DEP/DUA/1/11/12 (Transcript version)

Peggy Johnstone

(1776-1777)

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Peggy Johnstone

A patient whom had formerly occas to treat in Royal Infirm for same compl. with which is at pres. affectd.

Formerly thought that little room for doubt respecting nature of compl.

Still less at pres.

And have no hesit in pronouncing [dises] to be Hysteria.

Will perhaps indeed imagine that in some partic does not at pres. corresp. in every partic circumst with defin of best nosol.

And especially to be remarkd that no mention made in this case of the Glob. his.

Which with some reckoned pathog. symp

This opin however if taken strictly can by no means adopt.

Readily allow indeed that no symptom more freq. than the glob. rising to throat & giving sense of suffoc.

Probab

Perhaps also none more freq. Probab

Perhaps even no case in which has not in some parox or othr occurrd to greater or less. degree.

Are by no means howevr to look for it as attend of every parox.

And sometimes even for long periods of the disease will be entirely wanting.

In so much that this disease at diff times puts on very diff. appear.

And accordingly very consid variety in defin. given of it by diff. nosol.

Although know none of them that have introd sympt into their defin which do not freq. occurr.

Often even variety of other sympt as pecul state of mind, affections of alim canal headach affections of urine & like which may with [propr] call hyster although no propr fits.

In these instances greatr room for doubt

But where such fits as in pres. case know one disease only with which any danger of confounding this affect.

That is Epilepsy.

And where hysteric fits violent must be allowed that any distinct as to be convey by descript a very diffic matter.

Yet those freq. accustom to witness both kinds of fits at no loss to disting them on seeing them.

During epilep parox. an [inexpress] [wildn] in look never occurring in hyster.

While latter accomp with sympt of terror & deject not attend of epilep.

Besides this few epilep. fits during which does not occur total abol. of senses.

And very rarely if ever happens that during hyster patient not sensib of all done around her.

On this ground alone would reckon us suffic warranted to pronounce pres. patien of hyster. kind.

But besides this many other corrob. circum. in those affect of which she complains when free from fits.

Such for ex as palpit. murmuring of bowels from wind, freq. belchings &e

Here therefore are I appreh subjected to only one othr doubt.

And that is whether compl of patien be real or feignd.

Few diseases with regard to which Women more apt to play the import than hysteria.

And can often feign fits with so great accuracy that very diff. to disting [deceit]

From begining howevr was disp. to consider pres. as a real disease.

And now certainly fewer inducements to feign than if by that means hoped to secure resid in an hospit.

On whole then disposed in every partic to retain formr opin.

And to consider as then did, disease of patient to have been induced & supported by an affect of menst. disch.

Were formerly told that prev to any [attack] of pres. compl. Menses used at each period to contin for near space of eight days.

And that besides this returnd at short intervals.

During time of flow howevr imprud exposed herself to cold.

And that upon this menses sudden stopt & pres sympt induced.

This acct reckon by no means [imp]

And cannot seem stranger that should look upon this as cause of hysterics when consider that very name of disease derivd from womb.

As presumed that every instance of hyster, derivd origine from thence.

Now mentiond in case that Catam regul.

But on farther questioning patient on this subj. informs us that although regul in point of time still flow in small quantit only.

On this circum consider prognos as in great measure hinging.

And am very doubtful as to her contin free from pres. compl. till menses in natural state.

From appear at last period have some ground for entertaining hopes.

At that time had not mere show of disch

Was both more copious & of longer [durat] than formerly.

And accordingly since that has enjoy greater respite than before.

Would not however have it [understood] that consider this case to have been affect of discharge.

Am inclind to view them merely as concom. circum.

And to considr both to proceed from return of natural condit of system.

Do not howevr look upon health of patient as yet by any means restored.

And am far from expecting that prog to cure will be uniform.

Although would hope for recov. here shall not be disappointed at finding it somewhat ted.

But should it even be more [trying] than imagine, see no reason to appreh fatal termin.

And patient will at least afford opport. for trial of diff. med

May however remark that in this case have already used many.

Both with view of removing pecul [morbid] of system in general & alim canal in partic.

And with intent of restor. menses to natural state.

As have now no differ. idea of nature of disease from what had formerly am led therefore still to follow same gen. prin.

And would wish to try what may now be done by means of other med.

Partic with view to radic cure.

For mitig sympt. however had recourse to Aether

In every instance of such compl. a matter of conseq. to mitig parox after has already taken place.

Still more matter. if can anticip [impend] parox.

With these intent Antisp. of diff kinds in freq. use

And of all these perhaps none more powerful than Aether.

Hence ordered it to pres. patient & I think with good affect.

At least she herself disposed to think that had consid influ in dimin viol of fits.

Like all others of same kind lower influ by freq. repet.

Hence was unwilling to persist in use when necess. for it less urgent.

With intent however of returning to use when circum should require

At least as long as seemd to be prod of good affect.

With this med for mitig sympt was intent to try a chalyb. with view to radic cure.

And as one of most certain & active preparat ordered Sal. Mart.

While this restored tone of syst. hopd that might be means of bringing back menst. disch.

In course prop. howevr very soon interrupted by app. of Menses.

And at this period flowed to greater extent than for some formr ones.

This with some othr fav. circum partic dimin freq. of fits led me to think at least of interm course.

And as only [remaining] compl. of patien wind in bowels ordered infus. amar as a bitter & aromat.

Is intent to continue this med till next menst period.

Then perhaps with view of support the discharge may have recourse to aloet pill as stimul to rectum.

And if menses shall again flow to natural extent may not be necess to employ any othr med.

About approach of menst period howevr have greatest reason to be appreh of return

Was not therefore much surprized at that which had last day occas to observe.

And from appreh of recurren. orderd repetit of Aether.

As now nearly space of month since last flow of Catamen

If patient throughout whole interv shall continue to enjoy health that has hitherto done will not think of altering pres course.

Partic if menses flow to natural extent.

But should formr sympt return will again have recourse to plan already begun

And push the chalyb. during next interv between menst. to very consid extent.

If this shall in end however disap expect. have next thoughts of trying Peruv. Bark.

Formerly prop this med & had even begun it in Royal Infirm.

But from some interrupt & from finishing course soon after being concluded had not opport of giving it fair trial.

Should this also fail may probab conjoin these med.

Or may employ challyb. in some othr form.

If these fail shall I own have less expect. consid med which have already tried.

Yet before dismissing her may try what can be done by Foetid Gum Camphor or the like.

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As Dr M. has now finished his Sat lect prop as at first intended to [tranf.] Clin Lect to that day

And shall deliver next on Sat. at 11 o’Clock contin report at one as [usu]