithstanding use vomiting after food still continued.

And even medicine itself seldom retained on stomach.

From this concluded morbid irritability so great more powerful means of [allaying] it were necessary.

And accordingly had recourse to Opium in more considerable quantity.

Gave it under form of liquid Laudanum, diffused in Mint water.

From very first doses, good effects obtained.

And by continuation for no long time vomiting entirely ceased.

After patient had continued free from it for near space of [fortnight], [reckoned] farther attendance unnecessary.

Hence then little doubt either in attributing cure to [illegible] or in referring disease to peculiar morbid irritability.

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Explanatory notes:

1) Latin term referring to the body of collected knowledge about the therapeutic properties of any substance used for healing (i.e., medicines).