DEP/DUA/1/27/14 (Transcript version)

Isabel Mill

(1781-1782)

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Isabel Mill.

This patient since case introd into Regist has never attended.

Hence unnecess to make many observat respect her.

Espec. as in case nothing very singul or uncommon.

Selected her as exhib example of disease very freq to be met with often very obstin.

And which at same time puts on perhaps, as great variety of app. as have occas to treat in pract.

Here no hesit in consid affect to which patient subj as an examp of Hyster.

Does not indeed appear with all the charact [ment] in defin of nosol.

And partic never attend with convuls fainting & other sympt giving it resemb to Epilep.

But these although common sympt in regul hyster far from being [essent]

And among diversit of appear which disease puts on, in some patient these sympt. sometimes pres. sometimes abs.

In case before us disease suff markd by pain accomp. with sense of ball, rising rising from belly to throat & ther prod sense of suffoc.

Termin however on disch of wind by eructat.

That this the glob. hysteria can admit of no doubt.

And although would not go so far as those who hold it to be infallib [pathogno] of disease, a sympt always occur in hyster, never in any other affec yet in such circum as pres suffic to charact the case.

For here no appear which can lead to suspic of any other affect.

And while wants all circum in which Hyster sometimes resemb. Epilep has none of those dyspept sympt which very freq occurr in hystr.

But which at same time in comm to it both with that genus & hypochond

Consid it therefore as very pure inst of Hysteria.

Even in this state howevr disease consid as of sever. species.

For my own part long inclind to imag that most import. distinct both with respect to prognos & diagnosis pract at least into hyster fits, & hyster sympt.

Not indeed that both may not freq. occurr in same patient.

But although often conj. yet cases which entirely under one or other form.

And in pres case, hitherto at least form very steady.

Has never been in state of perman compl. putting on app of other diseases

But entirely under that of transit fits return freq & at irreg periods.

And although these not with all the sympt with which hystr parox sometimes attended, yet no doubt in consid pres form of disease, as fully entit to name of hyster fits.

But while this distinct of conseq. must also admit that not without use to determ, where, it can be done cause from which hyster more immed proceeds.

And accordingly will find that all the species, or rather varit. markd by markd by nosol. writers, founded entirely on diversit of causes.

In case before us, disease of long standing, & nothing cert. known with respect to cause.

Patient however obs. that from time that menses became irregul which happend sever months before came under our care, affect much aggrav.

At one time, was prevail opin that this disease entirely from affect of uterus.

And hence name of disease.

But although this opin by no means well founded yet cert that with state of uterus, affect often connectd

And accord among species or [variety] mentiond by Dr Cullen one half of them from affect of uterus.

While in some inst arises from eman mensium, in others from menorrh, & in third from Leucorrhoea.

Here therefore no doubt, that patien right in conj, when disp to attrib aggrav of affect, to irregul in menst disch.

And from this case appears, that while disease very apt to arise from commen. of menst disch, so likewise much affected at time of depart.

For with pres. patient may now be expected, that should soon cease.

Is however univ allowed, that this period very critic with females.

Hence then cannot seem surp. that should have been attend with aggrav of affect, to which before subj.

From all circum taken togethr may suppose that not entirely without [apprn] respect this patient.

Hyster indeed under whatever form it appears, an affect always more alarm, than danger.

And perhaps even but few inst, where of itself proves fatal.

In case before us, sympt. by no means to be consid as very distress to pat

While at same time, not complic with any other affect.

Yet from contin at so advanced period of life, as age of fifty, less reason to hope that would admit of speedy cure.

And although still without complic, yet hard to say, what may be conseq of aggrav, at a period of life when syst. very liab to be affected by even slight causes.

Although therefore had regul cont attend, & strictly followed direct. should not have been surp to find, that enden endeav. without effect.

At same time no circum in case to discour from trial of prop meas.

And although disease of long contin yet, as far as could learn at least, trial had never been made of sever of these med, which in some cases at least are unquest. success.

In this case wishd first to make trial of Calx or Flowers of Zinc.

A remedy but lately introd into [pract] yet one with respect to which very diff opin entert.

First empl. in Holland as specif for cure of epilep, by an empir of name of [Luddemanus].

In his hands prod of such good effects that attract attent of Gaub.

And by him an acct of it pub in adversar. under title of Luna fixata [Luddem]

In this extolls it as being a med of great effic.

On such authort not surpriz. that soon empl. by medic pract in almost every diff quarter of Europe

And from trials made very oppos. judgem [formd] of medic virtues.

Some repres it as a med of no effic whatever.

And unquest. that in some inst. given to very great extent without prod any good effect, or even sensib operat.

Yet want of sensib operat, equally an obj. to med of undoubted effic partic Peruv. Bark.

And no just ground for condemning calx of Zinc, that has not succeeded in every case.

In hands of diff pract, use in many compl. attended with best effect

And from many trials which have myself had opport. of [makin] must own, that have formd very fav opin

And thus led to entert expect. that might have been attended with good effect in pres. inst.

But from want of attend on part of patient no opport afforded for trial.