DEP/DUA/1/37/50 (Normalised version)

Hugh McGregor

(1785)

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Hugh McGregor. April 16^th 1785.

In history of this patients case but few symptoms enumerated.

And in these nothing that can be considered as in any degree uncommon or peculiar.

Have here evident characteristics of that affection now generally known by name of Dyspepsia.

But still more generally by that of stomach complaint.

And which in present age & in this climate, perhaps one of the diseases most frequently to be met with.

And in which also have in some instances not only an obstinate but even a dangerous disease.

For by consequences at least not unfrequently fatal.

Yet must be allowed that in greater part of cases, rather troublesome than dangerous.

And in affection of present patient nothing to give alarm.

For symptoms could not here be considered as occurring, with any great degree of severity.

And had not at least been product of any appearance as indicating an affection of the system in general.

For not attended with any marks of inanity.

Or what in such cases a still more alarming appearance with any symptoms of dropsical kind.

But although disease did not appear with marks of danger yet could not be considered as slight.

For had now subsisted with patient to considerable degree for space of three years.

And of late had been observed considerably augmented in point of severity.

Hard therefore to say to what [heights] might soon arrive.

And must be confessed that even in apparently slightest cases, will sometimes resist utmost powers of art.

Removal particularly difficult with those of low rank, & necessarily of sedentary life.

For in general to be affected more by regimen & exercise than by medicine.

And with labouring poor, such [unattainable]

Hence then could not here with any confidence flatter ourselves with hopes of speedy cure.

But at same time, different remedies which might be tried, with at least prospect of benefit.

Enter therefore on practice, in hopes that might be able if not to remove, at least to alleviate affection.

Began you will observe by directing for patient the Elixir of Aloes & Rhubarb diluted with Peppermint water.

In first of these articles, a medicine, which from several circumstances, may conclude very useful in this affection.

In Rhubarb entering its composition have with these at least, with whose constitution does not disagree, one of best medicines for restoring tone to stomach.

And in aloes, an article which as supporting regular discharge by the belly, perhaps more generally agrees with dyspepsia patients than any other.

While in Cardamom seeds with which these here conjoined a very grateful & warm aromatic.

Accordingly in actual practice found product of best affects.

And although no purgative universally suited to dyspepsia some succeed with some others with different patients yet this generally [advantageous]

And in this disease, the supporting regular discharge by belly, & at same time the avoiding the induction of looseness, of utmost consequence.

For while former, very much alleviated, latter never fails to aggravate affection.

But here elixir besides being sufficiently purgative, has also, as already observed considerable effect in increasing tone of stomach.

With our patient, state of belly such, as not to require large doses.

Hence therefore, thought it better to employ, it as diluted with peppermint water.

An article which even by itself, highly useful in such affections.

For from active essential oil which it contains, operates as warm cordial stimulant to stomach.

And thus in particular, when in Dyspepsia very great distress from flatulence, operates as useful carminative

When began use of this medicine, derived from it very considerable relief.

For in short time, was not only free from vomiting, but also much less affected with pain.

And that this relief not effect of accident, apparent from what happened on an occasional intermission of medicine.

For on that intermission, affection again considerably aggravated.

This then gave reason to hope, that from repetition similar benefit as formerly might be derived.

And accordingly at succeeding report affection continued to be very much alleviated.

During course however of succeeding week, probably from irregularity of diet, or some similar circumstance, had again return of vomiting

While this however the case could in other respects expect no benefit from medicine.

Thought it necessary therefore to do something with view of allaying this tendency to inordinate action.

And with this view had recourse to addition of a small proportion of Thebaic Tincture.

From which, have in former cases, seen I think, best effects in this way.

Cannot however, here represent it, as having had immediate effect of checking vomiting.

For after use begun, that symptoms still at times continue

But although attended with pain, yet upon whole, stomach [ailment] considerably easier.

And hoped that by due continuation, end in view might be obtained.

Accordingly learnt at last report, that had been free from vomiting for near space of week.

And that during this period also pains considerably diminished.

Am in hopes therefore that by persisting in employment such alleviation of affection may be obtained that farther attendance unnecessary.

Or at least that may dismiss him, with direction to continue on some gentle stomachic bitters, as weak infusion of Wormwood, of Chamomile, or of Gentian as means of preventing return

If this however not the case, mean here to try with view of bracing the stomach, the Vitriol acid.

Probably employ it under form of Elixir where combined with aromatic & as diluted with Peppermint water.

If this also unsuccessful future practices employed must be accommodated to circumstances of case.