DEP/DUA/1/20/05 (Transcript version)

Robert Dunneval

(1779)

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Robt Dunneval

Case of this patient exhib a set of sympt by no means unfreq to be met with.

And much more diffic to cure than to disting from other affect.

From perusal of case might be concl that here subj to two distinct sets of sympt.

Affect of stomach & those of head.

Here however can have no doubt that latter conseq of former.

And that disease to be solely consid as being a stomach compl.

Sympt of which princip compl. when came under our care was pain at stomach.

This well known may arise from diff causes of which judgem only to be formd, by attending to concomit circum

Here may be observed that pains [much] aggrav. from taking food.

And that use of almost all kinds of food succeeded by freq. windy [eruct.]

In these circum have I think evid of weakned tone in stomach

And from this well known that pain as well as many other circum may be induced.

With this pain to be remarkd that anoth set of sympt sometimes alter.

At irregul interv on remiss of pain, is seizd with vertigo, priv of sight & of [hearin]

These affect of sense thus occurring, would naturally argue affect of state of brain.

Well known however that by intern of brain induced in conseq of stimuli applied even to most remote parts.

And from none more freq. than from pecul irritat in alim canal

Whether as effect of pecul stimulus or of pecul state of sensib.

Could have little hesit then in consid it as in pres case from this [orig]

And app suspen of pain not from removal of cause but from state of [Sent] princip induced by which [mean] of being affected in usual manner by painf impress.

Viewing then compl in this light would referr whole to morbid state of alim canal princip of stom.

And with this idea of nature [alth] has not all sympt of Dyspep. as introd into some nosol. syst. yet would be disp. to give it that name

As to prognos. this affect in gener. well known to be very obstin.

And partic with those whose occup. like that of pres. patient of a sedent nature.

Yet on other hand unless arises to a very great height although a distress is seldom a danger affect.

In many inst sympt much more severe than those which occurr in pres. case

And disease of our patient cannot yet be said to be of long stand

At least pres. degree of severit has contin only for space of about 4 weeks.

Must here howevr observe that for simil compl. same patient once before under my care.

Hence then may inferr dispos. to this affect of much earlier date

But even from this circum judgem in some meas. fav to be drawn.

For as then soon in great meas. yielded may expect same on pres [occas]

Now however more than formerly [cannot] look for radic cure.

And on slightest excit cause reason to appreh. that compl. will be again in some meas renewed.

Such howevr from situat of pat. hardly to be supposed will be capab of avoiding.

Is howevr our business to allev or remov pres. disease & as far as we [can] to prev. return

[Of] meas for this purpose then come next to speak

Consid disease as affect of weakned tone of stom. had to look only for cure from restorat of prop vigour.

For this purpose great variety of diff tonics in common use.

Princip however recourse had to veget bitters & astring.

And that from these conj. at least with tonic regim often greatest benef. cannot be refused.

Have often however been inclind to think that no less advant here to be expected from miner than from veget tonics.

And wishd to make trial in pres inst

To this the rather induced, from pecul affect of head, partic vertigo to which stomach compl here gave rise.

From this inferrd that debilit [coresp] with pecul morbid state of sensib.

And as counteract such have ever found that best effects obtained from mineral tonics.

Here had recourse to Zinc in state of calx.

A med with regard to medical power of which pract a good deal divided.

Must indeed be allowed that has not answerd high expectat. which on late introd entert with regard to it

And many from freq. disapp now look upon it as really a med of no effic

That given to much greater extent than commonly done will not cure every or even many inst of Epilep must be allowed.

But that from thence should inferr it of no activ is by no means a fair [concl.]

Nor can such a concl. be drawn from want of obvious operat.

From similar argt might deny effic of best med, Peruv Bark &e.

That is an astring & tonic in saline state as in form of white vitriol no one will deny

And that when given in state of Calx should as well as other metal, [illegible] be rendered active in stom is at least highly probab.

But while these grounds for inferring active powers effic farther confirmd by numer observat.

Many cases in diff period works by auth pract of great emmin & accurr. in which attended with best affects.

And besides these observat am from my own exper inclind to think fav of it in all cases dep. on atonia with morbid sensib.

Pres. however first inst of a dyspep affect in which have ever empl. it.

Here conj with valerian, an artic cheif affects of which depend on purul impress to nerves.

And thus operat sometimes as antispasmod

But here cheifly employd with intent of giving form.

From time that use of this med began has had no returns of vertigo.

And indeed all compl. very greatly relievd.

After however had contin use of it for eight days belly very bound.

This imagind might possib proceed from the med.

But besides this in disease itself [natur] dispostit to it.

And whatever cause has unquest [tend] to aggrav. the affect.

Consid therefore as necess to take meas for removal.

For this purpose conj with Zinc the use of aloet pills

By these means belly kept regular in point of disch. & compl. in every respect very much allev.

And am in hopes that by contin may be entirly removd.

Shall not therfore wish to have recourse to any other plan of cure

And on that acct do not reckon it necess to prop other meas. if pres in end found ineffect.

Especially as these greatly regulatd by state of compl at time.

Am however in hopes that in place of other remed may soon be able to [dismss] patient from future attend.