DEP/DUA/1/13/12 (Transcript version)

Elizabeth Curries

(1777)

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Elizabeth Curries.

Disease of this patient not every day to be met with.

Especially with one so far advanced in life as pres. patient.

For appreh. that affect, or rather pecul modif. of affect under which she labours is one more common with infants than at later periods.

Sympts under which this patient lab. as introd into our register in point of [ord] not inconsid.

Imagine howevr that by much greater part of these, as debilit, lowness of spts. diffic of breathing &e conseq. of disease.

And to same head may also referr cons sensat of inanit.

For take this to be immed conseq. of food being disch. in indigested state

While at same time state of belly such that has commonly in space of 24 hours 2 or 3 loose stools.

This by most nosol. consid as of itself constit a partic affect.

Which disting by title of Lienteria.

May however I appreh. with greater justice be consid a mere modif of Diarrh.

And to be conseq. of weak & irrit state of alim canal.

Considr diarrhea then, & that too in partic state, to have been great disease to which this patient subj.

Cannot howevr repres. it as only affect.

For although look upon it to have been cause of many sympt yet others evid unconnected

And even of earlier date than this affect.

That is whitish colourd serous disch. from vagina occurring at menst. period.

Can be no doubt that this a certain degree of fluor albus.

Affect at utmost however but slight.

And with many women even to greater height is hardly consid as obj. of attent.

Consid it therefore as but very inconsid part of pres. patients disease.

And while plan of cure entirely [accur] to diarrhea consid this also to be only object which ought to regard in prognos.

With regard to this must own was not disposed to entertain very fav judgem

The affection in its nature one of those consid to be of danger. tendency.

And unquest gives indicat of most debilit state of bowels.

In some respects indeed case before us with favour circumst.

Did not occur at early period of life which commonly attacks.

Our patient as being arrivd at prime of life might be supposed to induce more than tender inf.

But on other hand to be alledged that a greater deviat from natural state

And while already of consid. cont. had proceeded such a length as greatly to depress spts & exhaust strength.

Should not therfore be surprised at its proving even soon fatal to her.

And appreh. that could not subsist undr it for very long time in pres. state.

Am far howevr from repres. affection as a danger one an incurable a desperate one

On contrary should here be [dispos] to hope for good effect from use of med.

And had patient cont. regul. in attend am inclind to think, that might have been able to allev. if not to cure her disease.

To regular attendance howevr her great debilit was strong object.

And did not perhaps at first reap all benef from prescrip which she expectd.

From these reasons probab. it is that of late her visits to us have not been repeated.

And am even doubtful whether shall see much more of her.

After observat already given howvr, [respec] what would conceive to be termin of diseas shall briefly state plan of cure which would have reckond it most advis. to follow.

And make few remarks on practice as far as went.

Have as already observd consider essent. part of affect to be pecul. debilit state of alim canal.

And that debilit at same time conj. with pecul. dispost. to action.

Or perhaps rathr inducing it.

Two great objects then to be had in view are

1 The restraining inordinate motion

2 The restoring due tone to alim canal.

First of these ends cheifly to be [obtnd] by gentle sedatives.

Last by astring & tonics.

And such the nature of med which employd with this patient.

Began practice here by putting patient on a mixt. of Confect. Japon.

In this med had an astring & opiate united

And use soon followd by those affects which wishd to obt. from it.

Went even length of binding patients belly

From which she compl. that uneasinss in sever. respects encreasd.

To induct. of such a state therefore this circum a strong obj.

And farther appeard that tone of bowels not so far restored as to give prop. [illegible]

Thought it necess. therefore to avoid if could the recurren of a simil state.

Was with this intent that wishd to avoid Opiate

For to this not to the astring ascribd this affect.

Consid to be merely affect of temporary removal of irritab. not of stricture by tonic

By this circum determ to employ in place of elect Japon simple infus of terra Japon.

Although at same time consid these affects to be wholey founded in imagin of patient.

At same time with view of preserv. disch by belly & farthr strength tone ordered patient to take daily small propor. of Rhub. with Magnes.

This course however not of much longer cont. than formr.

For to Inf. Japon patient disposed to ascribe worst affects.

Such for ex. as prev. sleep during night prod headach & occas. even some degr. of [delir]

Soon therfore omittd use.

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And with cont. of Rhub. alone loosenss rathr encreasd.

In this situat thought of again making trial of Elect. Japon as patient had before employd it.

Especially as she herself expressd some inclin for such a trial

After use howevr for space of eight days found sympt. nearly in same state as when cam under our care.

And patient whose lowness of spts soon led her to despair expected no farthr benef. from use.

From this therefore again necess led to change, if wishd that patient should take med.

Although at same time not satisf that might not have derivd advantage from persist. in course in which already put.

Although altered formula have cont. formr intent.

And still directed use of anoth astring.

With this view had recourse to Lig. [Campech] in form of Decoct.

What howevr has been affect of this have not learnd.

As have seen nothing of patient [since] first put upon use of it.

May here however from this circum presume that not attended with desired affect.

And that disconsol. temper of patient led her to apply to some othr pract.

Had she cont. under our care might have made trial of sever. other [remed].

Partic of Rhubarb in diff. forms of G. Kin. of Peruv. Bark &e.

And reckon it not improbab. that might at last have hit upon some tonic or astring suited to habit from which migh have obt. good affect.

Of future plans with this patient howevr need now say nothing.

As from absence for some time past probab. is that will here nothing farther with regard to her.