DEP/DUA/1/25/06 (Transcript version)

Margaret Park

(1780-1781)

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Margt Park.

In disease to which this patient subj many sympt.

And these such at least & not unif or necess. conjoind.

At same time such complic no very rare occurr.

And little hesit in pron. disease to be a hysteric affect.

That part of compl. to which [most] freq subj of this nature little doubt.

Seldom passes a day or two without fits of coldness, shiv palpit insensib &e

And what clearly indic nature of these with sense of ball rising to throat.

In these cannot indeed be said that have exact descript of regul hyster fits.

For here no mention of convuls agitat of legs & arms

Which if not most disting at least among most obv. sympt of hyster fits

But want of these no obj to this suppos.

For occurrs in numberless inst.

And in these sympt as describd in case no accur resemb. to any other affect

For although shiv & coldness [com] in fever yet here without encreased heat. [accel] circul or what still more charact. without anxietas febrilis.

At same time concomm globus hyst evid indicat of inord action of alim cana

And indeed by some consid as pathognom of hyst.

While then take this view of these sympt. would consid also in same light others which though less freq. more distress.

That is reachings & vomitings with which at times affected.

These we are informd also usherd in by simil shiv fits.

But most remark circum attendin them is colour & taste of fluid disch

While of brownish app. has at same time consid bitterness.

These qualit can hardly suppose to arise from any matters taken in under form of alim.

But readily afforded by secret. [furnishd] from system itself.

And partic from bile.

In which indeed, even in natural state, have nearly these qualit.

While however from this origin would still consid it as sympt of Hyster.

And indeed not very rare occur.

Not many months ago had occas to observe in pract a remark inst of this kind

Patient a young lady long subj to hyster which had app in many diff form.

At length appear of dysphag. so that for space of sever weeks [illegible] incap of swallowing any thing either solid or fluid.

During all that time supp. by inject of anim broths.

But although nothing taken into stom often affected with severe vomt.

And matter disch entirely of dark brown colour & bitter taste.

With these appear. was also affected with almost incess. hyst. fits.

In so much that seldom observd to sleep, for space even of few min togeth, either night or day.

From this distress situat howevr after trial of many diff pract had grad recov.

And as hyster sympt left her vomiting also disapp.

Could be no doubt then that here as in many other cases to be consid as one of number num sympt of hysteria

And in inst before us would also look upon it entirely in that light.

Besides these however still third compl with regard to which perhaps greater diffic.

That is irregul & scantiness of menstr. disch.

When patient first came under care seemd to be her [illegible] susp. that from this all other compl. origin.

And cannot be denied that amenorrh. a cause adequate to [effect]

Indeed none of sympt here takin place, which may not, as well as various others, origin from this source

Hence suppos not unnatur

But on other hand to be observd that if obstr of menst. or scanty disch often cause so also very freq conseq. of other compl.

And from few, oftener induced, than from hyster affect.

Farther to be observed that irregul of menses had superv. only after other sympt.

That some appear of them, even but few weeks before patient came under our care.

And lastly that patient now arrivd at that period of life, when with many women cease viz 45 year.

A period at which if still contin, irregul induced from slightes causes

From all these circum then view irregul menstruat as here connected with other affect.

And look upon case as affording example of hysteria.

Rathr however under form of what may be calld Hysteric sympt. than of prop. hyster fits.

With this idea of affect. cannot I think entert prosp of very speedy termin

For perhaps few diseases which more diffic entirely to overcome.

Seldom to be brought about unless from very consid change of habit.

And rathr to be effected by some perman alterat in mode of life than by med.

That such however will take place in pres case no reason to believe.

And utmost that am here disp to expect is allev of sympt.

Of which however must still look for aggravat on fresh accid.

If therefore can obt for this patien even tolerab. remiss shall be very glad to dismiss her.

Meanwhile howevr will afford opport of trying how far by means of diff remed disease can be allev or removed.

In hysteria in general great object to be aimd at removal of fits or symp which have already taken place

[And] Prevention of return.

For effect former measure must be accomod to such partic appear as occurr

But princip to be brought about by those prod sudden & powerful influ on nervous system.

And in this way often effect of most active artic both of tribe of stimul. & sedatives.

Prevent of return cheifly to be [expected] on these princip.

1 The prev action of excit causes

2 The counteract influ when have acted

3 Or the remov pecul irritab. without which could not prod effect.

On these gener. princip will better underst. meaning in pract here employd

Began treatm by direct for this patient mixt of equal parts of Tinct. Fulig & peppermint water.

Though first of these artic has name from soot which enters compos. yet consider activ as prin depend on [anoth] ingred.

The assafoetida viz which enter comp

And here as that artic acted upon by weak spirit consid it as in many cases prefer. to Tinct. Foetid where menst volatile alk. spt.

A menst indeed which in some inst coop with effect of med.

But which in all must very much limit dose.

Hence then addit advant from exhib as acted upon by a diff menst.

And in fluid state obt action more [exp] than when given in subst.

This then circum by which induced to employ it in this form.

But in any form look upon it as in such compl. a very active med.

Can be no doubt that impress on nerves of alim canal has very powerf. influ on whole syst.

In this respect general effects seem to be rather those of stim than sedativ

Here however may observe that among tribe of stimul. very great diver.

Nay perhaps hardly any two stimul. impress, by which of precis same nature.

General affects of stimul. that encrease animal energy.

And This cheifly indic by induc action, excit pain & [arousing] from [torpid] state.

And in most insts by encreas. [illegible] of bloods motion.

These affects in some degree from Assafoetida.

But at same time operates much more powerfully as antispas than some other artic which in these ways greater influence.

And from circum, of both [alayin] & prevent spasm affect, often mod of best effects in this compl.

Under formul. of Tinct Fulig is used with wood soot.

An artic supposed also to have somewhat of same effect.

And which unquest. some influ as contain empyr. oil of veget from whence obtaind.

But in qualit very much varied accord to veget empl.

And upon whole consid effects as princip from Assafoetida.

So that inclind to think [better] anoth formuli Tinct. Foetida. [Simnlex]

In this state howevr of Tinct Fulig here united with equal quantity of peppermint water.

Princip with view to dilut.

But at same time also [conspir] in effect of easing patient from operat as carmin.

To these added [small] propor of Sugar

In which had in view the promot union & in some meas cov. taste.

From this med no remark [illegible]

Nor any indeed any obvious operat unless as tending to expuls of flatus.

But with relief in this respect some mitigat also of most other sympt.

Still however affected with bound state of belly

A circum which reckond it necess to obviate as prod of many inconven

But partic as acting as cause by which inordin action often excited.

Was with this view then that had recourse to Pil. Aloet.

But besides this had also in view the state of menst. disch.

For now natural period [approachd]

And by giving stimul. to rectum imagind that might without hazard be induced or rend. more free.

In this latter way however had no influ

And indeed in former not very powerf

In so much that obliged to augm dose.

Under this course contin for some weeks.

But without seeming to derive from it such benef as to encour to contin

Have now therfore altered course

And have put patient on use of Valerian

An artic of antispas power of which must own entert fav. opin

And from proper contin hope for mitigat of affect.

To aloet pills have [substued] Pil. ex Colocynth cum aloe.

Which from [illegible] as well as colocynth posses stronger purgat powers than Aloes alone.

To this course shall now be desire of giving fair trial.

And if any fav app. shall encr quantity of Valer employd

If ineffect future meas to be [accord] to situat at time.