DEP/DUA/1/45/32 (Normalised version)

Barbara Sinclair

(1789)

---

No24^th Barbara Sinclair.

When formerly spoke of case of this patient observed that had not found decided opinion with respect to it.

And as continued only but short time under care was in same [situation] when left us

For during course of attendance nothing occurred tending either to corroborate or confuse supposition formerly thrown out.

Then observed that principal part of complaint evidently Dyspeptic.

But that presumption these were merely symptoms either of Hysteria or of Amenorrhea.

And of two suppositions was rather inclined to last.

On this ground formerly suggested intention of employing with this patient electricity.

Which although by no means suited to every instance of Amenorrhea is yet upon whole one of most powerful emmenagogues with which am acquainted.

But prior to employment of this thought it necessary to ascertain one particular at least with some degree of probability.

Whether viz patient was pregnant or not.

For no doubt that with those desirous of procuring abortion pregnancy though exists often denied.

And at same time pretend that obstruction of menstrual from other causes.

With a pregnant woman however, electric shocks, always to be avoided.

Especially when employed in manner commonly directed for restoration of menses.

That is through region of uterus. For by mere concussion independent of other circumstances foetus may be destroyed or detached.

Hence then in every suspicious case [caution] necessary in exhibiting.

Here indeed may be thought that from length of time pregnancy would have been discovered by bulk.

For obstruction said to be of six months standing.

And by that time in general considerable increase of size.

But in this respect, well known that in different women, very considerable diversity of shape.

And some with whom even at later periods hardly discovered.

But besides this exposed to still another difficulty in judging for that circumstance.

For to take off suspicion of pregnancy often pretended that obstruction of much older date than really is

Hence then at least requisite that other particulars should be taken in conjunction with this

Accordingly before directing electricity here wished at least to have repeated opportunity of seeing patient.

And in mean time was intention to employ endeavours merely in obviating symptoms.

With this view first prescribed for our patient the Pill Foetid cum Aloe.

A formula as have already oftener than once observed consisting of equal parts of Aloes, Assafoetida & Soap.

A combination often useful to patients in different circumstances.

But especially where much uneasiness from flatulence combined with bound state of belly.

In case of present patient latter of these circumstances indeed did not take place.

For belly we were informed regular.

But no doubt that many of symptoms particularly distension swelling & pain effect of latter.

And from this circumstance hoped that might afford her some relief.

Mitigation however at first at least not so considerable as expected.

For after continuing for week, found that little other influence than that of moving belly.

This led me to conjoin with these the use of a combination of Valerian & Zinc.

An article from which as allaying tendency to inordinate action have often I think seen good effects.

With our patient however [were] alleged to excite sickness at stomach.

But as without vomiting did not think it sufficient reason for omitting use.

Since directed continuation however [have] seen nothing farther of this patient.

And as left us nearly in same state of uncertainty with regard to disease as when came under care, any farther conjecture with regard to it unnecessary.