DEP/DUA/1/35/24 (Normalised version)

Jean Grant

(1784)

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Jean Grant. July 2^d.

Of disease of this patient have not I own been able to form any decided opinion

And from want of attendance at the Dispensary since first applied for assistance here, have had almost no opportunity of acquiring farther information respecting disease than communicated in first account.

According to representation then given symptoms chiefly distressing to her, sickness at stomach & uneasiness from wind.

Than these few affections more common.

And indeed are among most frequent symptoms of that troublesome & very common disease Dyspepsia.

But as the attendants of Dyspepsia are what may be reckoned constant symptoms.

Or at least patient daily subjected to them without any other periodic [remission] or exacerbation, than what arises from obvious causes as taking food or like

In case before us however, stated periods of different kind.

Has we are told regular remission & exacerbation continuing each for space of eight days.

And this had occurred not merely for one or two periods but during space of whole year.

If therefore from symptoms to give disease name of Dyspepsia & must confess am at loss what other name to affix to it, is at least a modification of that affection different from what have ever before met with.

In this point of view might be considered as no less singular than [curious]

And many conjectures might be offered respecting cause

But before proposing any of these, should first here esteem it necessary to determine facts.

For even supposing that patient no motive in deceiving us, may yet have deceived herself.

And if any degree of that [mental] affection which in Hypochondria united with dyspeptic symptoms can easily conceive, that without any proper foundation may suppose herself one week, worse than another.

Here therefore improper to conject as to cause till reality of [Phenomena] [illegible] duly ascertained.

May only observe that if such periodic exacerbation & remission had really taken place, one conjecture at least as to cause afforded from aguish state of habit.

For informed that subjected to a very severe intermittent six years before from which would appear that never had complete recovery.

At least seldom free from symptoms of it during easterly winds

And in particular had been regularly subjected to these every spring.

Well known however that aguish habit, often gives modification to other diseases.

Particularly in way of inducing in them uncommon remission & exacerbation.

These however it must be allowed, in general [observed] the type of the intermittent.

And a type with remission & exacerbation for space of eight days, at least very uncommon.

Such however sometimes observed under different modification of erratic intermittents as have been called.

And at least not impossible that from something of this nature, present complaint modified in manner here represented, at least if such modification actually takes place.

But with respect to this have already expressed doubts.

And as now but little prospect that shall have farther opportunity of seeing patient, these doubts not probably resolved.

Hence little need here be said [either] with respect to prognosis, or cure.

May only observe that as far as had opportunity of seeing case, or hearing account of patient nothing that could be considered as dangerous or alarming.

For although complaint distressing yet had produced no effect on general habit.

Except function of stomach all others remained in sound state.

And disorder in these would probably have less influence as now in some degree habitual to patient.

But from this very circumstance great reason to be apprehensive of obstinacy.

For after continued in manner that had done for space of year, could not expect that would readily yield.

And although apparently mitigated for short time yet had reason to fear that renewed again by slight causes.

Especially if in any degree connected with aguish habit, to which now subjected for six years.

And to causes exciting symptoms of which, frequently & unavoidably exposed not only during spring & autumn [season] but also on every change of wind to east.

Hence then although had continued regular attendance yet might probably have at last been obliged to dismiss her, little better than when came under care.

[At] same time, both with view of combating stomach complaint, & likewise disposition to intermittent some practices might have been employed.

And that too not altogether without hopes of success.

Here in particular with view to both affections, might have expected some benefit from use of Peruvian Bark.

Especially if conjoined with air & exercise.

But prior to having recourse to Bark, was intention in first place to make trial of another medicine, nearly with same view.

viz. Tincture Absinthe.

Need not observe that this one of strongest, & most common of vegetable bitters, which this country affords.

And before Bark known was in frequent use for removal of intermittents.

While at all times held to be one of most efficacious remedies [against] those stomach complaints to which bitters suited

[Hence] therefore wished at least to see, what could be obtained from it.

And as best form of exhibiting it had recourse to Tincture Absinthe.

These however impregnated so strongly that requires some dilution

And with this view [added] to it equal parts of common & of peppermint water.

On this medicine was intention to continue patient for some time.

But having given up attendance, have had no opportunity of knowing affect & [unnecessary] to say anything farther with respect to case