DEP/DUA/1/21/13 (Transcript version)

Elizabeth Hill

(1779-1780)

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Eliz Hill.

With regard to case very great diff

And equally at loss both as to name & nature of affect.

Was however in hopes that from careful observ of progr some light might be thrown upon it.

And before occas to speak more decis opin than from hist.

From this however in some meas preclud by patient herself.

For since admitted under care irregul in attend.

And as not able to find place of abode no opport of seeing her for some weeks past.

Not improb. that may not return

Is yet however a case meriting attent

Hence less necess. to be very partic

And shall now therefore state at some length But may yet state conject, as found on histor. at time of admiss

Princip part of compl. consistd in severe pains.

These though more freq. in some places than others yet in none const.

Wherever occurr of what may be calld transit nature.

And obv. induced by very slight cause

Such for example as quick mot &e

Though not conf to partic part, yet cheifly in region of stomach or head.

And as there taking place no symp which can lead to suppos of any [loc] affect.

As these obvious too [accomp] with some other sympt.

Partic nausea inclin to vomit & palpit when affects stomach

And in more than one inst tempor. blindness when affect head.

From these concurr circum then led at least to some conj as to nature

Pain well known from diver of cause

But all ultim refer. to one of these circ.

Stimul cause direct acting on Nerves

Distens of extrem. - Or contract of same

Here do not suppose extrem of Nerv. themselves possessd of any dist or [contra] power.

But may be brought into either state by [moti] of parts, partic of musc fibres with which conn.

And from both no doubt that painf sensat arise.

These indeed still [illegible] refer to gener. head of stimul.

Yet very diff from stimuli whether extern or intern. acting on sent extrem where state of tens. not changd.

Hence then foundat for difference

But may farther observe that [when] pain from all these impress. effect of equal impress. by no means alway the same.

At one time strong impress [whether] from Stim, disens or contract, little affec

At anoth even slightest in either way will give rise to very sev. pain

This freq. to be attrib to no other circum than cond of med cond imp. to sensor, or state of Nerv. power

And perhaps even diversity more freq. from this source than any other.

Such condit best expressd by name of mobility.

And when occurrs for most part prod also of other sympt.

In pres. case indicat of it prom tempor. affect of vision, naus. &e

Inclind then to think that to this source pains compl of by pres pat in great meas to be attrib.

While however supp. this mobilit still some excit cause of pain [req]

And this in pres inst would susp. rather to arise from contract of spasm affect kind than any other cause

This the rather to be susp. from sudden. with which ind. & triffling accid giving rise to them.

And to contract from slight cause mobilit itself gives greatest disp.

This then opin as to cause & nature of pain which here occurrs.

And if conject well founded name which would affix to it perhaps immat

In nosolog syst. great variety of gener. to which might be referrd.

[Gashod] from affect of stomach.

Cephalag. from affect of head &e

But all these names merely for sympt.

And by no means applic to whole.

Accord to syst. of nosolog. this affect in no degree corresp. with definit of hysteria.

Yet if consult hist. as deliv by best pract authors will find it an affect app. under great variety of diff forms.

+ And perhaps may with more justice give it gener denom of Nerv. affect than any other.

And perhaps no affect in reality more diversif in appear.

Without entering minutely into these distinct most useful in pract is [illegible] Hyster. fits & Hyst. sympt.

In former of these cheifly if not only that nosol. have defined.

[And] here those sympt constit such a state of the disease entirly [wanting]

None of sympt howevr which are not every day remarkd as occur. in Hyst

And this name are farther led to affix to it from idea given of path.

Would then consid affect of pres. patient as entit to appel of Hyster.

And as app under form of Hyster sympt.

Must at same time however remark that offer this conj with great diffid.

Affect by no means cert. or distinctly markd.

And before decis opin should have wishd to have seen more +.

Whether opin well founded or not still I think no ground for fav. progn.

For if conj. true, disease to which patient subj always in nature obstin

And partic so when app. under such form as pres.

Seldom even admitt of compl. [cure]

And although mitig & allev yet in some degree cont. for life.

But although really a diff affect yet from circum of case no reason to hope for speedy recov.

Has already cont. & that too with obstin for consid time.

To sympt even of shortest durat has been subj for years.

While again sever parts of compl. have as it were grown up with [con]

And with attacks of headach in partic has been distressd even from infancy.