DEP/DUA/1/37/35 (Normalised version)

Betty Willis

1785

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Betty Willis. March. 26^th. 1785.

Concerning case of this patient have not I own been able to form any decided opinion.

When came under our care symptoms numerous.

And at same time such as occur in different disorders.

Hence might give foundation for affixing different appellations to the affection.

Since became patient here symptoms have undergone a considerable change

Hence may at present be considered as labouring under different disease from what had when came under our care.

But this affection am inclined to look upon as more of accidental or transitory nature.

Appears chiefly under form of severe cough & probably a catarrhal affection

While with regard to former complaint though of much longer continuation yet greater room for doubt.

Most distressing symptom severe pain referred to region of stomach.

And when consider that this transitory only & attended with considerable swelling can have little doubt that arises from flatulence.

Here also cause giving pain, produced borborygmi & eructation.

To stomach affection also may refer not only nausea & tendency to vomit but also vertigo, & headache.

For well known, that from stomach complaints such very frequently arise.

In these then may be considered as having if not all, at least the common symptoms of dyspepsia.

And at same time such as most strongly characterise that disease

Of this also farther indication in sourness at stomach.

But some other symptoms again which at least not common in that affection.

Particularly frequent syncope to which is subjected.

In this, as well as in state of spirits, have what should rather be disposed to consider as hysteria symptoms

And in this disease, well known that many affections of the alimentary canal take place.

While at same time, so liable to variety in appearance, that hard to say under what forms, may not sometimes present itself.

To supposition of this disease also, age of patient rather favourable.

For was at that period, when with females, hysteria a much more common affection than Dyspepsia.

From these circumstances then could not help thinking that here some room for doubt.

But at same time, am disposed to consider, supposition of dyspepsia as most probable.

In this view, affection could not be considered as slight.

For besides number & severity of symptoms, disease had also already been of very considerable continuation

Had subsisted, before came under our care, for space of six years.

And during that time, had increased in violence.

May also add, that attended with appearance, both uncommon and alarming.

For as such may always consider syncope which if give up idea of hysteria, here to be considered as well as vertigo & headache, as consequence of stomach ailment

Is indeed true that pure dyspepsia seldom a fatal disease.

But in some instances, this has even been consequence, of mere exhaustion of system.

Still more reason I think to apprehend danger, where had proceeded to such length, as to induce deliquium animi.

But at same time in other respects, symptoms of present patient less alarming.

For notwithstanding continuation of disease, severity of pain, & frequency of vomiting, yet had not given rise to any obvious marks of exhaustion.

And some probability that depression of spirits, had led her to represent affection in most unfavourable light.

Hence then expected that should have rather to combat an obstinate, than a dangerous affection.

And hoped even that by proper aid if could not remove might yet alleviate complaint.

But as doubtful with respect to nature so must also necessarily be, with respect to termination of disease.

And now, can speak with as little certainty, as before.

For although as already observed appearance of disease in some respects varied, yet with regard to primary affection in as great uncertainty as ever.

Began treatment you will observe, on idea of patient being subjected to a dyspeptic affection, by having recourse to one of most active, & strongest of vegetable bitters. The Tincture Absinthe.

In our pharmacopoeia¹ objective is to prepare this Tincture of very great activity.

And with this intention is directed to be made by what called double infusion

That is after menstruum has acted on one proportion of absinthe is added to another.

And imagined that thus stronger tincture than if whole absinthe introduced at once

In this however, am inclined to think, that college² have been led into mistake.

At least in trials which I have made, can make fully as strong a tincture by single, as by double infusion.

And am even persuaded, that a Tincture of equal strength, may be obtained from smaller quantity of absinthe.

Or in other words, that menstruum unable fully to extract quality of absinthe directed to be used.

But whether these observations well founded or not, can be no doubt that Tincture Absinthe prepared according to Edinburgh Pharmacopoeia a very strong bitter.

In so much that even in small doses few stomachs able to bear it, by itself.

Here therefore given in a diluted state.

And as a diluent had recourse to Peppermint water.

This need hardly observe, from proportion of pungent essential oil which contains, operates as very powerful carminative.

And by this means, in many instances of stomach affection gives very great relief from pain, by immediate discharge of wind.

To this combination, have in other instances, had recourse in former practices & with best effect.

Hoped therefore, that would here also be product of good consequences.

As at first taken gave no uneasiness at stomach

And vomiting at least not more frequent than before.

Seemed however to have but little influence as tending to alleviate affection.

And while stomach affection continued with former severity, became now also affected with distressing cough.

Was with view to alleviation of this that had recourse to Pill Thebaic.

And of all means of [immediately] allaying this inordinate action, none perhaps more effectual.

Here however, in effect of this also disappointed.

For opium taken to extent of grain i at bed time, seemed to have no influence on cough.

While at same time, mixture with Tincture Absinthe, was not only without effect of relieving stomach complaint but after every dose, was affected with vomiting.

Though consider this as being rather consequence of disease, than of medicine yet after trial already given, reckoned it sufficient reason for discontinuing use.

Wished to see, what would be state of stomach complaints, while left entirely to themselves.

But at same time, urgency of cough now united with pain of breast, claimed attention.

And as Pill Thebaic of themselves insufficient, with continuation of these, ordered the application of a blister afterwards to be converted into an issue.

What has since been state of cough, have not yet had an opportunity of learning.

And according to condition in which find her, future measures must be entirely directed.

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Explanatory notes:

1) An official publication containing a list of medicinal drugs with their effects and directions for their use. The Royal College of Physicians of Edinburgh's Pharmacopoeia was first published in 1699.

2) The Royal College of Physicians of Edinburgh, established in 1681.