DEP/DUA/1/43/22 (Normalised version)

Ann McLean

(1787-1788)

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N^o22 Ann McLean at 36

Formerly pronounced disease of this patient an example of Hysteria.

And while continued under our care no reason to alter opinion either of nature of disease, or of conjecture formed as to termination.

After so long standing, did not expect to be able to eradicate affection.

And imagine that endeavours chiefly to be directed towards obviating urgent symptoms.

Cannot however say that even in this way had much influence.

Or at least relief obtained more of temporary than permanent nature.

But at same time, as will appear from more particular view had not only no [bad] effect but attended with some benefit.

Of all symptoms here occurring [those] most distressing to patient were affection of alimentary canal.

Was particularly with view to these that had here recourse to mixture with bitter & aromatic Tincture.

An article of which have already oftener than once had occasion to state opinion.

And which am disposed to consider as very useful stomachicus.

Particularly in cases of flatulence & indigestion.

For while from immediate action has effect of expelling wind & promoting digestion has also at same time in after effects a tendency to strengthen tone.

Accordingly from time that began use thought symptoms somewhat alleviated

Did not however seem to be fully sufficient for discharge of flatulence.

And at same time continued to be frequently affected with globus hysteria.

From this therefore seemed necessary to do something farther, with view of obviating inordinate action.

And with this intention had recourse to Assafoetida.

Here however as no occasion to obviate costiveness employed it under form of Pill Foetid simple.

That is equal parts of Assafoetida & Soap.

While latter of these articles used only to give proper form the former one of most powerful of the Antispasmodics.

And particularly as tending to allay inordinate actions of alimentary canal.

Accordingly little doubt in attributing it to this that Globus hysteria had become much less frequent.

Now therefore patient upon the whole considerably easier.

And was inclined to hope that by persisting in use this relief might be continued.

Merely directed therefore that should persist in same course

But at succeeding report found that relief not so permanent as could be wished.

For notwithstanding continuation, now complained of being much affected with swelling at stomach particularly occurring early in morning.

This however consider as affect of opportunity for accumulation of wind [occurring] during night.

And as also in some degree proceeding from influence of medicines having ceased.

Imagine however that might be counteracted, by tone of stomach, in consequence of persisting in medicine, acquiring greater vigour

And therefore with continuation of former practice directed only, as means of counteracting it, the occasional use of Peppermint water

But since that time, have seen nothing more of patient.

And of situation since cannot pretend to form any conjecture.

At same time do not think it very probable, that either in way of aggravation or diminishment is much different from what had been for some years before