DEP/DUA/1/16/13 (Transcript version)

Thomas Mann

(1777-1778)

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Thosm Mann

Respecting name to be given to disease of this patient somewhat at loss.

Disease consisted of two parts.

Fits with which attackd at uncert. intervals.

And affect of alim canal to which more const. subj.

In fits [something] indicat epilep. [appr]

Partic in abolit of sense with which [attendd]

And in state of torpor by which succeedd

Are told that during fits loses sense both of seeing & hearing.

And that after them is even for space of day or two affect with torpor.

From which may concl. that there occurs no inconsid disorder of [intern] [sense]

To this may be added that Hyster. [only] disease having resemb. a more freq. [affec] with women

And that upon whole a rare disease with men

Yet although these circum in fav of epilep other here arguing hyster.

Partic patient according to descript affected with globus hyster. by many consid as pathog.

And although absence no proof that affect not hyster. yet. pres. strong evid of nature of disease.

Besides this still farther evid of that compl. in all affect of alim canal.

These indeed may be [complic] with epilep.

Yet at least not freq. combin.

While on other hand constit essent part of Hyster.

And here inclind to consider all sym of disease to which patient subj as parts of that affect.

With regard to progn may observe that this patient as well as former also dismissd.

And that too after interval consid longer than usual from any compl.

Would not howevr from this inferr that radic or certainly cured.

Yet benef. at least such that consid farther attend for pres. unnecess.

This howevr will more partic appear from few remarks on pract.

Consid affect to be Hyster. put patien on use of diff. antispas.

viz Aether & Assafetid.

From these hoped that by anticip of fits & by expuls of wind from intest.

While at same time by addit of cloves with Assafoetid hoped to keep belly open and thus remove cause of irrit.

Employm of these med seemd so far attended with good effect.

But although mitig sympt & probab. kept off fit for some time did not prev. [ret]

This led me to comb. use of pills with tonic.

And for this purpose employd Zinc.

A med which at pres some practit hold in very high esteem others consid as totally ineffec

For my own part must own entert fav opin of it.

And cannot help thinking that even pres case affords example of good [affect]

Comb. here with Valer. prin to give form.

But in some meas also as Antisp.

First gave it to extent only of three gr [day]

But soon encr. to 10.

On this course patient cont for six weeks

And during all that period while sympt more [const] grad left him remained [illegible] free from any return of fit.

Consid him therefore if not cured at least as having obt very benef. remiss.

In this situat thought it now advis to give up med for some time than to persist in use.

Was therfore dismissd from farthr attend here

And would fain hope that may cont free from affect

Shall not however be surprized to find that subj. to return of compl.

And in that case shall have recourse not without hopes of success to [same] [meas]