DEP/DUA/1/34/08 (Normalised version)

Isabel Murray

(1783-1784)

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Isabel Murray.

Concerning disease of this patient cannot I own from account she has [given] of her complaint form any certain or decided opinion.

And now some suspicion that shall have no opportunity of judging from farther observations.

For since first prescribed for her has not attended us

And not improbable that shall see nothing farther of her in this place.

According to her own general account she labours under an intermittent

But although represents herself as affected with daily paroxysms returning at a particular hour yet description by no means corresponds to that disease

For besides immense continuation of coldness & trembling for no less than space of 12 hours, is not succeeded either by hot or sweating fits.

Must therefore look upon it as entirely of different nature

And as far, as could form any conjecture, was inclined to look upon it as a peculiar modification of a hysteria fit.

This idea somewhat favoured by symptoms of which affected at other times, particularly what from description may have concluded to be globus hysterica.

And indeed all other symptoms with which affected, as cough, dyspnoea, sense of tightness in thorax or like may have proceeded from same cause

This the rather probable as cough without expectoration which might have expected if of catarrhal kind

Besides to be farther observed that although fits of trembling but of late date, yet cough commenced at same time with sensation of ball.

Both one & other being of six months duration.

On present affection however reckon it less safe to offer conjectures not only as but little chance of again seeing patient, but because not altogether without suspicion concerning account given.

When saw this patient had some reasons for conjecting either that was desirous of deceiving us or had [imposed] upon herself.

And that really imagined what did not take place.

In these circumstances altogether unnecessary at present at least to offer any conjecture with regard to prognosis.

If returns to attendance, by what shall afterwards see may be [enabled] to form better opinion

And in that case may perhaps take a future opportunity of stating to you my sentiments more fully on this subject.

Shall at present therefore conclude with observing that in practices here directed went [chiefly] on idea that affection of the Hysteria kind.

Directed vomit with view of emptying stomach & checking regular periodic [return] of accession.

And had recourse to pills of Cuprum Ammoniala with view to removal of that irritability, without which these accessions would not return.

But what has been effect of either have not been able to learn

And what will be our future practice if patient should return must be determined by accounts we shall then receive.