DEP/DUA/1/47/53 (Normalised version)

Betty Smith

(1790)

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No31 Betty Smith at 9.

When formerly spoke of case of this patient represented it as distinctly marked instance of Chorea or convulsive strictly so called.

The St Vitus dance as commonly styled.

Then took occasion to state sentiments with regard to it at considerable length.

And during course of patients attendance here no circumstance has occurred to lead me to alter opinion formerly [delivered].

Then observed that though affection considerable & extended, affects by turns almost every muscle, yet hoped for favourable termination.

To this led in first place, from reflecting that Chorea a disease which in general has favourable termination.

And particularly when occurs during 7^th and 15^th year of age.

The period at which more common than any other.

But consider it as still more favourable that patient not affected with any inordinate actions during sleep in the night.

A circumstance evidently showing, that morbid irritability, not at least so great as in some instances.

And that for [induction] the [conjunction] of some of these stimuli, to which when awake we are naturally exposed was here requisite.

On these grounds the founded favourable expectation.

But this I must acknowledge took place sooner than expected.

And must also add, that am inclined to think was in good measure the effect of remedies here employed.

Taking it for granted as formerly observed that disease the effect of uncommon irritability in moving fibres great objective was to diminish this tendency to inordinate action.

For this purpose had here [recourse] to Zincum praecipitate.

An article of which at our last lecture had occasion to make some observations when treating of case of John Miller.

Then observed that consider it as preferable either to Calx of Zinc on one hand or to White Vitriol [on] other.

Articles both of which of late frequently employed to remove disposition to inordinate action.

And although by no means successful in every case, yet have frequently I think seen best effects from them.

To Zincum praecipitate for introduction of which are indebted to Pearson of London

I have of late only had recourse.

But as far as my experience goes, am inclined to consider it as more active that the calx formed by [illegible].

And as less apt to nauseate than the salt formed by the Vitriol acid.

In this case as well as in that of Miller was also conjoined with Valerian.

An article which even from very early periods of medicine, employed with view of preventing return of inordinate actions.

And indeed by some represented as having even produced cure in Epilepsy.

Its influence as antispasmodic demonstrated by effects on some of brute creatures particularly its affects on Cats.

But to produce much effect of humoural system must be given in large doses.

And these stomachs of young people often not able to bear.

There with five grains of Zincum praecipitate conjoined ℈i of Valerian.

And hoped that might at least operate as adjuvant.

This dose taken thrice a day without any inconvenience.

And may also add without any obvious operation.

Such indeed it seldom has unless where excites nausea.

And this as in no degree [complies] with benefits of medicine always to be avoided.

From time however that this medicine begun affection gradually diminished.

And continued to do so till entirely left him.

About end of month was able to dismiss her entirely free from complaint.

And are I am inclined to think, principally if not entirely to be ascribed to Zinc & Valerian.