DEP/DUA/1/31/34 (Normalised version)

Betty Main

(1782-1783)

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Betty Main

Of disease of this patient reckon it unnecessary to make many observations.

Neither important nor singular.

Although at first from description [inclined] to different opinion.

Evidently labours under complication of affections.

And these in no degree connected with each other.

Eruptive disease about ears neck & head, am inclined to consider as of the herpetic kind.

While symptoms of alimentary canal & stomach may with propriety be included under genus appellation of Dyspepsia.

Of these complaints latter of by much the longest date

And probably will longest continue to distress patient

But at same time has never taken place as far as have any opportunity of discovering to any great degree.

At same time, must own, am inclined to suspect, that this patients complaint loses nothing in description.

For has on different occasions expressed much more [apprehension] & unease about effect of head, & ear than warranted by external appearance.

May draw therefore same conclusion with regard to other complaints.

And even according to her own account though distressed with unease & sense of weight after eating, yet has never had sickness acidity vomiting or [illegible].

Hence then nothing at least to be apprehended from all stomach ailments with which she is affected.

At the same time, from state of temperament, cannot expect that will soon consider herself as freed from the [affection]

And indeed, not to be expected, that can ever be altogether free of temporary inconvenience from flatulence.

Affection of ear & hairy scalp appearing under form of eruption but of very recent date

And since came under our care has at one time been completely removed

Although again some return of it yet this but to slight degree.

And as was formerly the [case] reason I think to hope that may soon be removed.

From what now said of nature of this patients case will not be surprised that since came under care have had recourse but to few [practices] in treatment.

With view to affection of alimentary canal employed pills of Assafoetida & Aloes

And with view to herpetic eruption had recourse to Oleum Camphor.

From use of latter eruptions soon diminished in parts first affected.

But broke out in others.

This led to direction of shaving of head that might obtain more thorough application.

And from this persistence in use affection seemed to be completely removed.

In this situation was intermitted

Pills also at first seemed product of good effects.

But had even more influence than could have wished in moving belly.

For in consequence of use had two sometimes even three stools in course of the day.

With this however, both became free from coldness at stomach, & [likewise] much less distressed with flatulence.

But after some continuation lost affect of operating as purgative

And with return of costiveness had also return of some [degree] at least of affection of alimentary canal.

This soon followed by slightest [return] of affection about the ear.

With a view to this latter have again had recourse to Camphor oil.

And with intention of counteracting former as formerly so much advantage from keeping belly gently open employed the Pill extract Colocynth cum Aloe.

Which when simple aloetic purgatives fail have often found, very successfully to answer intention.

Under these medicines hope will soon be in condition to be dismissed.

And after what have already said of nature of this case & opinion of disposition of patient will not be surprised if takes first opportunity for that purpose.

During continuation of attendance however may [find] other practices requisite.

If new occurrences take place these must be accommodated to symptoms.

If [mere] continuation of present results medicine now employed or increase under use may have recourse to Unguent Saturn or Unguent Vitriol with a view of combating eruption.

And with view to Stomach ailment may [have] recourse to Tincture Amor. Elixir extract Aloe & Rheo, or some other warm Stomachicus bitters or purgatives.

But shall be better [pleased] if can find favourable opportunity for dismissing patient without employing any of them.