DEP/DUA/1/13/22 (Transcript version)

Alexander Orrock

(1777)

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Alexr Orrock

Case of this patient very soon fav. termin under our care.

Or at least patient receivd such interm from affect that judged it unnecess for him to cont. any longer his attend.

Would howevr be by no means aston. if should again be affected with return of former ailments.

And must own that relief he obt from his compl. much sooner than should have expected.

For consider his case as by no means without singul.

Easier I appreh. to form probab. guess as to nature of this affect. than to [affix] either prop. name to it or to expl. all [phaen.]

Evid that essent. part of disease consist in pain begining in abdom.

And these while last, subsists with very great viol.

Among nosol. writers all pains of intest not from any fixd case refer only to general head of colica

To bestowing this denomin on pres affection howevr some object.

From transit nature as well as from freq. of returns diff in appearance at least from what gener. known by title of colica.

And that even when arises from flatu which manif. appears to be cause in inst. before us.

But besides this several other [pecul] in pres. case.

Partic sympt preceding attack viz uncommon flow of saliva into mouth.

In what mannr this connected with other parts of affect. must own am totally at loss to say.

Observable however that encreased separ of fluid by saliv glands is effect of diff pecul. sensat.

Thus for ex not unfreq. arises even from partic sounds.

May at least conject therfore that prod in pres. inst by a cause somewhat simil

And that depends on pecul sensation arising from bowels which proceeds viol pain.

May here observe that this not only inst in which have known such a appear to occurr.

Have met with two inst of epilep. of which flow of insipid watery fluid into mouth was forerunner.

And these was disp. to imagine that might be expl. on suppos now thrown out.

But whether in one case or other the suppos. well founded will not pretend to [asser]

As singul here in circum preceding pain so also in conseq. of it.

Or at least in direct. in which [illegible].

Are told that in every attack here begins at under part of belly.

And that there in paind part manif. swelling & distens.

Soon however propagated from part in which origin through trunk of body in general.

But that termin as it [were] under arm pits in which is partic severe.

From what cause determind in this partic direction must own cannot pretend to say.

Some would be disposed to referr it to contin membranes.

While at same time would referr sever. under arm pit to termin & interruption there.

To this reasoning must own that [known] no very strong object.

At same time can hardly consider it as confirmed by phaenom.

For although in partic cases, pain as in pres. may always follow certain course, yet when compare together diff cases course much varied.

While at same time in all connex of memb. the same.

Am therefore more disposed to considr direction in which propagated to be in each case effect of partic condit of parts which seem more especially affected.

But at same time probab. more from condit of nerves than of simple solids.

Yet on whatever footing are to explain [appearance] which are either forerunner or conseq of pres. attacks can I appreh be little doubt in ascribing these princip part of compl. to an affect of spas. kind.

And such compl. induced by disten from wind.

This equally evid from swelling belly & from relief on disch of wind.

On this idea of nature of affects did not despair of being able to effect cure

Or at least of allev. severity of pains & of dimin freq. of attack

When howevr [considered] viol of attack was disposed to think that would not be easily affected.

And when reflected that had now subsisted for space of 12 years, imagind that would not be brought about in short space of time.

While therefore lookd for favourable termin yet dreaded that case would be ted.

[In] this howevr from facts appeard that appreh. groundless.

Consid cure of this affect as turning on two circum.

First on freq. expuls of wind by which cause inducing spasmod affection would be taken off.

And secondly on removal of dispos. to spasm from which although irrit cause in some degree remaind yet would soon cease to be prod of former affect

Was with view of [answering] both [inten] that had here recourse to use of Pil Gumos.

In which trusted cheifly to stimul. & antispas. powers of the Assafoetid.

Little reason to doubt that this med fully answerd intent which had in view.

From time that began this med had free disch of wind downwards.

And seemd to have farther affect of obt regul. evac of fecul. matter.

For during use belly natural.

With these changes patient at same time freed from any return of pain.

And after suffering no relapse for space of month thought it unnecess to persist longer in use.

Dismissed him therfore at least for the time cured.

Would not howevr say that will cont. free from any returns.

But if this should be case will probab [hear] of patient again.

And by use of same med may I hope be removed.