DEP/DUA/1/16/04 (Transcript version)

Ann Frazer

(1777-1778)

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From list of Dispen patients selected as subj of lect. case of Ann Frazer.

And from hist of affect as deliv to us compl. seemed to be pecul. & interesting.

Yet since first applied for aid have never again seen her at this place.

Cannot therfore say how far acct given to be depended upon.

And if at first really as she repres. it cannot yet say are left in dark with regard to what has been after progr of affect.

Unnecess. therefore to make any many observ concerning her affect.

Especially as besides uncert. from reason already ment. have nothing to add respect pract.

May only in general observe howevr that consider her affect as being entirely of nervous kind.

Palpit occurring from such a cause very freq to be met with.

These no doubt consist in inordin motion of heart.

And easy to understand from what circum such a state of action may arise.

Regul. of motion must dep. on certain state of stim exciting to action & of sensib on which that stim to exert influ.

While therfore may be affected by cond. or quantity of blood at heart will be no less so by state of nerv power in moving [fibres].

And while first in general marked by [such] obvious occurr. last will take place where agency from whence arisen cannot be traced.

From this circum then induced to referr palpit in pres. inst to that [source]

And this the rather probab. when consider othr affect to which patient subj

For here inordin action not conf. to heart alone.

But fits of palpit accomp. with simil. affect of alim canal.

Is from such inord. action that are to assign [efforts] during fit to expell wind either upwards or downwards.

Here can not suppose that immed extricat of wind is effect of fit.

But must necess. concl. that has prev. existed in alim canal.

And perhaps few periods at [which] to greatr or less degree is not pres. in intest.

Extricat may be consid as necess. conseq of process to which alim matters subj.

No part of alim either fluid or solid when does not cont air in fixd state.

And from solut of latter, from mixt of formr escape a necess. conseq.

Where indeed due tone of intest canal soon, either in great meas. reab. or expelld.

Yet from these causes must conclud that in every inst is to some degree pres.

And while With ordin action of intest canal would remain in great meas at rest or subj to regul. motion

When however inordin action occurs will be subj to uncommotion

And thus from accumul & conf. at partic parts what before diff over whole tract of intest will be prod of that uneas. arising from distens.

Is then on these princip. that would expl. troublesome [efforts] to expuls during fit.

And consider this part of affect as [corrob] opin respecting former.

May I appreh. view also in same light affect of urine.

Yet at same time must own do not know on what princip can be expl. with equal certainty.

Can be little doubt that morbid condit in disch of urine & even in secret often from partic state of nerv. influ.

And manif to high degree in diff nervous affect partic hyster.

Probab to be referrd to inordin cond. either in secret organ or passag canals through which must pass.

In all these circum then little pecul.

And although sympt thus varied yet disposed to consider [all] as [const] merely parts of one affect.

To this howevr do not know what name according to any nosol. syst. can with prop affix.

Of all other gener. indeed most nearly [app] Hyster.

But is at least a modif so diff. that will not corresp. to any defin of that [affec.]

Can only therefore denom it by vague appelat of nerv. affect.

But if thus diffic respecting name still greater concerning one partic of affect of [which] have as yet taken no notice.

That is what told respecting attack of fits

These informed returned period at stated hours four times every day.

This circum must own should have wishd to have had conf. by [future] observat

And even if could now expl. it such explan. probab. to be consid as unnecess till fact ascertaind.

But whether true or not in pres inst. can be little doubt that in diff. [disease] both of nerv & febrile kind regul & period attacks do take place.

And as acct.ing for such returns must acknowledge must acknowledge that have never yet heard any expl. in smallest deg probab.

Or which indeed not liab to unsurm diff. & object.

Great pains best to referr some of them to period revol. of syst.

And to those laws to which human oeconom. necess. subj. by habit.

But if pres. [report] true what laws, what habit or [disch] revol. can expl [return] at partic hours here mentiond.

If these observat well founded affords one, of many inst, of diff. to which, with regard to this circum, are subject.

And in explan of which can go no length on most probab. theories that have yet been offered.

Thus then on suppos of truth of repres. have pointed out conject which disp to form of nature of this disease

And on that repres. also should have been inclind to pronounce it an affect in nature obstin.

But from opin in great meas conject could not be disp. to form certain or pos. judgement

And from not having since seen patient precluded from any farther source of inform.

While at same time probab. is that unless by mere accid shall [hear] nothing farther of this patient.

What [then] would have been plan of treatment had she come prop. under [care] unnecss. to say.

Suff. only to observe that [directed] [action] prev to fits with view of determ. how far would have effect in anticip [them]

And thus judging with more certainty of nature of affect.

But even of this have never had oport of receiving prop. inform