DEP/DUA/1/20/09 (Transcript version)

Margaret Brown

(1779)

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Margt. Brown.

This patient may consid as now in great measure free from affect to which subj. when came under care

Sympt to which she was princip subj. frequent loose stools.

These attended with gripes, tenesm & a disch. at times at least of bloody [nat]

Not however as entering the compos of matter disch. but in separ. streaks.

This combin of sympt accord. to some practit would constit what they call Dysentery.

But conf. that term entirely to a disease depend on pecul. febrile contag, to disease to which this patient was subj. would give name of diarrhoea.

Besides what now enum indeed, some other sympt in this case.

Partic swelling of belly grinding of teeth &e.

These however consid as merely conseq. of weakened state of bowels.

And would view also in same light, pain seated in breast with which affected but which from concom [eruct], evid dep on flatul in alim canal.

These sympt we are told even more urgent before loosness began.

And may probab. be consid as indic constit weak state of alim canal.

In such a habit less surpriz that from an accid occur. diarrh should be induced

And accord to conject of patients mother, not improbab that was here conseq. of expos to cold, from walking bare footed.

Than this few meas perhaps which have more immed effect as induc constrict of the surface.

And from this well known that determin internally which must of course take place, very ready to induce freq loose stools.

From contin of these, intest soon so far abraded, that gripes, tenesm & bloody stools soon the conseq of affect

Have thus then stated sentim respect nature of patients affect [when] came under our care.

And had I then been to give prognos. should have been inclined to give fav opin as to event.

Could not indeed have expected that constit weakness of bowels to which pat subj for sever years would have ceased in short time.

But should at least have entert hopes of speedy & fav termin of Diar.

Such an event has we may say already taken place.

For from some of last reports apper that patient, now as free from diarrh, as if had never been subj to it.

Still indeed have some of those sympt. which give indicat of weakn of stomach & intest.

And with such not surpr. if from any slight accid, diarrh shall return

This however hope will not be case while patient contin under our care

And indeed if no new appear takes place see little farther benef to be expected from attend here.

In treatm of this case while Diarrh contin remed princip empl. & on which indeed put greatest depend. was repeatd emet.

These long [recom.] & indeed even held in high esteem by most emmin practit.

Diff indeed in sentim with regard to most advant mode of admin.

Some recom that should be given merely in such doses as without [actual] vomiting will excite nausea.

Can be no doubt that thus very great determ to the surface.

And indeed many of most comm emet in small doses operate as powerf. sudorif.

Cannot help thinking howevr with Dr Sydenh. & many others that here great benef from full vomiting.

And while not less influence as altering [ballence] of circulat, is of serv. also as evac [contents] of stomach

That Emet were of great serv. use to this patient can I appreh admit of little doubt.

For while attend with effect of excit full vomiting from time that use begun sympt. [grad] dimin.

And soon entirely free at least from loosness to which subj. for sever. week before.

Besides Emet indeed took for short time a small quantit of Succus Jap. with Rhubarb & Cinnam.

And probab that this med also from astring had share in dimin freq of stools.

In pres state of sympt do not consider either contin of this or of the Emet to be necess.

Still however, as indeed may be readily imagind, patient affected with those sympt which arise from debilit of alim canal.

This however as already remarkd consid as in some meas. constit state of bowels.

And to be overcome rather by regim than by medicines.

Was therefore more with view that might not seem totally inact. than with any other intent that directed frict with camphor. oil external.

For was in hopes that during delay for space of week compl. might be mitig.

And if after this find pain of breast easier is intent to dismiss this patient.

If not shall put her on use of some tonic or stomach med. conj. some artic for expuls. of wind.

Now hope howevr that upon whole little farther will be requis with respect to this case

And therfore consider any other suggest of pract as unnecess.