DEP/DUA/1/15/08 (Transcript version)

Grizel Frazer

(1777-1778)

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Grizel Frazer.

With disease of this patient a good deal of diffic.

And must own equally at loss with regard both to name & to nature of affect.

At loss also to say whether whole sympt belong to one disease or whether are to consid affect as of complic nature

Princip part of compl. consist of local & transit swelling in abdom.

Not fixd to any partic part but Has also a progress through the abdom

And sometimes begin at one place sometimes at anoth usually termin in stom.

Swelling propag. in this manner cannot depend on any fixd affect of [visc]

Not infreq. merely arises from accid flatus in bowels.

And this may be case with it in pres. patient.

While at same time unconnected with other parts of her disease.

While though less painful yet perhaps more threatening.

That is attacks of shivering & coldness succeeded by heat.

These well known to be most common charact of febrile access.

And to being such in pres. case some counten given by impaird appetite & bound state of belly.

Yet to any suppos of this kind long contin of disease a very strong object.

Can hardly conceive febrile attacks from whatever cause prod to have subsist for so long time without proving fatal.

Farther to be observd that these success of cold, shiver. & hot fits not with affect of circulat.

Do not as is commonly case with febr parox observe any regul. period of [illegible]

From these partic then inclind to [rejec] suppos of being febrile.

And well known that feelings of heat & cold often the prod of other causes.

With that sex Hysteria most freq.

Partic concommit of Nerv. affections.

And of none more freq. than of Hyster.

A disease appear of which perhaps under as great variety of forms as any other to which system subj.

To this suppos gives some presumpt that patient a female.

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Perhaps still farther that here prob. origin of disease from affect of uterus.

For while some parts of compl. dated from pregn. others from deliv of twins.

From such a state although not always bad effects yet greater opport. of morb affection than from ordin pregn.

And presumpt that succeeding [illegible] disch. more excess.

Hence then here causes which might be supposed to give chance of morbid affect of uterus.

And need hardly observe that once prevailing opin. that all hyster affect from morbid state of this viscus.

This evid appears exclus of other circum from name of disease alone.

And hysteria a name as evid suppos disease of womb as Pleurit an affect of pleura or odontalgia of tooth.

Now indeed such conject respecting cause of disease exploded.

And admitted that if be not more partic an affect of anoth part is at least disease of system.

Perhaps even may venture to assert that more immed results from pecul. irrit of alim canal.

Yet although uterus not immed cause of hystr. cannot be refused that affect of this viscus often a cause in more remote way.

More freq. results from diseased state of menst evac. than from any other circum

Hence then cause of disease here an addit circum corrob. suppos.

Lastly suppos of Hysteria still farther corrob by affect of senses.

True indeed, in this disease have not as in epilep. abolit of senses.

Yet in hyster parox these much more affected than in common febrile attacks.

In this part of affect then find much more near resemb. to hyster. than to fever.

And would naturally inquire how far how far other compl. also of patient refer also to same head.

Hyster. not indeed marked by obvious swelling in abdom.

Nor in common attended with any [remark] pain there

Yet one of most freq. sympt sense of ball moving in abdom.

And not only rising as in pres case to stomach but even through tract of oesoph to fauces.

When reaches that place gives sense of suffocat so freq. a distressing sympt in this affection.

This sense of ball moving in belly by some disting well known by title of glob. hyster by some consid as pathog of the affect.

This opin indeed am not disp. to adopt

Yet no one will refuse that at least a very freq. occur. in the affect.

And although compl. as here describd by patient not exact resemb. to it, yet in sever. partic approaches it.

On whole then disp. to consider this as part also of same affect.

Would then view her as subj. not to comp of disease but to one only.

And to that would give name of hyster

Must indeed allow that if compare it with nosol. defin. in most accur. [illegible] does not bear to these exact corresp.

Perhaps however this rather to be ascribd to variety of appear which disease puts on than to any othr cause

And indeed to be observd that from this circum defin of Hyster. very diff. matter.

Hence it is that best nosol. have defind it in very diff ways.

For if consult these defin will hardly think that define same disease

Can therfore have less hesit in giving same name to diff. variety.

At same time not without diffid that pronounce this patients disease to be Hyster.

And would even qualify what have said by viewing it as inst. somewhat anom.

Have thus deliv opin as to what disease is next to say how I imagine it will termin.

And here must own hopes by no [means] sanguine.

Hyster in general an affect in nature obstin.

And partic so when as in pres. case occurrs not in most regul form but with anom sympt.

Is farther unfavour. that has already subs. for so long time.

And that patient already at advancd period of life.

Hence no chance of recov from those revolut to which female syst. [subject]

While however thus dread obstin of disease must own not disp to con it as danger.

If indeed cold & hot fits of nature diff from what here conject may be sooner fatal than aware of.

But if conj. well founded more alarming than danger.

And this indeed, is in general case with affect of hyster. kind.

Is then an affect where neither look for speedy termin in death nor recov.

And not even any great prosp. of afford much relief

This the rather to be dreaded as from meas. hitherto adopted, have as yet made but very little progr.

Am then very doubtful how far shall even be able to allev. patients affect

But if this accompl. is I must own utmost of expect. with pres. patient.

As to pract in this case may be observed that in such affect in gen. two great obj in treatmnt

The mitig or shortning of fits when pres. & the prev of return.

First inten cheifly to be answrd by such med as exert immed affect on N. [powr]

And by this means countract tendency to spasmod or convuls affect in musc fibres.

Prev of return to be aimd at in diff ways. But princip.

By anticip fits

By removing such causes as will serve to excite them

Or by removing condit of system without which excit causes will not have affect.

In practice with pres. patient have used meas. with view of accompl. all these ends.

Cannot however say that with any of them have had the success that could have wishd.

Yet shall briefly mention what aimd at by each.

And on what future plans am to attemp cure or allev of remaining compl.

First began by directing for patient the use of Pil Gummos.

These cheifly intended to obviate swelling of abdom mentiond in case.

Which hoped might do either on suppos of being strictly Glob. Hyster or arising from flatul.

As in both cases would hoped would result from influ of Assafoetid as an Antisp.

While at same time expectd might keep belly open.

Did not however fulfill wishes in either respect

Substit therefore as more active [purge] the vinum aloet.

And this combind with the Assafoet under form of Tinct. Fulig.

For in this Tinct princip active ingr is the Assafoetid.

And is cheifly in menstr. that differs from Tinct Foetid.

From this at first seemd to derive some tempor relief.

But in way of moving belly went farther than could have wishd.

And this even case after dose very consid dimin.

From any evac however, great reason to believe that dis would be augm.

And with view of prev return of fits put patient on course of Zinc with Val.

With view of anticip them after threatnings should occur directed Aether.

What will be affect of this course cannot yet pretend to say.

But if affords any relief shall wish to persist without alterat.

If not may try her with course of Per. Bark.

And in case both prove abort. shall be very glad to dismiss patient, if at any time even tempor mitig of sympt.

And if state of strength will admit of it notwith appar febrile attacks may in spring recom cold bathing