DEP/DUA/1/45/38 (Normalised version)

Alexander Murray

(1789)

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Alexander Murray at 15. N^o27.

Formerly observed that principal part of affection of this patient, [consists] evidently of stomach ailment.

But that doubtful whether to be considered as an example of Dyspepsia strictly so called, or of Hypochondria.

Affections probably differing, a good deal in nature.

Yet in many particulars especially evident symptoms nearly [approaching] to each other.

Here observe that many different particulars, seeming rather to favour supposition of Hypochondria.

Particularly depression of spirits, sense of coldness & continuation of complaint.

And to these also, might have added, temperament of patient, as discovered by obvious circumstances.

For was of that darker complexion black hair, & rough skin, which generally considered as marking melancholy temperament.

But notwithstanding presumption from these particulars one circumstance which consider as very much against that supposition.

Age viz of patient.

Was only, you will observe, in 15^th year. Hypochondria however very rarely [illegible] but with those advanced in life.

And indeed seldom occurs before 50^th. This however can by no means represent as universally the case.

For even in my own practice have at least met with one instance of contrary.

A gentleman viz of [fashion] & family not yet 30, now subjected to distinctly marked hypochondria for more than [dozen] of [years]

But such cases may justly be considered as solitary instances.

And here was disposed to view [effect] merely as Dyspepsia, perhaps particularly modified from occurrence with melancholy temperament.

That is, viewed stomach ailment, not as consequence of Torpor, or want of due disposition to action, but of weak & even irritated state of alimentary canal.

And as far as had afterwards opportunity of judging, this view of the disease, rather confirmed than otherwise.

Here, as means of alleviating stomach ailment, & at same time opening belly, had recourse to a mixture of Magnesium & Rhubarb.

Need not remark, that in [former], have one of best absorbent [earths]

And while [destroys] [acid] in stomach from forming with that acid a neutral salt, operates often as a cathartic.

Almost in every instance has effect rather of opening belly than otherwise.

In Rhubarb again have one of [restoring] purgatives.

Which while operates as gentle laxative has tendency to strengthen tone, of stomach & bowels.

Thus then, from this [conjunction] where prevents acid the consequence of weak state of stomach, whether attended with costiveness or diarrhoea, often obtain best effects.

And particularly in acid of infants. For even at that period of life in daily use not only with safety but advantage.

With present patient was at least product of no inconvenience.

And may even I think say, that attended with some advantage.

For had at least effect of opening belly.

But notwithstanding this other symptoms continued as before.

Thought it right therefore, to try some other stomach medicine, with view of increasing tone & action of stomach.

And with this intention, had recourse to some of best vegetable bitters & aromatics under form of tincture.

This however thought it proper at least, in some degree to dilute.

For with those unaccustomed to it the effect of undiluted menstruum often [distressing].

After began use of this mixture, stomach complaint in short time somewhat alleviated.

And what might be considered as strong evidence of this [appetite] mended.

While at same time continued to have regular discharge.

With these [appearances] could have no hesitation, in directing continuation of same practice.

And although did not continue altogether free from return either of pain, or sourness, yet in several respects much better.

Particularly belly natural, slept well & had good appetite.

After finding him, in this state however, have now seen nothing of him for some time past.

And would fain hope, that desertion consequence of having not farther occasion for assistance.