DEP/DUA/1/12/08 (Transcript version)

Betty Brown

(1776-1777)

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Betty Brown.

A patient in whose case sympt though urgent but few in number

Almost every facult or funct of body in natural state.

And if except nausea & slight flying pains may even say almost only sympt excruciating headach.

With greater part of Nosol. this with its necess. conseq. consid as constit a genus.

And have even we may observe [formd] of it differ. gener.

For headach to be consid as great constit of Cephalalgia, Cephalea & Hemicrania.

Would not I own be disp. to follow them in minute divis requiring such [nua] perhaps also may add useless distinct.

And would even allow that by much greater part of headachs be be consid as symptom

Yet cannot help thinking that in such cases as pres. headach with prop. may be reckond a disease.

And on this acct in list of selected genera which have put into hands have introd one under title Cephalea.

And under this may I think safely comp. two other genera of Cephal. & Hemicrania.

On this footing then would pronounce cephalea to be disease of pres. patient.

Like most other diseases may arise from various causes.

And according to these even somewhat diff in [natu]

Especially when taken in extens acceptat now mentiond.

The ascertaining such diff howevr a matter of some conseq. in practice.

As what best accomod to cure in one case not suited to another.

Must own that in inst. before us am somewhat at loss respecting partic nature.

Of all others is perhaps most freq. the effect of a certain state of stomach.

Well know that by what commonly calld foulness of stomach very distressing headach [prod].

And of this [some] presumpt in case before us from nausea with which patient affected

By no means howevr to be consid as certain evidence.

And intermiss of which admitts serve at least to give counten. to another suppos.

Headach well known to be one of most urgen sympt of intermitt. fever.

And when of this nature, freq. even pres. without proper febrile paroxisms.

Besides these freq. depends also on other causes

Sometimes to be consid as mere nerv. affect.

In so much that under partic form has obt name of clavic hysterica.

Sometimes dependen on a rheum affection of the chron. kind.

And this perhaps even the most general cause of habitual headachs.

Is very generally the [cause] of those affected by manif changes of weather.

Partic such as induced with great severity by exposure to cold.

Might besides these point out other [caus] of this affect.

As for example its depend on plethora constip or the like.

But four first mentiond take at least to be the more general causes.

And of these was disposed to consid pres. instance as of one or other of first kinds.

On this idea treatment has hitherto preceded

And although cannot say with affect that could wish yet not without use.

And must own that pres a case in which should look for fav termin.

Or at least if shall find it obstin. am yet in hopes that no reason to dread any fatal tenden.

Hitherto cheif part of cure in the case has been use of repeated emetics & Peruv Bark

From first expected that patient might be relievd from stomach being [cleaned].

Last cheifly given on presumpt of latent intermittent.

Hoped also that after emetics and even on suppos of sordes might give such tone to stomach as to prev. future generat

After emetics patient on diff occas. seems to have enjoyd temporary cure relief.

But would not appear that from Peruv bark any partic benefite.

On this acct therfore do not now intend to persist any longer in use.

As presume that either in no degree depend on intermitt tendency.

Or that insuff to prevent fresh collect of sordes.

Mean not therefore to push pres. meas any farther at present.

If find her relievd at next visit shall see how far relief perman without bark

Either omitting med altogeth. or using only what may serve as a placebo.

If sympt aggrav. or even in formr state shall think of making trial at least for space of a week with aether.

From both internal & external use of which the best conseq. often observd to arise.

If this also fail shall next have [recour] to drain from head in form of blister.

Which where the affect of the Rheumat kind is perhaps more useful than any other med.

After these trials should sympt still cont. will be directed by occurrences of which cannot at pres. be aware.