DEP/DUA/1/42/20 (Normalised version)

Agnes Sead

(1787-1788)

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N^o20^th Agnes Sead at 18.

In case of this patient a complication of affections.

But what most distressing & what chiefly led her to apply for our assistance the Diarrhoea

This had subsisted with her for considerable length of time.

And to state of intestines thus induced are to refer gripes, & tenesmus, as well as pain of back & loins.

To same cause also may I apprehend refer ardor urinae

For here without any symptoms which could lead to supposition of its proceeding from any other cause.

And by no means uncommon to find such an affection of contiguous parts.

But if diarrhoea of long standing have a complaint of still greater obstinacy in cough.

Here I own am not without apprehension of Phthisis.

For patient at that period of life when very common.

And besides constant quickness of pulse has also other symptoms of febrile state

Particularly intense thirst impeded appetite & want of sleep.

And among other particulars may reckon it an unfavourable appearance that catamenia have so long disappeared.

These indeed are told had appeared but seldom with this patient.

And had ceased to flow prior to commencement of any other symptoms.

From this may perhaps be thought that some grounds for considering as case of Amenorrhea only

And certain that from obstruction of menstrual discharge all present & many other symptoms will arise.

But amenorrhea much more frequently a consequence than a cause of Phthisis.

And here I own inclined to consider obstruction as symptom of condition of system.

Although however apprehensive of Phthisis do not think that yet at least is decidedly such.

Nor do I here consider diarrhoea as being of colliquative kind, which often symptom of Consumption.

For then occurs only as symptom of last stages of disease

And seldom of that continuation which has already taken place with present patient.

In treatment of case considered Diarrhoea as first object of attention

For while most distressing to patient, was at same time that part of affection, which had best chance of removing.

And by means employed to allay looseness might likewise hope to mitigate cough.

Is with these intentions that have had recourse to Opium under form of Pill Thebaic & Succus Japonica as an astringent.

From these hope for mitigation if not removal of looseness.

And by affect on cough will be better able to judge of nature of pulmonary affection.

Practices then directed accordingly.

But of these either now or hereafter to be employed reserve observations till shall again resume consideration of case in order of list.