DEP/DUA/1/24/14 (Transcript version)

Robert Watt

(1780-1781)

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Robt Watt.

Princip compl. evid affect of Stom

And perhaps better entit to name of Dyspep. than any other.

From this then may be consid as a common affect.

Yet with respect to appear is a modif of the disease very diff. from what commonly occurs.

And for own part have not before met with any inst exactly simil.

This will appear from comp. hist of case with common sympt of Dysp.

Those prin are, acid, flatul. eruct. want of appet. naus. vomiting, pain in stom & intest & bound belly.

Of these sympt it is true sever here occurr. in usual form

Partic flatul & constipat.

But pain in stomach & intest but very inconsid.

Is an occurr only which has but lately taken place

And is much more of dull & [illegible] kind than what commonly attends

Were this however only pecul. should consid it as but inconsid

Much grater diversit singul. in anoth symp

And that too one of most common [occur]

What expressd viz by vomiting

Here accord to acct. given us reject of victuals from stomach not conseq of violent action.

But brought up in such grad [man] that rather to be consid as Ruminativ than vomitus.

This, to some degree indeed by no means a rare occurr in Dysp.

But very seldom occurr to that height which takes place in pres case

And in formr pract. have never met with it to such degree.

In so much that consider pres case as with greater prop. entit to appel of Ruminativ if such genus can with prop. be [estab] than any before [occur].

For This sympt also with some Nosol has given [nam] to genus.

But at same time multip of genr. attended with many diff. without good effc.

And although diff modif of sympt yet agrees essent in nature with Dysp. or stomach compl.

And although Many sympt indeed of Dysp wanting. Yet uneas. after meals, [illegible] of victuals, flatul, & constip, suffic to constit this affect.

Here however to be obs. another sympt. not commonly markd in Dysp.

That is freq & severe attacks of Head

May be question how far this sympt of stomach compl. or a separ disease.

Would not posit assert that latter is not case here.

But at same time when consid how freq. headach conseq of disord stomch more probab. that connectd.

And that Cephal. merely sympt of Dysp

This then idea of pres. affect.

But whether diseases in reality depend on each other or not can with regard to neither give fav. progn.

Nothing indeed in either so far alarm as to threat danger.

But obstin with which already [subsit] precludes hopes of speedy cure.

This partic the case with regard to stomach compl.

For notwith diff remed has now we are told subs. for space of 8 years.

And during that period means of cure very little effect even in dimin.

For although tempor. relief yet upon whole encr. in viol.

And if Headach depend on stomach compl. till remov of former latter, cannot even look for allev of latter former.

But besides obstin nature of compl, another circum in case also leading to unfav. concl. opin.

Well known that such affect after mitigat very liab. to relapse.

Partic in conseq of irregul in diet or in conseq of improp. food.

Can hardly however expect that with patients situat & empl. in life, these partic attended to as ought.

Hence then even if allev prod yet const. danger of relapse.

And upon whole expectat with this patient by no means sanguine.

Utmost that expect is to be able to dismiss him with some allev.

And shall not be surprizd if leaves us in no better situat, than when came under care or even with encr.

Yet still may at least afford us opp. for trial of diff. meas.

And [sever] which without any [hazrd] from use may be empl. with some probab. of success.

If any of these shall succeed in effect. cure, obstin of case stronger evid of effic.

Here, if cure can be effected, is prin to be expected from means giving [stregth] & vig to stomach.

For although disease prin [charac] by inord action, yet consid this as depend on debilit & irrit state.

While however for radic cure means to be employd for restor strength, necss also to attend to means of obv. urgent sympt.

And partic to enjoining the obviat those sympts which can have any tenden to encrease affect.

Such however never fails to be conseq of acid, bound belly &e.

On these general intent med [illegible] employd in this case, have been [direc]

Here will observe that since this patient came under care, unif cont. on course with which began

Directed for him mixt [consist] of Tinct. Absinth diluted with Pepp. Water

From latter expected some effect as counteract flatul & prom. expuls of wind from stom.

But here cheifly empl. as corrigens.

As [illegible] from aromat oil which cont. to cover taste without dimin effec of the Worm wood.

Same also will readily conject was sole intent of addit of sugar.

And this even with many, in [som] meas necess to correct the Pep. Wat.

Here what prin relied upon as active basis of med was Tinct. [Abs]

This tinct formd from one of [strong] vegetab bitter which this country [prod].

Formerly two species of Absinth a place in Pharmac.

Now however one only as equally serving purp of both retaind.

And College have with prop. pref. what indig indig in this country, while at same time strong & [purul] bitter.

Here may remark that Tinct [Absin] a new formula.

For although formerly two species of the plant in Pharmac. was only empl. in comb with other artic or occas added to stomach bitters.

Consid advant however from such [form] as pres.

For thus can be occas. & to any extent, introd in extemp prescript.

To be observed that in prepar. a partic mode employd.

That viz of double infus. Spt. Menst used first added to quantity of lb ii to ℥iv

Afterwards second infus of same spt. with half quantity of Wormw

Supposed that in this manner greater strength & purer spt. bitter, than if same quant of spt applied to whole wormwood at once

And that this the case at least highly probab.

At same time have never for my own part, seen any decis evid of it from prop. trials.

But whether stronger or not, can be no doubt that by rectif spt. [strength] of Worm. very fully extract.

As means therefore of exhib [actions], of this veget bitter, was here empl.

And although in pres. form but little exper of effic, yet from some trials both in this & other ways expected influ as counteract compl.

With this however from [beging] conj. also anothr med.

I mean Pil. Foetid cum Aloe

Of these pills, which consist of equal parts of Aloes. Assafoetid & Soap have already had occas to speak.

Look upon them as very useful both in counteract flatul & in obv. costiveness.

And with these intent here empl.

After what already said of them when used in other cases for simil purp. now unnecss to add any thing.

May only observe that at first given only to extent of gr V

In this quantity although had some effect yet not so consid as could have wishd.

Since that encreased to double the quantity

And now have effect of keeping belly gently open.

On this course patient has now cont. for space of sev. weeks.

Cannot say that progr. to cure [great]

Yet upon whole rather allev. as otherwise.

Change so far fav. as to led me to think of still contin same meas

At least at pres. no thoughts of any other alterat than augm quant. of Tinct. Absinth in mixture.

And if shall be means of comp. cure or even consid allev. will lead me to think very fav of this med.

Will not however be surp. to find that after prop trial cannot obt. from it the wishd for effect.

And that with view of attempt cure obliged to have recourse to other exped.

If this the case shall first wish to try effects of some purgat oper. more [brisk] than what already [empl].

For this purp. in place of pres. pills have thoughts of trying Aloes in liquid form.

And partic of empl. it under form of Elix Aloes or Prop as comm calld.

This while warm purgat at same time gener consid as stomach.

And by prod purgat action may have affect of counteract inord motion which most distress.

If this fails have some thought of trial of Columbo.

Which upon whole one of [best] stomach among tribe of Veg. bitters with which am yet acquainted.

Have some thought also of having here recourse to use of [Ag.] [Pip.] Jamic.

In which one of most pleas & best of veget aromat.

And which of late in some cases of stomach compl. have used with consid success.

Among other trials also, as [mean] of restrain inord action, & morb. [sens] may here suggest Laud.

At same time however taking care to obv. costiv by prop. measures.

But in all these meas must be regul. by future circum.

And if cont. to be benef. by pres course shall not soon subs. anoth