DEP/DUA/1/47/06 (Normalised version)

Mathew Steele

(1789)

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No19. Mathew Steele at 47.

In case of this patient have I think, an instance of Dyspepsia or stomach ailment.

At same time must be allowed that not altogether without peculiarity.

And particularly is attended with more severe pain than usually occurs when no proper local disease of stomach.

Here however, reason I think to believe that pain entirely the effect of inordinate action.

For neither any evidence of scirrhous on one hand, or of inflammation on [indeed].

Indeed symptoms which are we may say universal attendants of these here wanting

And here, may I think with great probability consider pain, as the mere effect of inordinate action induced by distension from flatulence.

And this flatulence the consequence of weak tone of muscular fibers of alimentary canal, by which unable to resist [exhalation] of air.

This state of tone however often accompanied even with uncommon tendency to action, or morbid irritability.

And although dyspepsia may arise from many different morbid conditions of stomach yet this perhaps most common.

With this view of the disease are naturally led to [hope] favorability of termination.

And although at present violent yet from short continuation may even look for that in no long time.

Particularly by avoiding causes tending to weaken tone, & by use of that regimen both with respect to diet & exercise which increases vigor of muscular fibers in general.

But in way of medicine also something may be done, both as tending to radical cure, to alleviation of symptoms.

Thus with view of strengthening stomach & expelling flatulence, have directed a mixture the basis of which aromatic & bitter tincture.

With view of alleviating pain & allaying tendency to inordinate action have had recourse to Opium under form Pill Thebaic.

And lastly to prevent & counteract costiveness have directed occasional use of Pill ex. Colocynth cum Aloe.

From these medicines am hopeful that in no long time considerable benefit may be obtained.

And unless some reason occurs to lead me to alter plan, shall be disposed to give it a fair trial.

But of present practice as well as of those which may afterwards be adopted reserve farther observations till shall again treat of case in order of list.