DEP/DUA/1/41/04 (Normalised version)

Bell McKay

(1786-1787)

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Nelly Gordon delayed.

Bell McKay.

So little subject of practice that unnecessary to add anything to former observations.

For never returned after last spoke of case.

And therefore while entirely precluded from practice have seen nothing which can lead in any degree to change of opinion.

Then observed that principle & most distressing symptoms of hysterical kind.

Such for example as sense of ball, headache, fits of deliquium etc.

These however consider as all proceeding from obstruction of menstrual.

For well known that product of almost infinite diversity of [symptoms].

And here the rather to be inferred as all common upon [obstruction].

To this indeed age of patient may perhaps be considered as [objection]

For had you will observe already arrived at 46^th year.

A period by which menses [has] often ceased.

But to be observed that this female on a former occasion subjected to similar symptoms.

And that then on restoration of discharge entirely ceased.

From this then reason to infer, that now induced by [same] [cause]

And that on similar event same consequences would [ensue]

But after so long absence reckon it more probable that will see no more of menstrual discharge

And should have expected to have been able to afford more relief to patient from obviating symptoms than from aiming at restoration.

While at same time trusted chief hopes of radical cure on period arriving when menses would naturally have ceased with this female.

A period varying considerably in different females.

But probably always connected with state of circulation though uterus.

With view to different symptoms here various practices might have been tried.

Particularly for combatting uneasiness from flatulence & deliquium animi.

But consider acid at stomach as no less immediately claiming attention.

For well known that acid presence in stomach often supports & aggravates other affections of alimentary canal.

Was with view to this, that had recourse to Magnesium with Rhubarb.

But have not learnt what effect has resulted from it.

And as now no chance of seeing anything more of this patient, farther conjecture or suggestions respecting treatment unnecessary.